I
spend a fair amount of time thinking
about the future of medicine. I dream of
tiny machines that we can send afloat in
patients’ bloodstreams that will detect cancer at the cellular level. I think often about
the way policy in health care could alter
our paradigms so that we receive increased
compensation for treating people before they
get sick rather than after. I wonder how the
community I will practice in will look twenty
years from now, whether we will integrate ourselves with Physical
Therapists and Optometrists or do our best to isolate our profession. But mostly I wonder about my patients.
I hope that they will like me. I get anxious when I think about
them dying. I imagine sitting across from them and solving their
problems, so that they can leave my office healthier and happier.
I have conversations with them in my mind, discussing the importance of this or that medication and I go over discussing the
importance of healthy living each time, asking what they eat and if
they are able to exercise, and what prevents them from leading the
life they desire. In my future, I always discuss more, prescribe less,
integrate my plan with the patient’s and make sure they understand
where we are heading.
As usual, life taught me a valuable lesson when I needed it most.
Yesterday I helped my grandfather spread mulch across his yard.
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I didn’t know I would be helping him, but when we got there he
was about to start his second load so I volunteered. He doesn’t use
the bagged or bulk kind; he makes his own. We rode down to the
corner of his lot and he showed me a pile of decomposing leaves
from two years ago. Beside it, last year’s leaves were in much better
shape but were already a deep brown. He told me that every year he
brings all the leaves from the yard and heaps them up into a pile,
which ends up being about forty feet long and three of four feet
wide. He lets them rot, essentially, for two years and then spreads
the resulting compost in the areas of his yard that need it most,
one shovelful at a time.
I was about to tell him that I thought he should just buy some
chemicals and spread them around like everyone else when I stopped
to think. I looked around. His lawn wasn’t perfect, but it looked
pretty good. It was green and healthy nearly everywhere. Who knows
how much money he’d saved? And already in his eighties, doing
work like this surely kept him healthy. Further, he was reducing
the amount of chemicals required to keep his lawn respectable.
What a metaphor, I thought. Here I stood, a future physician,
ready to throw chemicals at a problem rather than take the harder,
but likely better and more holistic route. In an age of Medicine ready
to throw physical-exam skills aside for sake of better imaging, and
ready to ditch lifelong patient relationships for “Any Provider,” I
think it helps us all to remind ourselves that sometimes the old
ways are the best. LM
Note: Ben Rogers is a first-year resident in internal medicine at
Washington University in St. Louis.
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Ben Rogers, MD
A monthly feature written by the students of U of L Medical School
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