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Sunday, May 07, 2006

Devotion,curiosity, hard work and the Midnight Meal

JAMA has reviewed a book that would probably interest senior docs who trained in the 60' and 70's particularly at a big city hospital. According to the review there is plenty of interest for younger one as well. The book is The Midnight Meal and other Essays about Doctors, Patients and Medicine by Jerome Lowenstein,an internist who trained at Bellevue and stayed on to teach there.I like to think that thoughtful physicians who have been doing it for 30 years or more have something to offer. His comments do.

I took my pulmonary boards at Bellevue (back when it was an oral exam) and much he has to say resonates with my memories of another big city hospital, Charity in New Orleans.

In his section on
"Can you teach compassion? ", he writes

"...teachers in medicine can only hope to facilitate the development of students or young physicians,challenging and stimulating them and acting as role models."

I know much of my development was influenced by role models.I can still remember much about those physicians in surprising detail many years later. The passage of time has made it very clear to me how important those role models were

The reviewer says " Devotion, curiosity and hard work were the messages of these teachers"

The messages I got from my role models also included respect for the patient,duty to do what was right for the patient,the obligation to know as much as you could because that may actually save a life or mitigate an illness's effect.There was no message sent about going home at five o'clock and leaving the problems to some one else.

The "midnight meal" part of the book's title refers to a meal, leftovers mainly, served late at night to the docs on call.Charity Hosptial did that as well-we called it "Late Doctors" It was a good time to catch consultants (our paging system left a little to be desired). The late meal was often the highlight of a night on call. It seemed that way at the time but the real highlight was the incredible and intense opportunity to learn how to be a physician by taking care of real patients often late into the night under the tutorage of more senior (sometimes only by a year or so) physicians.

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