Paul Goldfinger, medical student. The George Washington University School of Medicine, delivery suite. The GW University Hospital, Foggy Bottom in D.C. Photographer Bill Adams, a fellow med student, from Utah.   From the Goldfinger family album.

By Paul Goldfinger, MD, Editor Blogfinger.net

We did get to deliver babies, and that was a thrill.  But I don’t recall much instruction in epidemiology which is now the most important discipline.

Medical education is always evolving.  In 1966 we didn’t have the drugs and technologies that are taken for granted today, and our work emphasized physical diagnosis, skillful history taking and careful problem solving at a personal level.

Some  areas which were not emphasized then  included nutrition, cancer therapy, and preventive medicine.  Our only imaging tool was X-Ray.     Of course, over time those concerns became more important as knowledge progressed. For example my career traced the progressive development of ultrasound as a diagnostic tool.

When I advanced to postgraduate work at Mt. Sinai in NYC, I saw diseases in person that were only seen by me in textbooks before.    But in a teaching hospital like that you saw the most unusual disorders.  During my first day I was introduced to myesthenia gravis, sarcoidosis, systemic lupus, aplastic anemia and other rare conditions. We even got to treat tuberculosis which still is popping up around the world today.

Epidemiology came up on rare occasions as when we first learned of the existence of  HIV (which slipped under the door and from the shadows–barely noticeable at first in New York.)

Some of the doctors were famous innovators and had written textbooks or edited medical journals.  It was thrilling to meet them.  That year  a number of important journals were housed at Mt. Sinai, including the American Journal of Medicine, The American Journal of Cardiology, Progress in Cardiovascular Diseases, and Circulation.  On rounds we would hear about the latest discoveries before they were published.

I recall one cardiologist there who was working on a very early computer program that would read ECG’s.  That has been pretty well developed by now, but many hospitals still have humans “over-read” the cardiograms.

One day I was checking a patient, and an elderly doctor came in to see the person  in the next bed.  I went out to the nurse’s station, and she said, “That’s Dr Crohn of Crohn’s disease.”  And there were others who had medical discoveries named for them.

I never got to have a disease or discovery  named for me.  If I had my choice, it would be technology to accurately diagnose twins.  Even X-Ray’s made mistakes with that one.

As far as delivering more babies, I did get to deliver two in the backs of two New York City yellow cabs, parked at the curb.

Today, with the coronavirus pandemic, the medical profession is learning on the fly, as it always has, and I am proud of my courageous colleagues who are acquiring experience and knowledge as they confront the coronavirus, its consequences, dangers, shifting presentations, and treatment and prevention challenges.

I recall the fearless doctors and nurses in Africa who placed themselves in grave danger treating Ebola.

The coronavirus keeps changing (shifting sands) and, as the Times, July 29, 2020,  reported today, it is fragmenting— “splintering into deadly pieces.”

The Times says, “There’s not just one coronavirus outbreak in the United Sates. Now there are many, each requiring its own mix of solutions.”

Many medical professionals have become sick themselves while bravely confronting the virus face to face, and some have become very ill.

One of the consequences of the pandemic is that some older doctors have been retiring early.

I saw some medical students today, bright eyed and wearing their immaculate white coats.   I wished  (to myself) for them not to get sick while they help care for virus patients.

Of course, that wish has to extend to all who are involved in that risky task.

And then it all comes full circle:

BILL FRISELL:    Vocal Petra Haden.   From the album: When You Wish Upon a Star.