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On Being a Doctor |

Just Playing Doctor

David Alex Stroh, BS
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From Johns Hopkins School of Medicine, Baltimore, MD 21205.

Requests for Single Reprints: David Alex Stroh, BS, Johns Hopkins School of Medicine, 1620 McElderry Street, Baltimore, MD 21205; e-mail, DAStroh@gmail.com.

Ann Intern Med. 2009;150(6):421-422. doi:10.7326/0003-4819-150-6-200903170-00014
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The first thing I learned from the county hospital: Put on any color coat, and folks will call you “doc.” Every time they said it, I breathed a quick reminder that I wasn't a doctor, as of yet. Still it felt like a game—putting on my cloak of illusion and temporarily stepping into a different world. But, like many others, I was experiencing things that would be important in either helping me to actually get there or sending me running in the other direction. Both receiving and giving training, after all, is a big part of being a doctor. If you ever thought that career shadowing was a worthless exercise in babysitting, I assure you that nothing could be further from the truth. I am a blank canvas, a dry sponge, the timeless tabula rasa. Paint me a picture, let me soak up your wisdom, and I'l understand. My perspective is a unique one: I'm not a doctor, but I'e worked under quite a few of them, and they speak openly with me. How many nonphysicians get unguarded insight into medicine? Yet, with each iteration, I got the same question: Why do you want to go into medicine? It used to hit like a cruel joke half of the time when I sensed that what they meant was: “Why would you?” The question doesn't bother me now—after dozens of such encounters I'e settled on an acceptable answer. But into the stunned silence of earlier trials, my hosts would often impart their responses. Concerned physicians stepped in to ask the incoming generations what we were thinking. Is there a reason to it all, or are we just playing doctor?





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Knights of the White Coats
Posted on March 18, 2009
Edward J. Volpintesta
No Affiliation
Conflict of Interest: None Declared

The author's enthusiasm and sense of purpose are refreshing. I have always thought that if real change is going to come it must come from the younger generation. It is they who have listened to previous generations' complaints and it is they who see and are repulsed by the soul-sickness that has descended on physicians almost everywhere. What's more, the resilience and fortitude and stamina that are necessary to do the job can only sprout from their youth and idealism.

Many of us who have been in practice for 25-30 years have not had the uniformity of political commitment necessary to make real change happen. I think David Stroh's generation will. Physicians of my generation started out in a mostly benign medical environment. Soon cost containment and regulation of fees were thrust upon us. Being ambushed so to speak, we were not ready or disciplined enough to make a strong stand against the powerful forces united against us. Worse my generation was victimized by an unprecedented slew of malpractice suits mostly frivolous that jaded many of them. The doctor-patient relationship was no longer seen as neutral ground but rather as one fraught with land mines disguised as frivolous malpractice suits.

New advances in technology made it more desirable to order imaging studies and lab tests rather than spend time at the bedside. Patients became intellectual challenges not sick people. Pushed by technology we somehow rationalized that it was okay to delegate the human factor of health care to nurses and physician assistants. Patients came to see many of us as detached and cold.

David Stroh's generation has the advantage of sitting back and assimilating all that has happened. Listening to older doctors' stories and frustrations should give him and his contemporaries the panoramic view that my generation was too close to to see clearly. The challenges facing these "knights of the white coats" will be great but the rewards of overcoming them will be worth the effort and sacrifice and perseverance.

Conflict of Interest:

None declared

The True Knights with the White Coats!
Posted on March 20, 2009
Osama S.M. Amin
Dept. of Neurology, Baghdad Teaching Hospital, Baghdad, Iraq
Conflict of Interest: None Declared

Yes, the title perfectly fits our doctors in Iraq! In amidst of chaos, bombings, sectarian violence, lack of electricity, government corruption, shortage of medicines, shortage of experienced physicians and surgeons (who still suffer abduction and murder, especially those who have Western qualifications), our patients wander everywhere, trying desperately to find someone who may diagnose their "serious disease" or to do a "simple" operation for them!

On the other hand, the new generation of doctors, restricted by the above, have been disconnected from their mentors and are left alone in the battle; many of whom become cold-blooded and have no feelings to sympathize with others; a painful fact that definitely and adversely affects patient's care.

This generation, instead of conducting studies or enrolling in postgraduate trainings (like their counterpart in other countries) finds itself helpless and hopeless. What to do? They either go to nearby countries to work (for a shy monthly salary) or to seek asylum (and preferring humiliation on medical degrees). Others are staying home, dazed and confused by the current situation.

In spite of these dreadful facts, I hope, in the foreseeable future, that Iraq will again take its role and regain its leadership.

Conflict of Interest:

None declared

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