Sunday, January 29, 2012

The House of God, discussion

Thank you to those who made it to the discussion today. There was a mixture of reactions to the book: some of loved it, some were turned off by the writing style, but overall we had a good discussion.

The dialogue from the chat are after the jump.

Cindy: Well Amanda, would you like us to hold off on discussing certain parts of the book?
Amanda: Not at all. I'm not thinking that I'll finish it, to be honest. I was really turned off by the writing style. How did you guys feel about the tone of the writing?
Carla: do we want to facetime/huddle or have a record of this
Amanda: I think just chat, so we can post it on the blog (since it's just us).
Carla: sounds good
Cindy: I really didn't favor his graphic sexual escapades, but I surprisingly enjoyed the overall story
Carla: I liked the writing style minus the raunchy stuff
Cindy: There have been other books we have read that I have tried to force myself to read, but this one didn't require any forcing
Carla: I was able to read it very quickly
Carla: After a year no the floors a lot of what he said just made sense to me too
Cindy: Do you feel that, as a person going into the medical profession, it is very common for doctors to become desensitized to the human emotions of their patients?
Carla: yes and no
I think Fats is the best example of today's doctor
Also remember I am still only in medical school so really I know very little
Cindy: right, but you are just a few months from that
so you are the closest to expert we have in the group
Carla: you can't walk around all day carrying the emotion of all your patients but when you are in the room a doctor should be in-tune with the patients emotions that's why doctors aren't machines
and that is scary Cindy
Amanda: Do you think this book is still relevant today, having been written in 1978?
Carla: I think the back drop of the nixon-watergate was a good way to show the passage of time. Personally when I work long hours with random days off I am not sure what day it is and a month passes without any knowing
Not as much there are many restrictions on interns such as not being able to work over 80hrs a week or longer than 16hrs that is brand new this year
Cindy: I wondered that too Amanda. How much have hospitals and the medical field changed?
Is that in response to mental health issues and exhaustion amongst interns?
Carla: It is claimed to help with patient care that a less fatigued intern won't make as many mistakes they are doing studies to see if this is true and from what I heard that it may not improve patient care much because you have more hand offs and less continuity of care. B
But I think it has improved the mental health for the most part of residents
every week you have to have 24hrs out of the hospital
it gives you a chance to re-group and remember there is life outside of the hospital
Carla: Also I don't think there is quite so much hanky-panky in the hospitals anymore at least
Amanda: Yeeeeah. The raunchy tristes with nurses really dated the book, in my opinion. It's the same sort of sexist tone I've noticed in the early John Grisham novels.
Carla: I hope my on-call room hasn't been used for that
Carla: There are few young nurses at least in Buffalo
Cindy: What did you think about the contrasting techniques of treating the patients: Fat's method of doing nothing vs. Jo's method of doing everything?
Carla: I loved it and that continues to be a battle
Cindy: If neither of them were curing patients, then which method is better?
Carla: not only in the hospital but everyday life. you have one person always trying to do something on their way and then another who is carefree about life and plans nothing
Carla: I my opinion Fats is right
Carla: It is one reason I like Peds we didn't get blood draws every morning all the test we ordered had to have a specific purpose and we really thought about how it would change management
Cindy: Jo was committed to finding a cure, and doing something should get you closer to a cure than doing nothing. However, I think Fats treated the patient with humanity that Jo lacked. He didn't put them through vigorous tests that ultimately worsened their conditions, but he also didn't seek a cure.
Carla: how often is there a cure?
Cindy: I don't know. In medicine there are so many unknowns
Cindy: After a year, there was not a single cure.
Carla: which is why I am not going into internal medicine
Cindy: I could relate to how the interns appeared to lose sight of why they originally got into Medicine. They were so beat up and discouraged that they stopped caring.
Cindy: Berry comment on it: "They make me sad, but the way you treat them, making fun of them, like they were animals, is sick. You guys are sick."
Carla: It is sad but I see it daily especially since I was recently TAing 2nd years the difference between them and us is big and us and interns even larger
Humor is a mature defense mechanism that is all am going to say about that
Cindy: I sort of see that happening with me and my co-workers. We get tired of feeling like nothing we do makes a difference, we kind of stop trying.
or, like they did with the charts, we just start BSing it
Amanda: Hazing is a problem in the legal profession as well. Once an intern or young associate goes through the program, there's no incentive to stop it from happening to the next generation.
Carla: that is the problem
Amanda: It's considered a rite of passage, but the folks who are judging its efficacy have no other frame of reference.
Carla: especially now some attendees think the residents are soft and don't get as good of an education because of the work hour regulations
Carla: you do scut work because I did. I saw that a couple of times. I can't imagine that any of it is effective except for instilling fear
Cindy: What do you think is the significance of Roy's father and the assortment of lines from letters throughout the book
Carla: I think it is characteristic of someone trying to be supportive but not knowing what to say
I also got the feeling that he and his father were not on great terms
Cindy: His dad has such a different experience
and it sounds like the older doctors as well had very different experiences
Carla: they were probably trained in the military and quickly
Cindy: they were all still optimistic. Do you think that is because so many years passed since their internships and thus they suppressed the bad memories, or because things were really different?
Carla: his dad was a dentist right?
Cindy: Yes, and don't dentist have like the highest rate of suicide?
Carla: I think the further away anyone gets from things that they tend to remember the good
yeah I think now they do not sure about in the 70's
Carla: Have either of you spent significant amount of time in a hospital? I personally have never really been a patient nor a visitor minus the time I went to see my friends brother after surgery
It was weird to be on the other side of a hospital I know so well
Amanda: My grandmother was hospitalized a few times, but never for more than a few days...
Carla: did you get to interact with the staff
Cindy: My grandfather suffered a brain aneurysm when I was in high school
Amanda: Not much. Certainly not doctors.
Carla: I was just curious because I interact with family but for the most part we don't see family and a busy day I may only see a patient for 30min of the entire day
Cindy: My dad says some of them were very professional and some harsh. The doctors all seemed very polite but you only saw them once a day.
Cindy: yeah, that sounds like what was true with my dad's experience. It was the nurses that they mostly interacted with.
Carla: yeah I think they have a much more demanding job than any doctor for that reason.
Cindy: So, any remaining thoughts on The House of God?
Amanda: No... Sorry I didn't have much to contribute this time 'round.
Carla: I will be reading it again after intern year but that is what a lot of people do
Cindy: Well Carla, let us know how it compares to your experience

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