Current Issue
Spring 2014
BMM Current Issue
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Letter from the Editor
I’m not sure if it was luck or the consistent extraordinariness of Brown students that gave me three great cover options for this issue. But how to choose just one?

You can’t help but feel hopeful when you look at these new doctors. They are going into a health care system in tumult, an experiment that is testing ways to make the system fair for patients, for physicians, and for society. They’ve signed up for the challenge, and have years of continued personal sacrifice ahead. I decided that was worth having three different covers. You’ll meet three more graduating students in “A Date with Destiny” (page 32). This issue’s feature story about internal medicine residents who make visits in patient homes reminded me of a time in my childhood when my mother was a caregiver to an elderly woman. As her health deteriorated, Mrs. C moved in with us, and her doctor began making his biweekly visits with her in our
home.

I knew this was rare and special even in the mid-1980s, but now I understand that the doctor was doing more than accommodating a frail patient. He was checking out her new environment, ensuring she was well cared for and safe. I wish health care providers, not just doctors, had more opportunities to do that, especially for the most vulnerable—the elderly, children with special needs. What is learned at a patient’s dining room table might be the thing that keeps them from slipping through the cracks.

-Kris Cambra
Letters to the Editor
Classical Education

In your last issue you touted the benefits of the PLME (Program in Liberal Medical Education) (“The Whole Physician,” Winter 2014). That is all hogwash, in my opinion. I firmly believe in a PCME (program in conservative or classical medical education). 

My father was the product of such an education. He and my mother both came from Ukraine, a former republic of the Soviet Union. Both of them attended medical school there (although my mother couldn’t finish because of the war and because she was younger than my father). Under the Soviet system, colleges or universities were for the sole purpose of attaining training in one’s chosen profession. All of the broad, general education that one had to have was achieved in the gymnasia, or high school. Right after graduation from this secondary school, my parents matriculated into medical schools. The duration of medical studies was five years, after which time my pop received his MD degree. During his medical school years nothing that he learned was superfluous. … 

When I was at Brown as an undergrad I took Music 1-2, a course taught by Mr. Fischer. My father asked me why I would need to take a music course if I was planning to pursue a medical career. I couldn’t give him a good answer except to say that I was fulfilling a distribution requirement. My paw came to the conclusion that premedical studies in this country were nothing more than a business-making activity, something done to make the educators money. It does nothing to make one a better physician or surgeon. The argument that it makes us better humanists is just a bunch of bull, because no one was a better “humanist” than my father, speaking from a completely objective point of view. He did not have a particularly busy practice, he took time with his patients, and oh yes, he made house calls. He was of the opinion that there are some patients who are too sick to be seen in his office but not sick enough to go to the ER. He would make his rounds wearing his fedora hat and carrying his black bag. When he died prematurely at age 59 his patients sorely missed him. Now that was a model of what a general practitioner should be like. And yet he had been trained under a PCME. ...

So let’s start focusing on what’s really important in our society and reform health care from a disease-oriented approach to a health-oriented approach and we’d all be better off. That is the real essence of humanism.

George Chudolij ’72 MD ’76
East Freetown, MA


Kid Stuff

I thoroughly enjoyed Kylah Goodfellow Klinge’s essay, “Question Away” (Winter 2014), and believe that she is absolutely right in insisting on doctors’ listening with more open minds to their patients’ concerns. However, I would like to point out that Ms. Klinge’s assessment of type 1 diabetes—“I was no longer young and healthy. I was diabetic”—implies that diabetes is antithetical to youth. In fact, most type 1 diabetics are diagnosed in childhood or adolescence. The condition was, until recently, referred to as “juvenile diabetes.” I was diagnosed at the age of 11.

Emily Petit
North Kingstown, RI
 
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