Personal Account of Medical Worker or Student or Patient – Page 3

The Intern Blues

The Book of the Week is “The Intern Blues, The Timeless Classic About the Making of a Doctor” by Robert Marion, published in 2012. This ebook documents the internship experiences of three medical school graduates in the mid 1980’s.

At that time, interns were “on call”– had to work eighteen to twenty-four hours in a row, usually overnight, in a hospital every three days. Every month for an entire year, the interns in this ebook were assigned to a different unit such as pediatrics, neonatal intensive care, or the emergency room, at a medical center in the Bronx in New York City.

The hospital staff was kept busy treating patients with conditions whose causes were poverty-related— people in poor health, and those who suffered physical harm from violence and drugs. Many patients and their families had psychological problems. One intern remarked, “…we have two psychotic crackheads roaming around the ER, we also had two psychotic crackheads who were paranoid and had no idea what was going on, which is a wonderful combination.”

Severely sleep-deprived, along with doing a ton of paperwork and presentations, the interns had to admit patients, keep “…track of names, symptoms, physical findings, lab results, and treatments…” They witnessed life-or-death situations for which they felt they were not psychologically prepared. They had to tell patients’ families that their loved ones had died, make serious decisions on whether to report child abuse to the authorities (which was a whole bureaucratic process itself), deal with difficult nurses and lab technicians, not to mention their supervisors; all this, along with the extremely stressful circumstances surrounding the AIDS epidemic.

On top of that, one of the three interns became pregnant during her internship. Read the book to learn how that worked out for her, and to get an insider’s view of what it was like to be a medical intern a few decades ago.

Healing Hearts

The Book of the Week is “Healing Hearts” by Kathy E. Magliato, M.D., published in 2010. This is a personal account detailing one woman’s experiences trying to balance her medical training and career, with her family life.

She details various issues, including but not limited to: the long, rigorous road to becoming a full-fledged doctor in her specialty; the discrimination she faces in a male-dominated field; the job emergencies that cut into quality time with her family; and the healthcare crisis in the United States.

Magliato and her husband have a combined 43 years of education and training in medicine. She, in cardiac surgery; he, in liver transplants. She describes the hardships she faces when passionately attempting to save lives. She must ignore her own physical needs while standing for, say, fifteen hours in a row to help provide patients with a replacement heart, or veins or valves. She needs to hold particular medical instruments in place for many minutes without flinching, lest she harm the patient.

Magliato predicts a collapse of the American health care system. The reason is simply that health insurance companies do not pay what hospitals bill them; rather, they pay what they feel like paying. An insurance company might be billed $385,000 for heart surgery hospitalization, but it might pay the hospital only $54,000.

“…a hospital is ecstatic whenever it collects more than 10% of the bill. How can hospitals not only survive but be able to deliver state of the art care when their price is not met? They can only increase their quantity until the hospital is full. They can only cut their costs until the delivery of quality health care is jeopardized.”

Against Medical Advice

The Book of the Week is “Against Medical Advice” by James Patterson and Hal Friedman, published in 2008. This book discusses the struggle of a teenage boy (Friedman’s son) with various psychological disorders; obsessive-compulsive disorder and Tourette’s syndrome among them.

Cory tried to live a normal life, but by his teen years, he had fallen woefully behind socially and educationally. He had friends, but they were misfits like himself. At one point, he tried checking into an institution but found his life was not improving. However, the law required him to stay there a certain number of days, unless his parents signed a document stating he was refusing to accept the judgement of professionals about his treatment.

A last-ditch effort saw Cory enter an extremely radical program– a survival camp, of sorts– in which kids were forced to cooperate with each other in a harsh environment, or literally face death.

Read the book to learn how Cory fared.

Weekends At Bellvue

The Book of the Week is “Weekends at Bellvue” by Julie Holland, published in 2009. This is a personal account of a psychiatrist who, for nine years, managed weekend admissions to Bellvue, the New York City mental hospital.

Prior to Bellvue, Dr. Holland did her residency at Mount Sinai Hospital in 1992. On her first day, she was put in charge of a patient who believed he was God. Later, she joked to her mother, “…I am starting my medical career at the very top… I am God’s doctor!”

She describes the office politics at Bellvue, why she admitted or released all kinds of patients, including criminals, crime victims, the homeless, addicts, malingerers and people truly in need of help. Colorful vignettes are alternated with details of her personal life. She discusses the growth of her personal relationships– with a close colleague, and with her own psychiatrist, with her eventual life partner, and children. She also relates her fears of being the victim of retaliation by a former employee, and dangerous patients.

There were some extreme stories. At the occurrence of the World Trade Center disaster, a manic Iowa man rode a bus all the way to Ground Zero to help with the recovery effort. There, he was somehow able to get inside and operate a backhoe. He told Dr. Holland, “They need my help.”

Dr. Holland realized she was frustrated that she was able to help patients only temporarily. Bellvue is a revolving door of sorts. Some patients return again and again, because they lack a support system to lift them permanently out of their bad situations, such as addiction, homelessness, or their going off their medication. If Dr. Holland judged that their situations warranted admission to Bellvue, they might get detoxed or restarted on their medication, and/or a comfortable place to sleep in the short term, but once released, would return to the same situation again.

In the end, Dr. Holland left Bellvue because she felt she could be of more assistance to patients in private practice in that she could establish a one-on-one long-term treatment program with them.

The Seeing Glass

The Book of the Week is “The Seeing Glass” by Jacquelin Gorman, published in 1998. This is the personal account of a woman who was diagnosed with multiple sclerosis. The major symptom she experienced was blindness. This generated an amusing anecdote.

When Gorman was admitted to a hospital in New York City for which she served as an attorney, she found the legalese in the documents she was required to sign, familiar (her husband read them aloud to her). She was the one who had written that legalese, irony of ironies.

Gorman also discusses her family members; most memorable among them, her uncle Ogden Nash, and autistic brother.

Time on Fire

The Book of the Week is “Time On Fire” by Evan Handler, published in 1997. The author, a Broadway actor, tells his readers how he survived a five-year bout with myelogenous leukemia in the early 1990’s. His condition necessitated various extreme treatments from which, at that time, fewer than half of patients emerged alive. He details them, good and bad, he received from various medical facilities, whose names he mentions. One action he took, among others, was to get a private hospital room so as to minimize his stress level. One should spare no expense when one is fighting for one’s life. This intense survival story was inspiring, rather than depressing.

Over My Head

The Book of the Week is “Over My Head” by Claudia L. Osborn, published in 2000. This depressing memoir describes what happened to the author, a medical doctor, after she sustained a severe head injury. She was, without wearing a helmet, bicycling in the Rocky Mountains with a friend when she was hit by a truck. She did not remember the accident. The damage done to her brain prevented her from resuming her career. Osborn was referred to New York University’s head trauma program to try to recover her ability to live a normal life. The program features group therapy. Read the book to learn the kinds of techniques used to help brain-damaged individuals regain cognitive skills, and how the author fared thereafter.