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.
Jane: Thank you; you are too kind.
Your comment reminds me of another doctor who had a disease named for him. John Barlow was a South African cardiologist who took an early interest in mitral valve prolapse, a condition that is found in about 3% of populations world-wide. His research introduced this disorder to the medical community, so it was called Barlow’s Syndrome.
I was fascinated by the subject, and one year, at the annual American Heart meetings, I attended a symposium on Barlow’s syndrome. It was like the disease of the month, and a huge hall was packed to hear about it. Some doctors couldn’t even find a seat.
On the stage was a panel of experts who were discussing the condition and all the recent advances and controversies about it. But there was a disagreement among the panelists. I was sitting near the front, and the man next to me raised his hand. He stood and was handed a microphone and he said, “I’m John Barlow and I believe I can straighten this out….”
So that was a real Woody Allen moment such as when Woody, in Annie Hall, was in line to see a movie:
Here is a link, but don’t watch it unless you like Woody and can tolerate some sexual references. (This clip is rated X in Ocean Grove, and PG in Asbury Park.)
https://www.youtube.com/watch?v=vTSmbMm7MDg
Anyhow Jane—I am delighted to hear that you are doing fine. It’s not every day that a doctor gets such a long followup on a patient.
Best wishes Paul
My husband and I had a cardiologist that would take his time and have a conversation and beyond. I was having PVC’s and saw Dr. Goldfinger in his office on Route 46 in Dover across from Stewart’s Root Beer Stand. I think he introduced echocardiograms to Dover General Hospital. Despite being in the middle of office hours he told me to go to Dover General Hospital now and he would meet me there where I had an echocardiogram which revealed I had a mitral valve prolapse but told me not to worry I would never die of it.
It was a great relief because the heart beats were so worrisome. He was so right; I am still here but I will not forget that he took his time not only with me but for many years treating my husband.
So thank you Dr.Goldfinger for being a caring physician and maybe you don’t have something named for you but you did much more by the compassionate care and listening to your patients.
As far as having a disease named for me, while at Mt. Sinai I had the opportunity to report on and have published a case of subarachnoid hemorrhage with ECG changes. It was a chance to speculate on the mechanism, which I did. But I never got famous for that.
Years later I was at a national meeting of the American College of Cardiology when I saw Les Kuhn, MD, one of my teachers at Sinai and an editor at the AJC.
He looked up and saw me, probably without remembering my name, but he smiled and said, “Hey.. there’s Dr. Subarachnoid Hemorrhage!”
And, by way of surprising coincidences, when I arrived at Dover General. (Morris County) I met Bernie Weintraub, a neurologist from Bowman Grey. We talked and, remarkably, he also had published a paper on SAH, but from the neurology side.
I thought that no other hospital in the world could have two new doctors on the staff who were published re: subarachnoid hemorrhage. But, then again, coincidences do happen.