Volume 1 Issue 1
Some would argue that the humanities may be as integral to medical training as physiology and anatomy. Such areas as history, ethics, sociology, literature, philosophy, psychology, and the visual arts have not traditionally been a part of most medical school curricula. However, it has become increasingly apparent that the integration of such material leads to the training of physicians who are more observant, analytic, reflective, and empathetic. The Mount Sinai School of Medicine at New York University recently published data in Academic Medicine (August, 2010) revealing equivalent academic performance in medical school amongst a cadre of students who were accepted to their medical school with a humanities or social science degree and without the traditional premedical course requirements. This challenges years of dogma the Education “ideal candidate” for acceptance into medical school, but Liaison Committee onregarding Medical visits the regional campus is perhaps something we have always known at heart. A good physician may be well grounded in the core fund of knowledge necessary to diagnose and treat, but great physicians are the ones who understand that such diagnosis and treatment is the result of painstaking work by physicians who have come before them, that diagnosis sometimes is impossible without creativity and imagination, that stories are elicited out of patients by establishing humane connections, that treatment is useless unless one understands the psychosocial context of the patient being treated, and that placing a hand on a human being, prescribing a drug, or cutting skin is not done without consideration of the ethics of such an action. This inaugural edition compiles the work of faculty and students who put aside their work of the day for a moment in order to reflect on just this. The pieces vary from advice to other students, humor, personal reactions in providing care, and reflections on individual growth and ethical responsibilities as one reaches milestones in medical training. At this time of Thanksgiving, I am grateful for the efforts of all the contributors as well as Brian Garnet and Paul Rothenberg who took on the gauntlet of organizing and presenting the pieces that follow. Rave reviews can be emailed to me, and any harsh critical comments sent directly to them. I am hopeful that all will enjoy and consider submitting a piece for future editions.
Our Patients... Daniel Lichtstein, M.D.
OBLITERANTS
UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE
Fall 2010
Introduction... Gauri Agarwal, M.D.
They come, and they keep on coming.
Was she depressed? Afraid? Did anyone ask?
They leave, at least most of them leave.
Fluids and pain meds, another short stay.
We see them for just a moment in time.
No time to explain, no time to connect.
They don’t usually remember our names, or we theirs.
We should have done more. Another diabetic not taking her meds.
Medicines too expensive to buy. Appointments made and rarely kept.
“Non-compliant,” we said, but we didn’t ask why.
A short time home, and then back again.
Insulin, supplies, and seven more drugs.
Sicker than before. What have we learned?
With five kids to feed, what would she do? We could have tried to do more.
The man with pneumonia had no shoes. Did anyone notice or ask why?
Each of our patients has a story to tell.
Oxygen and antibiotics, “home” in two days.
For each there is much more than the illness itself.
But “home” was a blanket in an alley. We could have done more.
A few more questions, just a little more time. We could have done more.
The young Haitian woman with sickle crisis rarely spoke.
We should have done more.
Obliterants is a journal distributed to the faculty, affiliated faculty, medical students, and staff of the University of Miami Miller School of Medicine Regional Campus.