Доктор Бернард Лаун не доволен.

Would you like coffee or tea?

Модераторы: Ren_Yumi, AOkhotin, Алексей Живов, Alon, dr.Ira

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Igor
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Доктор Бернард Лаун не доволен.

Сообщение Igor »

Доктор Бернард Лаун
обвиняет современную медицину.

Детская вера в волшебство техники — серьезная причина, почему американская публика притерпелась к негуманному врачеванию. (с)

http://scepsis.ru/library/id_1578.html
С уважением, д-р Шевченко.
Artem_Co
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Сообщение Artem_Co »

Почему вы такой мрачный и подавленный?

— Любой был бы, если бы ему сказали то, что мне. Интерны говорят, у меня сердечный приступ; младший ассистент - острый инфаркт, старший — коронарный тромбоз, а лечащий врач — что я перенес обострение ишемической болезни. Как же, боже милостивый, выкарабкаться, если столько напастей на одно сердце? А когда я спросил у сестры, что со мной, она ответила: лучше не спрашивайте!
Ren_Yumi
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Сообщение Ren_Yumi »

Bernard Lown хорошо пишет, мне кажется. Я вот эту книжку люблю:

http://www.amazon.com/gp/reader/0345425 ... eader-link
Ren_Yumi
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Сообщение Ren_Yumi »

А по поводу интернов:

Don't ask for whom the beeper beeps; it beeps for thee
by Perri Klass, M.D.

The only metaphor I can come up with, I'm afraid, probably says more about me than it does about my subject. And I shudder to think what Freud would have made of it. What I keep thinking is that maybe men have an easier time adjusting to wearing beepers. I mean, what's a beeper but an appendage, worn below the belt, which periodically calls attention to itself in the most peremptory way imaginable. You can be surrounded by friends or enjoying a quiet moment alone, and there goes your beeper, embarrassing you, startling you, and demanding to be satisfied. I mean, in the last analysis, the real problem with the beeper is that it's meant to be your servant, and instead you find yourself its slave. So maybe men do find this more natural. But enough of this.

A beeper, to extricate it from these heavy-duty associations and symbolic constructs, is a small rectangular object attached to a good strong clip. You clip it on to your pocket or your waistband or whatever, and it keeps you in touch with the hospital page system. There are many varieties of beeper. There's the kind that just beeps, letting you know that you have to call some central number to find out who's trying to reach you, and there's the kind that beeps and then displays the number of the person who's paging you. There are also beepers with speakers that actually allow a brief message to be transmitted by telephone, thus giving your fun-loving friends the opportunity to beep you while you're in a patient's room and announce, in crackling but clearly audible voices, "Please come to the beer party in the residents' lounge."

When you're a medical student, the beeper is by and large the prerogative (and the badge of office) of the resident, the real doctor. There were a couple of clinical rotations in medical school during which students were given beepers, and I remember regarding mine with a mixture of pride and awe - would it go off and would I know how to cope with whatever question it asked? Of course, usually when it went off it was the resident wanting to know if I'd found those lost x-rays yet, or my mother calling to find out what I'd learned recently in medical school. And when all was said and done, those medical school beepers were transient attachments (after all, they're hardly going to beep the medical student if something awful happens).

The very first day of my internship, I got a beeper of my own. It was handed to me by a resident who was finishing his internship year. It had a dinosaur sticker peeling off the front and a dime taped to the back, to be used if one were outside the hospital and had to use a pay phone to answer a page. This beeper and I immediately embarked on a close and complex relationship, from which it's to be hoped that both of us will emerge not too much the worse for wear.


It Beeps For Thee: Ten Typical Beeps in an Intern's Day
1. A nurse taking care of one of your patients calls to ask whether you really want all those lab tests you ordered yesterday evening, and do you realize you ordered those same tests two days ago and they were all done then? Thank her very much; it had slipped your mind. Cancel the tests.

2. A doctor calls to ask about a patient of hers who's in the hospital under your care. She doesn't want the patient discharged yet, whereas you were hoping to send her home today.

3. The medical records department calls to say they can't locate a certain patient's chart and wonders if it might be signed out to you. Explain that you've never heard of the patient, and don't have any charts signed out to you and wouldn't know where they were if you did.

4. The emergency room calls you to come admit a patient who has a disease you've never heard of along with two other diseases you have heard of. They further inform you that the patient has been in the emergency room for more than five hours, what with one thing and another, and they would appreciate it if you could get right down there and take him away.

5. Your mother calls to ask whether you're having a nice time, and did you ever ask anyone about your great-aunt's new high blood pressure medicine and what side effects it might be having?

6. The urology resident calls to say he heard you were looking for him. Explain to him that actually you were looking for the neurology resident, but thank him for giving you a ring.

7. A patient you sent home two weeks ago calls to tell you he's having pain in his lower back, and since you were such a good doctor he'd like to come see you again.

8. A nurse who's taking care of another one of your patients calls to tell you that his blood pressure is rising steadily, and maybe you should do something about it when you get a chance.

9. A social worker calls to tell you about an emergency meeting scheduled on one of your patients, who's ready to go home but has no home to go to.

10. A brand new nurse calls to read you a lengthy list of perfectly normal lab results that have just come back on a patient.

It's a love hate relationship, mostly hate. The beeper awakens you from sleep, pursues you into the bathroom. It interrupts conversations, and unfailingly prevents you from eating an uninterrupted meal. It's the background music of the hospital. No one looks up in a conference when a beeper goes off, unless it continues to beep persistently, letting everyone know that the person it's attached to is more soundly asleep than usual.

The beeper is the symbol of the intern's availability. Sure, other doctors carry beepers, but they're mostly beeped by their offices or their answering services or for real emergencies. Not us. We get beeped by everyone and anyone. We get beeped for dumb questions, and life-and-death alerts. We get beeped all the time, because we are, at the most basic level, running the hospital. We get beeped because when anything goes wrong it's the intern's fault until proved otherwise. Probably there isn't any other way to run a hospital.

And of course there's nothing to help you appreciate useless, irritating, nonsense pages like one good emergency page. The beeper goes off and you answer the call and the voice at the other end says the patient seems to be having an allergic reaction. Or the patient is getting bluer by the minute. And as you rush off to what you know is supposed to be the rescue, you wish most of all that the page had turned out to be from the linen department, asking you whether you had lost all the white coats assigned to you at the beginning of the year (of course you haven't lost them; you just haven't had them washed).


I'm OK, You're a Beeper: Ten Things You Can Do With Your Beeper
1. Put cute stickers on it, especially if you're a pediatrician. Hearts are always popular, though cuddly little teddy bears or bunnies go over well too. These stickers won't affect the malicious nature of your beeper, but they'll dress it up a little.

2. Attach a dime (or a quarter if that's what it takes where you live) to it. Consider it mad money - if you ever get really mad and just walk out, and you're halfway across the city when your beeper goes off, you can at least call in from a pay phone.

3. Fasten your ID card, a credit card, and a couple of dollar bills around it with rubber bands so you don't have to carry a wallet. This will give you the refreshing feeling that your beeper is on your side rather than secretly pledged to your worst enemies. It will also make it much more poignant when you eventually lose the beeper.

4. Drop it in your backpack without turning it off before you go to a movie: it will start beeping during the most tender love scene and will continue to beep loudly and persistently while you search through the pack for it.

5. Forget to turn it on in the morning, or forget to notice that it's warning you about low batteries. Eventually they'll start paging you over the hospital's overhead public address system, and you can briefly experience the delights of fame.

6. Sing to it. In a show put on by my medical school class, Night and Day was thought to be an appropriate song for a doctor-beeper duet. "Night and day, I am the one."

7. Take it for a swim. Everyone fantasizes about throwing beepers in the toilet, but few have the courage to do it. So just get in the shower with your clothes on one morning (easy enough to do when you've been up all night) and teach that beeper who's boss.

8. Buy it flowers; it's only doing its best, poor thing. Make little dresses for it out of construction paper and felt scraps. Kiss it passionately. Don't worry abut your unusual behavior getting you into trouble; you're an intern and you're expected to be just a little bit crazy.

9. Beep yourself out of boring meetings, or have a friend do it for you. This can save untold hours, and nobody ever minds an intern leaving the room to answer a page.

10. Impress non-doctors. Intimidate waiters in fancy restaurants who want you to order wine you can't afford. A simple gesture to the beeper explains it all: I'm on call so I can't drink.

Hospitals aren't places of exceptional etiquette. No one ever asks when you answer a page, Did I get you at a bad moment? Is this a convenient time to talk? Somehow the illusion is preserved that we're all sitting comfortably at big desks, telephones and note pads at the ready. In fact, we're usually standing in hospital corridors, having interrupted an examination of a patient or a conversation with two other people - or we're shouting into the one phone in the cafeteria, our food growing cold on a distant table, a line of other paged doctors already forming.

The page operators get to know you pretty well; they know who calls you, recognize the voice of your significant other, tease you about what you say when you answer (do you go for the more formal identification, "This is Dr. Schmoe returning a page," or do you just say, "Hi, it's Joe"?).

I suppose in the end it's a symbiosis; you complain bitterly about your beeper but you also know it for the vital umbilical cord that it is. It keeps you connected. It keeps you in communication (no, on second though not an umbilical cord - maybe a telegraph wire). It means you're a real doctor. And it wakes you up at night, just in case you thought that being a real doctor was going to be easy. And maybe in a fit of anger or frustration you'll throw it dramatically into the sea (or more prosaically into the toilet) or slam it against the wall or bury it in your now cold macaroni and cheese. But the mood will pass and you'll find it's miraculously undamaged (even by the hospital cafeteria macaroni and cheese, which can take the paint right off a car) and you'll clip it back on and feel for it every now and then with a nervous little pat. Are you there? you'll ask it, until it puts your mind at ease by calling to you with that familiar shrill voice. Again and again and again.
Igor
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Сообщение Igor »

Ren_Yumi писал(а):А по поводу интернов:
you're an intern and you're expected to be just a little bit crazy.
Нормально. :lol:
С уважением, д-р Шевченко.
Ren_Yumi
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Сообщение Ren_Yumi »

AOkhotin
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с уважением, Артемий Охотин

Телеграм-канал Вальсальва: https://telegram.me/valsalvaru

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Artem_Co
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Хаусизмы

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Ren_Yumi
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Сообщение Ren_Yumi »

End-of-Life Care: Improving Communication Skills to Enhance Palliative Care
http://www.medscape.com/viewarticle/574420
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