The 10th Justice

First, a couple months ago I wrote an essay titled "Illness as Memory". Originally, I thought the idea was so compelling that it should be a book, but the energy to do the research for a project that big has not welled up in me, yet. But the idea is alive. Today, on the website QuantaMagazine this article appeared: https://www.quantamagazine.org/stem-cells-remember-tissues-past-injuries-20181112/. Stem cells may have memories of previous injuries and how to fix them. These memories may give rise to a variety of autoimmune diseases.  If my essay interested you, I suggest you take a look at this link. Another theme in several of my posts has been the harm done to the profession of medicine by business people. In a recent New Yorker article, Atul Gawande, writes about the electronic medical record program EPIC. Here is the link: https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers. And here is my take on this issue. But first I want to back up a...

If experience qualifies as expertise, then, on the subject of the physician-patient relationship, I am an expert. During my career as an emergency physician, I saw well over 100,000 new patients. As a patient I survived two cancers, multiple blood clots in my lungs, and a bunch of other non-lethal problems. In addition, I have read a number of books about the physician patient relationship. So, now that you know my credentials, here is what I have learned... All patients want to be treated with respect. They want the doctor to listen carefully, ask questions and respond in a non-demeaning manner. This needs to be done in person, with eye to eye contact. The information acquired needs to be in the doctor's head and not just in his computer. Information in the computer is for billing, to refer back to, or to send to another physician. A good doctor builds a model of the patient in his head consisting of age, sex, prior medical history, family history, psychosocial status, current s...