Spring 2005
ARTICLES Medical professionalism and Maslow's needs hierarchy The author previously proposed that medical professionalism can be understood as a tiered construct with at least two levels: basic professionalism (in brief, doing the right thing well) and higher professionalism (in brief, service that clearly transcends self-interest). Here, it is suggested that higher professionalism is better understood in the context of what the humanistic psychologist Abraham Maslow called self-actualization, the pursuit of being needs as opposed to deficit needs. For medicine to sustain a higher level of professionalism compared to that required for most occupations, at least two conditions must be met: (1) adequate (but not superfluous) satisfaction of physicians' deficit needs; and (2) commitment of physicians and their organizations to a level of service that is unmistakably in society's best interest.
Medical journalism: An industry obsessed with "cures" needs one for itself Medical news comprises some of the most important information disseminated daily to American society. Accurate stories can provide context for public health issues and serve to educate the public, but poorly selected stories can promote unsubstantiated claims and lead to public confusion about which health matters are truly important. Improving the quality of medical news will require a stronger partnership between the medical community and the media. Physicians must learn to be better communicators, while journalists should take opportunities to improve their background knowledge in medicine. Both sides must aim for truth over sensationalism. The future health of America will largely depend on the strength and integrity of this partnership.
Hearts are too good to die: The history of defibrillation Efforts to revive the apparent dead with electricity date to the 18th century. Ventricular fibrillation was observed by Ludwid (1848) and induced and electrically terminated by MacWilliam (1885-1887) and Prevost and Batelli (1899). MacWilliam suggested that development of a defibrillator was delayed by the critical period of 2 to 4 minutes after which hypoxic injury prevented a successful outcome. A portable defibrillator was first developed at Johns Hopkins by Kouwenhoven, who was seeking a method to rescue electrocuted electrical line workers. Similar work by Wiggers and Beck led to the first open chest defibrillation at surgery (1947) and outside of the operating room (1955). Beck's concept, "heart too good to die," inspired the era of coronary care units and lay resuscitation. During the 1950s, Paul Zoll pioneered closed chest shocks for ventricular fibrillation and tachycardia. Michel Mirowski conceived of the possibility of implantable defibrillators that can prevent suddent death. Automated defibrillators for public use are now proliferating.
A short history of medical dictionaries The first full medical dictionary was likely a glossary of terms compiled in the 1c BC from the works of Hippocrates. It may have been patterned after glossaries prepared for interpreting the works of Homer and Plato and possibly inspired by the many earlier listings of botanicals and other useful medical agents. A few comprehensive medical dictionaries in manuscript form predate the development of the printing press in the mid-1400s. In the early 1500s there was an explosion of printed Latin translations of the works of Hippocrates, Dioscorides, Galen, Avicenna, etc. Latin glossaries were now necessary to provide definitions of terms originally written in Greek, Hebrew, Syriac, and Arabic. Dictionaries in Latin prevailed until the late-1700s, when medical dictionaries in vernacular languages began being compiled. The question is posed whether printed medical dictionaries will continue to be used with the advent of the electronic information age.
Dr. Schimke's brushes
A Baltimore bloodletting
The syndrome of the purloined letter Sometimes significant clues to diagnostic problems can be readily obtained by the right questions or by such apparent signs as facial expressions or bodily positions, but are overlooked as the doctor
turns to technical procedures. Interpreting the easily accessible
PERSPECTIVES Finding clarity-A generalist in a world of specialists
Goodbye to all that: A stethoscopic memoir More than any other item, the stethoscope has persisted as the symbol of the practicing doctor. Bereft of his or her stethoscope, the doctor suffers a loss that permeates many layers of the medical persona. When the time comes, as it must to all, to relinquish that symbol of the profession, it evokes a flood of memories of the past as well as fears of a future lost identity. Bidding farewell to the familiar icon is a poignant moment in the doctor's life
Night Rounds
Sarah and the facts of life
POETRY Galatic View Virginia Ham Captain Nicholas Time to Ponder Second Childhood The Art of the Open-Ended Question Office Visit-The Miner |
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