Advice to the Young Physician

Book excerpt: Advice to the Young Physician introduces the origins of important teachings that form the basis of medicine as it has been taught by some of history's greatest educators in medicine. Advice to the Young Physician reveals how to make the transition from technician to healer. This book reinforces the humanistic side of patient care, which is often overshadowed by the focus on highly technological elements. Medical students, residents, fellows, physicians, and allied health practitioners often forget the intricacies of the genomic makeup of adenoviruses, yet they remember the tips, anecdotes and aphorisms related by mentors, educators, and experienced physicians. The art of medicine comes from insights gained from unique and dynamic experiences between the physician, an enthusiastic medical student and the human patient, and is rarely found in books or taught in a universal and systematic way. Advice to the Young Physician provides numerous examples of best practices in order to internalize and practice the art of medicine, including tenets taught by Hippocrates, Maimonides, Osler, Peabody, Schweitzer and others. Advice to the Young Physician targets aspiring and new physicians with the intent to make them better physicians. It hits the mark. An effective mix of the writings of some of medicine's giants, as well as clinical experiences of the author, the book offers an historical framework and personal context to understand the attributes and attitudes of the good physician. It is a quick read that rewards the reader with a sampling of 4000 years of medical wisdom sprinkled with practical advice for the modern day doctor. --Richard G. Roberts, MD, JD, Professor of Family Medicine, University of Wisconsin School of Medicine and Public Health, President World Organization of Family Doctors, Past President American Academy of Family Physicians This is a small book and easy to read. It comprises several inspiring sketches of ancient and modern physicians whose reputations were based as much on their dedication to the humanism of medicine as it was to the science of medicine. Those who teach medical students and residents will find it a good source of medical history that, besides being important in itself, will add a new dimension and a little lightness to morning rounds. The author makes it clear that in our era of high technology it is easy to underestimate the importance of uniting humanism with science in caring for the sick. He also provides some practical information on such topics as how to present a case to attending physicians and how to communicate well with patients. The ancient physicians that history remembers were not only astute observers of signs and symptoms but also were deeply concerned about the psychological health of their patients and how disturbances in their emotional health often manifested in physical symptoms. Colgan starts with Hippocrates and Maimonides whose names many young physicians are familiar with. The former for the aphorism “first do no harm” and the latter for being one of the first to call medicine a “vocation” and a “calling.” The following “greats” are included in the book: Dr Albert Schweitzer whose “reverence for life” led him to his missionary medical work in Africa. He wrote Out of My Life and Thought and received the Nobel Peace Prize in 1952. Sir William Osler (1849–1919), known to some as the father of internal medicine, was a respected physician and teacher. He was the author of the Principles and Practice of Medicine, used for decades as the bible of medicine. But his fame rested equally on his dedication as a mentor to young physicians. He often gave graduation addresses to medical students reminding them to maintain a life-long interest in continuous learning and to treat the whole patient not just the disease. Francis Weld Peabody (1881–1927) a teacher at Harvard who had written a book The Care of the Patient in which he discussed how older practitioners often complained that younger doctors’ mindsets were so often over-concerned with testing that they sometimes forgot about how to take care of the whole patient. Dr. Theodore E. Woodward (1914–2005) who was famous for his dedication to patients. Once during a snowstorm he hitched a ride on a snowplow to see his patients at the hospital. He is responsible for the epigram “when you hear hoof beats think of horses not zebras.” Dr Edmund Pellegrino, respected for his studies in bioethics. His interest in protecting the sanctity of the doctor-patient relationship has particular importance in our current era when it seems that the art of medicine seems to be overshadowed by the business of medicine. He discusses this in his essay “The Commodification of Medical and Health Care.” Dr. Paul Farmer also is deeply concerned with the ethical ramifications of the commercialization that is overtaking the health system. He is devoted to improving public health on a worldwide scale. The author finishes up with some practical tips such as how to take a good history and how to avoid malpractice suits. He mentions the importance of finding a reasonable balance between our personal and professional lives. To offset the pressures that are sure to arise in caring for patients he reminds us as, Osler said, to look for the “poetry in life,” meaning to really try and understand the human side of the patients we treat. Throughout the book Colgan refers to doctors as “healers.” He suggests that healers are those who rise above the merely technical aspects of their craft and connect with patients in a special way—a way that respects their uniqueness and their human nature. It’s hard to describe in scientific terms what a healer is. As the author points out, most doctors know them when they see them. Edward J. Volpintesta, MD Bethe