Thrive
It was only later that I discovered the underlying reasons for the move. My parents purchased a home in neighboring Wilmette. The contract was signed and a date was set. Being in second grade, I doubt I worried about the details. Maybe I was concerned about enrolling in a new school, I don't remember. It was nothing in comparison to the tumult I would feel when we relocated after the wedding, before high school.When my dad died, I assume the contract was nullified. The overwhelming upheaval to our lives was so great, that a seven year old boy couldn't possibly comprehend the complexity of adul...
Source: In My Humble Opinion - January 16, 2017 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Identification and Intimacy
To say that there is no fear in the examining room is an inaccuracy. I'm not only talking patients here. Physicians may harbor just as much worry and discontent . There are the old standbys of course. The swat team of malpractice attorneys lounging in the waiting room ready to pounce. Or the old demon of misdiagnosis and the consequences that may follow.Few of us talk of that sinking feeling that comes with the realization that in the course of doing our jobs, we invite physical danger. During medical school, I remember a psychiatric patient barricaded one of my peers in an interview room.&nbs...
Source: In My Humble Opinion - January 13, 2017 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
My Advice to You
It will start as a minor curiosity. Maybe a student will seem slightly too close to the resident on your team. When the grades are posted you'll wonder why you didn't get honors but he did. You might wallow for a few days. Make an off-handed comment to your fellow students. Then you'll let it go, and move on. Or so you think. Until during surgery when the scrub nurse rips into you to make a point to the rest of your peers. And then the surgeon does the same to her in the operating room. There will be other times. During residency you will roll your eyes when you realize you...
Source: In My Humble Opinion - January 11, 2017 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
The Guidelineification of American Medicine
His voice was gruff and his expression surly.I don't want any more medications.His face was indented by deep clefts, remnants of eight decades of life hard lived. His tone was commanding and certain. I knew that he was fond of me, but I could feel his patience slipping. He neither asked about nor accepted his diagnosis of heart failure. I could tell him till I was blue (or he was for that matter) in the face that his low ejection fraction portended a poor prognosis, and national guidelines suggested both a beta blocker and defibrillator placement.He wouldn't budge. And before the age of elect...
Source: In My Humble Opinion - January 8, 2017 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
A Doctors Story
Many years ago, three doctors formed an internal medicine practice and were proud of the thousands of patients they accumulated. They were fine physicians and very dedicated to the masses who walked through their clinic doors. They saw patients in the office, rounded at two hospitals, and visited a number of nursing homes. This was truly a full service practice.Around 2005, Dr. A was starting to fatigue. He was well into his sixties and did not like the direction medicine was going. The hours were too strenuous, the documentation requirements were getting increasingly complicated, and he saw the wr...
Source: In My Humble Opinion - January 6, 2017 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Just Like She Said
If Bob had realized that these were his mother's last words, he might have stopped what he was doing and stood by her side. But her foley catheter was leaking again and the sheets were a mess. Besides, he didn't want to wake Rhonda in the adjacent bedroom. She had just gotten off third shift and needed to rest before taking over in a few hours.Bob felt guilty about losing his job, but given his mother's current state, he couldn't justify taking another gig out of town. Because the Medicare days at the nursing facility had finally run out, his aging mom was forced back home. At first she was able to...
Source: In My Humble Opinion - January 5, 2017 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Evolution
You won't at first. But then you will.It will start innocently. Probably even before medical school. You will have a morbid curiosity about passing ambulances and motor vehicle accidents. Your original empathy for the victim will disappear when you begin to think of them as patients. Test cases.The commodification accelerates during the early years of medical school. Anatomy, pathology, and physiology provide you a vocabulary to replace human pain and suffering. In gross anatomy you violate the viscera even as you hear your fellow students snigger in the background.&nb...
Source: In My Humble Opinion - January 3, 2017 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
And You Will Answer
There is a basic communication gap between you and I. How could there not be? It's not what you expect. I say you have cancer, or heart failure, or emphysema. Full stop. A conversation ensues. This is not what I'm talking about.It's more like when I report to you a series of normal lab results, and at the end flippantly mention a slight elevation of the white blood cell count. In my mind, it is a minor issue and likely do to that viral infection that you are recovering from. As the days pass, my words simmer and eventually come to a boil, consuming you. The elevation could be le...
Source: In My Humble Opinion - January 1, 2017 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
A Reconstructer Of Disassembled Parts
To say that William hardly thought about hospice would be an inaccuracy. He contemplated it, from time to time, during his thirty year tenure as a trauma surgeon. Usually for fleeting moments before dodging the conversation or deferring to one of his more junior colleagues. Surgeons didn't give up so easily, he reasoned. He fancied himself a fixer, a reconstructer of disassembled parts.Mostly, that is what was expected of him. His patients didn't come because of cancer or chronic illness. They came after tragedy. Unwillingly. Bodies sprawled on metal tables with insides amiss. And h...
Source: In My Humble Opinion - December 30, 2016 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
