Acknowledgements

Transcription

Acknowledgements
Acknowledgements
This book is about the wisdom of men and women who have helped make medicine
what it is today. Not many of the persons quoted are still alive today; most are
honored in history. I have had the opportunity to meet only a few of the “giants”
described: Paul Dudley White, Edmund Pellegrino, and Barbara Starfield. But we
know the words of all because they wrote or else, in some instances such as with
Theodore E. Woodward, someone recorded their words (or what the writer believed
were their words). As to the “giants” of more remote medical history—Hippocrates,
Maimonides, Snow, and others—their discoveries and their thoughts set the stage
for achievements of those that followed them. All cited in this book have influenced
how we teach and practice medicine in the twenty-first century.
The thoughts above are to introduce my belief that we all have “giants” in our
own lives, persons whose words, thoughts, and actions have shaped what we are
today. For me, there have been many outstanding individuals. Here, in more or less
the order in which they entered my life, are some of the physicians who have influenced and inspired me over the years: E. Thomas (Tom) Deutsch, Charles (Chuck)
Visokay, Joseph E. (Joe) Scherger, Peter A. Goodwin, Merle Pennington, John
Kendall, William (Bill) Toffler, John Saultz, Scott Fields, Daniel J. Ostergaard,
Robin Hull, Robert W. (Bob) Bomengen, Ray Friedman, Tom Hoggard, Mary
Burry, Ryuki Kassai, Takashi Yamada, Manabu Yoshimura, Michiyasu Yoshiara,
Subra Seetharaman, and Richard Colgan.
A heartfelt thank you is due to Coelleda O’Neil, who worked with me on a
quarter-century’s worth of books, and to Kathy Cacace, Katherine (Kate) Ghezzi,
and Janet Foltin of Springer Publishers who encouraged and supported my writing
“Medicine’s Giants.”
Thanks also to my wife, Anita D. Taylor, M.A. Ed., medical educator and author,
who, through some 33 books and many published reports, has read every word I
ever wrote or edited (and corrected more than a few).
© Springer Science+Business Media New York 2015
R.B. Taylor, On the Shoulders of Medicine’s Giants,
DOI 10.1007/978-1-4939-1335-0
233
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Brody H. Stories of sickness. New Haven: Yale University Press; 1987.
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New York: Praeger; 1983.
Durham RH. Encyclopedia of medical syndromes. New York: Harper and Brothers; 1960.
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Evans IH. Brewer’s dictionary of phrase and fable. New York: Harper & Row; 1970.
Fabing HJ, Marr R, editors:. Fischerisms, being a sheaf of sundry and diverse utterances culled
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Fortuine R. The words of medicine: sources, meanings, and delights. Springfield, Illinois: Charles
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Garland J. The physician and his practice. Boston: Little, Brown and Co.; 1954.
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1
This is a list of books recommended for the reader interested in the wisdom of the great physicians
of the past, the language of medicine, the process of clinical practice, and how to communicate
with patients and with one another.
© Springer Science+Business Media New York 2015
R.B. Taylor, On the Shoulders of Medicine’s Giants,
DOI 10.1007/978-1-4939-1335-0
235
236
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Haubrich WS. Medical meanings: a glossary of word origins. Philadelphia: American College of
Physicians; 1997.
Huth EJ, Murray TJ. Medicine in quotations: view of health and disease through the ages.
Philadelphia: American College of Physicians; 2006.
Inglis B. A history of medicine. New York: World; 1965.
Johnson WM. The true physician: the modern doctor of the old school. New York: Macmillan;
1936.
Johnson S. The ghost map: the story of London’s most terrifying epidemic—and how it changed
science, cities, and the modern world. New York: Riverhead Books, 2006.
Lindsay JA. Medical axioms, aphorisms, and clinical memoranda. London: H.K. Lewis Co.; 1923.
Lipkin M. The care of patients. New York: Oxford; 1974.
Magalini SI, Scrascia E. Dictionary of medical syndromes, 2nd edition. Philadelphia: Lippincott;
1981.
Maimonides M. Medical aphorisms: treatises 1–5, Bos G, ed. Provo UT: Brigham Young University
Press; 2004.
Major RH. Disease and destiny. New York: Appleton-Century; 1936.
Manning PR, DeBakey L. Medicine: preserving the passion, 2nd edition. New York: Springer;
2004.
Martí-Ibáñez F. Men, molds and history. New York: MD Publications; 1958.
Martí-Ibáñez F. A prelude to medical history. New York: MD Publications; 1961.
Mayo CH, Mayo WJ. Aphorisms of Dr. Charles Horace Mayo and Dr. William James Mayo.
Willius FA, editor. Rochester MN: Mayo Foundation for Medical Education and Research;
1988.
McDonald P. Oxford dictionary of medical quotations. New York: Oxford University Press; 2004.
Meador CK. A little book of doctors’ rules II. Philadelphia: Hanley & Belfus; 1999.
Meyers MA. Happy accidents. New York: Arcade Books; 2007.
Oldstone MBA. Viruses, plagues and history. New York: Oxford University Press; 1998.
Osler W. Aequanimitas with other addresses. Philadelphia: Blakiston; 1906.
Payer L. Medicine & culture: varieties of treatment in the United States, England, West Germany,
and France. New York: Henry Holt; 1988.
Pellegrino ED. Humanism and the physician. Knoxville TN: University of Tennessee Press; 1979.
Penfield W. The torch. Boston: Little, Brown and Co.; 1960.
Porter R. The greatest benefit to mankind. New York: Norton; 1997.
Rapport S, Wright H. Great adventures in medicine. New York: Dial Press; 1952.
Reveno WS. Medical maxims. Springfield IL: Charles C. Thomas; 1951.
Reynolds R, Stone J, editors. On doctoring. New York: Simon & Schuster; 1991.
Ross JJ. Shakespeare’s tremor and Orwell’s cough. New York: St. Martin’s Press; 2012.
Sebastian A. The dictionary of the history of medicine. New York: Parthenon; 1999.
Sherman IW. The power of plagues. Washington, DC: ASM Press; 2006.
Shryock RH. Medicine and society in America: 1660–1860. Ithaca, New York: Cornell University
Press; 1960.
Silverman ME, Murray TJ, Bryan CS. The quotable Osler. Philadelphia: American College of
Physicians; 2003.
Starr P. The social transformation of American medicine. New York: Basic Books; 1982.
Strauss MB. Familiar medical quotations. Boston: Little, Brown; 1968.
Taylor RB. Medical wisdom and doctoring: the art of 21st century medicine. New York: Springer;
2010.
Taylor RB. White coat tales: medicine’s heroes, heritage and misadventures. New York: Springer;
2008.
Weiss AB. Medical odysseys: the different and sometimes unexpected pathways to 20th century
medical discoveries. New Brunswick, New Jersey: Rutgers University Press; 1991.
Index
A
Abbreviating direct patient contact, 73
Abrams, Albert
and California Medical Association, 183
Dynomizer, 183
Electronic Reactions of Abrams
(ARA), 183
Oscilloclast, 183
Abuse, 7, 30, 33, 55, 121, 142, 143
by insurance providers, 29
Accountable Care Act of 2010, 21
Pelosi, Nancy, and, 21
Accreditation Council for Continuing Medical
Education (ACCME), 157
Acquired immunodeficiency syndrome
(AIDS)
AIDS orphans, 99
as a single disease, 191
in sub-Saharan Africa, 99
and various uncommon diseases, 191
Addressing social problems that affect health, 39
physician’s role, 39
Advocacy, 39
as part of healing, 39
Aequanimitas, book (1932), 49, 169
by Osler, 49, 169
Affordable Care Act, 21, 181, 223, 230
AIDS.See Acquired immunodeficiency
syndrome (AIDS)
Albright, Fuller
fundamentals underlying therapy, 146
instances to which the rules do not apply,
146
Parkinson disease and, 146
Albucasis, Arab physician
Al Tasrif, book, 128
surgery of abdomen, performed by, 128
Alexander, Annie Lowrie, 41
All or nothing, practice of medicine, 35
Alpha Omega Alpha (AOA)
motto of, 46
worthy to serve the suffering, 47
William H. Root, founder of, 47
American Medical Association Code of
Medical Ethics, 203
Amyotrophic lateral sclerosis, 87, 97
Apgar, Virginia, 41
Aquinas, Thomas, 37
Aristotle
deduction from other truths, 170
Nicomachean Ethics, 171
scientific knowledge, 170
truth, 170
Arrowsmith.See Lewis, Sinclair
Arsenic, used to treat herpetic affections, 131
Arsphenamine.See Salvarsan
A Sound of Thunder, article, 66
Ray Bradbury, 66, 67
Athens, plague of, 17, 30
Attorneys of the poor, physicians as, 39
Attributes of best teachers, 152
Attributes of future physician, 26
Auenbrugger, Leopold, 111
Auscultation, 110, 111, 215
Laennec, 110, 111, 215
Autonomy, 3, 20, 149, 193
Ayurveda system of lifestyle
and medicine, 28
© Springer Science+Business Media New York 2015
R.B. Taylor, On the Shoulders of Medicine’s Giants,
DOI 10.1007/978-1-4939-1335-0
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238
B
Bacon, Sir Francis
conclusion, 171
experience, 171
Banting, Frederick
and Charles Best, 213
insulin, 213
smart insulin pump, 212
Basic sciences
experience makes for a better
physician, 167
help us learn the language
of medicine, 167
Krebs cycle, 166
teach mental discipline, 167
Battle of Trafalgar (1805), 85
Beaumont, William
and Alexis St. Martin, 185
fistula in the stomach, 185
US Army surgeon, 185
Bedlam, 219
Bell, Joseph
as inspiration for Sherlock Holmes, 119
minor differences, recognition and
appreciation of, 116
successful diagnostician, 116–117
Beneficence, 149, 193, 202
vs. nonmaleficence, 149
Berger, John
A Fortunate Man, book (1967), 73
John Sassel, 72
listening and touching, 72–73
Bernard, Claude
concept of the milieu intérieur, 216
and homeostasis, 216
Language, 216–217
physiologists, poets and philosophers
will all speak same, 216, 217
Best doctors, 14, 163
Have integrated teaching into their
practices, 163
Biopsychosocial model, 115
George Engel, 115
Black death.See Bubonic plague
Blackwell, Elizabeth
Geneva Medical College, and, 40
pioneer, to be a, 40, 41
Blackwell, Emily, 41
Bloomfield, Arthur L.
harm, none whom we cannot, 200
and penicillin, 200
Stanford University School of Medicine,
professor at, 200
Boerhaave, Herman, 61
Bomengen, Doctor Bob, 37, 233
Index
Books, medical reference
and errors, 205
and misinformation, 205
out of date, 105, 205
Botulinum toxin (Botox), 23, 191
clinical uses of, 191
Bridge job, in physician retirement, 35
Brinkley, John R, 183
goat glands, 183
impotence, 183
Brody, Howard, 127
My story is broken, 127
Bubonic plague, 16, 17, 98
14th century, 17
Bulimia nervosa, 112, 113
C
Cabot, Richard C.
clues, 120–121
Differential Diagnosis, book (1919), 120
throw open the mind’s door, 120
Care, 2, 7, 10, 11, 14, 15, 20, 21, 23–25, 27,
29–31, 33, 35, 39, 47, 51, 57, 61,
63, 65, 67–69, 71, 73, 75, 79, 81,
95, 101–103, 106, 107, 109, 115,
120, 122, 132, 135, 139, 153, 163,
171, 176, 181, 198, 201–203,
205–207, 211, 213, 219–223,
225–227, 230, 231
pretend to, 75
Career
exhaustion, 33
satisfaction, 10, 11
CDC.See US Centers for Disease Control and
Prevention (CDC)
Cell, book (2014), 229
Celsus, 8, 109, 132, 133
Celsus, Aulus Cornelius
De Medicina, book, 132, 133
cardinal signs of inflammation, 133
surgeon, qualities of, 132
Chekhov, Anton, 70
Childbed fever, 94–95, 183
Cholera
and Broad Street pump, 93
epidemic in London (1854), 92
ghost map of cholera cases, 93
Chorea
dancing, and, 96–97
word origin, 96
Christian church
conversions at times of famine, earthquake/
pestilences, 145
growth and medical mission, 145
239
Index
Christ, Jesus
as a healer, 145
heal the sick, apostles sent to, 145
Churchill, Sir Winston, 45, 178
stumble over the truth, 179
tyrant, 45
writing a book, an adventure, 45
Circulatory system, 81
described by Harvey, 81
Clinical guidelines
being skeptical of, 137
GOBSAT guidelines, 137
National Guideline Clearinghouse
(NGC), 137
US Preventive Services Task Force
(USPSTF), 137
Clinical studies, industry-funded, 94
CME.See Continuing medical education
(CME)
Colgan, Richard
Advice to the Healer on the Art of Caring,
ed. 2, book (2013), 125
Theodore E. Woodward, and, 74
Colles, Abraham
great pox, 91
Practical Observation On The Venereal
Disease (1837), 91
syphilis, 91
venereal disease, 90, 91
Colles fracture, 90
Collins sign
Paddy Collins, 111
in patients with acute cholelithiasis, 111
Compassion
fatigue, 57
and multiple mini-interview (MMI), 22
Compound 606.See Salvarsan
Comte, August, 16
Concierge practice
criticisms
obligation to care for the
needy, 223
only for the wealthy, 223
“penny-a-week” model of healthcare, 223
retainer, membership practice, 222
Confucius, 128, 130, 131
newer methods of treatment vs.
old ones, 130
Continuing evolving and tentative
diagnosis, 109
Continuing medical education (CME)
and Accreditation Council for Continuing
Medical Education (ACCME), 157
CME imperative, 147
as a major industry in America, 156
medical meetings, 157
pharmaceutical industry support of, 157
and state medical licenses, 157
therapy, and, 147
Continuity
care, 14, 24–25, 109
and better diagnosis, 109
interpersonal, 25
Lochner, 25
Saultz, 25
Cooper, inguinal ligament of, 139
Cooper, Sir Astley Paston
best surgeon, 138
Cooper ligament, 139
mistakes, making the fewest, 138–139
Coping mechanisms
denial, anger, bargaining, depression,
and acceptance, 103
at the time of a terminal illness, 101
Corpus Hippocraticus, 107
Corrigan pulse, 112
in aortic regurgitation, 112
Corrigan, Sir Dominic.see enough, doctors
don’t, 112Lectures On The Nature
And Treatment Of Fever (1853), 113
Cowper, William
knowledge and wisdom, 168–169
The task (1785), 169
Crohn disease, 87
Curbstone diagnosis, 109
“Curbstone Diagnosis Costs Nothing,
Usually Worth Just as Much” in
Toledo Blade, 109
Cushing disease, 66
Cushing, Harvey, 66, 67
man in his world, 66
Cutting for Stone, book (2010), 229
Cyber-chondriacal patients, 57
Cystic fibrosis, 117, 212, 213
D
Da Costa, J. Chalmers, 139
Dark ages
Middle East in, 134
rationality and scholarship in, 134
da Vinci, Leonardo
experience, 170
reason, 170
Dead Sea, 51
Death
Kübler-Ross’ five stages of coping, 103
as the last frontier, 103
240
DeBakey, Michael
caring for patients, 52
intimate chambers of our patients’ lives,
52–53
not only a duty, a privilege, 52
procedure, 53
DelBene, Congresswoman Suzan, 85
living on a food-stamp budget, 85
Dercum disease, 125
as zebra diagnosis, 125
Deschapelles, Haiti, 47
Diabetes
gene therapy of, 145
insulin pump, 212
Diagnosis
computer-assisted
vs. brain, 104
and human observation and
examination, 104
defined, 104
failure, 104
and human cognitive function, 104
Diagnostic delay, 79
Diagnostic failure rate, 104
Diagnostic maneuvers, 47, 111
Dickey, Nancy, 41
Digitalis
foxglove, 128, 191
William Withering, and, 128, 191
Disease, definition of, 76
Disruptive discovery, 80–81, 84, 85
Dix-Hallpike test, 111
for benign paroxysmal positional vertigo,
diagnosis of, 111
DNA screening, 213
as part of the patient’s routine checkup, 213
Doctoring
course at University of California Los
Angeles School of Medicine, 55
gerund form of the verb “to doctor,”, 55
Doctor Waltman’s father
community physician, 230
paying attention to what is going on around
us, 230–231
suits, some physician, some not, 230
Dogmatists, 19
Down syndrome, 87
Doyle, Sir Arthur Conan.see what others
overlook, 118Sherlock Holmes,
118, 119
Drake, Daniel, 36, 37
self-complacency of physician, 36–37
Drug overdose, 143
as rising cause of death in the US, 143
Index
Drugs, 18, 19, 31, 33, 37, 63, 67, 79, 131, 139,
142, 143, 147, 148, 161, 163, 167,
173, 186, 187, 200, 201, 212, 217,
219, 225, 230
MK3475 (Merck & Co.), 212
Duell, Charles H., 185
Everything that can be invented has been
invented, 185
Duty hours, 224
limits on, 201
E
Ebola virus, 29, 31, 211
Edmund D. Pellegrino Center for Clinical
Bioethics at Georgetown
University, 48
Ehrlich, Paul
arsphenamine (Salvarsan), 186
compound 606, 189
German scientists, 186
and sulfonamides, 186
Einthoven, Willem, 215
invention of a practical
electrocardiogram, 215
Eliot, George
Middlemarch, book (1874), 209
Tertius Lydgate, 209
Eng, John
exenatide (Byetta), 173
Gila monster, 173
Epidemics
Athens, 98
Christianity, setting the stage for, 145
and the fall of Rome, 98–99
smallpox and the Spanish conquest of
Mexico, 99
Equi, Marie, 41
Errors, 28, 29, 104, 139, 186, 192–210.
See also Medical errors
of diagnosis, 28, 29
Ethical issues
values, 192, 193, 202, 203
when values collide, 202–203
Ethical values, in conflict
beneficence and non-maleficence, 202
in eminent domain, 202
in life-sustaining treatment of dying
patient, 203
in medicine, 202
in shortage of flu vaccine, 203
Typhoid Mary, and, 203
Evidence-based medicine (EBM)
definition of, 18
241
Index
evidence hierarchies, 171
U.S. Department of Health and Human
Services National Guidelines
Clearinghouse, 171
and McMaster University, 171
Experience
defined, 168
as a dreadful list of ghastly mistakes, 139
Leonardo da Vinci, and, 170
not as valued as in the past, 168
Osler and experiences, 168
Sir Francis Bacon, and, 171
F
Fads (in medicine)
diethylstilbestrol (DES), 161
high dose oxygen therapy, 161
silver protein, 161
thalidomide, 161
Feeling Alive after 65, book (1973), 106
Fischer, Martin H., 142, 231
medical profession, problems, 231
narcotic, use inversely proportional
to skill, 142
Fleming, Alexander
mold colony, 173
penicillin, 173
Flexner, Abraham
Medical education in the United States and
Canada, report (1910), 159, 163
medical school education, 158
more uniformly arduous and
expensive, 158
tour of US medical schools, 159
Flipped classroom model of teaching, 155
“Fortunate Man, A” (1967), 73
John Berger, 72
Foxglove
and congestive heart failure, 128
and digitalis, 128
and dropsy, 128
plant, 128, 129, 191
Fox, Sir Theodore
doing things merely because we know
how to do them, 148
The Lancet, editor of, 148
prolonging dying, 148
Freud, Sigmund
cocaine abuse, 142
“On Coca”, paper,1884, 142
hobby-horse, 44–45
psychology is my, 44
tyrant, 44–45
Fry, Arthur
3M Company, 191
Post-it note, 191
G
Garrison, Fielding H.
An Introduction To The History Of
Medicine, book (1913), 183
history of humanity, medical history
as the, 182–183
Gene therapy, 145, 212
of cystic fibrosis, 212
Geneva Medical College, 40
Geneva, oath of, 99
Genome, human, 63, 212
Genomic research, 63
God, 88, 18, 19, 59, 128, 145, 181
healed him, I dressed him
(Amboise Paré), 59
Goldberger, Joseph
filth parties, 175
pellagra germs, 173
vitamins, 173
Gold Humanism Honor Society
(GHHS), 47
Gout in history of the Western world, 82
Gregg, N. McAlister
cataracts in newborn children, 179
maternal rubella, 179
Groopman, Jerome, 123
doctors interrupting patient narrative, 123
Guidelines, clinical.See Clinical guidelines
H
Halsted, William Stewart, 142
addiction to cocaine and morphine, 142
champion of hemostasis in surgery, 141
confidence of the surgeon, 141
hemorrhage, 141
performed cholecystectomy on his own
mother, 141
radical mastectomy, 141
Hames, Curtis G.
disease, 185
Evans county, Georgia, 185
racial differences in the incidence
of hypertension and coronary
artery, 185
Harvard Medical School, 68, 69, 126, 146
Francis Weld Peabody, 66, 69
Harvey, Paul, 127
“the rest of the story,”, 127
242
Harvey, William
circuit of the blood, concept of, 80
disruptive discovery, 80–81
Healing power of caring, 38
Health hazard appraisal, 63
Heart function, ways to assess, 215
Heberden, William, 34, 35
ceasing doctoring, 34–35
Hemophilia
and Bolsheviks (1817), 99
and Romanov dynasty of Russia, 99
Herpes zoster ophthalmicus, 116, 118
Hertzler, Arthur E.
Halstead, Kansas, USA, 122
Horse and Buggy Doctor, book
(1938), 122
lived for his patients like all country
doctors, 224
medical books, 122
medical history as a work of art, 122–123
Hierarchy of natural systems, 67
perturbation in, 67
Hilfiker, David
anxiety and depression, 208
“Facing our Mistakes”, article (1984), 210
Healing the Wounds: A Physician Looks at
his Work, book (1985), 208
lives of many doctors, major factors in, 208
and mild cognitive impairment, 209
secrets, one of the world’s most poorly
kept, 208
Hippocrates
art, 194
do good, 194
harm, do no, 194–195
perfect accuracy, 196
seldom to be seen, 195
profession, 195
science, 204
History, medical, 126–127
avoiding premature “jumping-in,”, 127
as broken story, 127
as joint effort of the patient and physician,
126
key fact, 127
Paul Dudley White, and, 126
HIV.See Human immunodeficiency virus
(HIV)
Holmes, Oliver Wendell, Sr.
observation, 180, 181
outside influences, medicine sensitive to,
180–181
Holmes, Sherlock, 117–119
Joseph Bell, inspired by, 116
Hooke, Robert
Index
correspondence with Isaac Newton, 214
“shoulders of giants” quotation, 214
motions of the internal organs, 214–215
Hooker, Worthington
“first, do no harm,”, 194–195
Physician and Patient, book (1849), 195
Hope
cannot always connote cure, 59
as panacea, 59
Horse and Buggy Doctor, book (1938), 123
Hospice
alleviation of symptoms, 103
and Dame Cecily Saunders, 103
emotional and spiritual care, 103
in England, 101
futility of “curative” treatment for terminal
disease, 103
home hospice, 101
Hospitals
Aesculapian temple on the island
of Cos, 219
Bethlem Royal Hospital in London
and Albert Schweitzer, 219
Bedlam, word, 219
oldest existing psychiatric hospital
in Europe, 219
Pennsylvania Hospital, Philadelphia,
Pennsylvania, 219
Trudeau Sanitarium, Saranac Lake,
New York, 219
Huang Ti (Yellow Emperor),
106, 107, 194, 195
diseases revealed to me, 106, 107
most important requirement of the art
of healing, 194
observing myself, 106
Human genome, 63, 212
project, 212
and prospective medicine, 63
Human immunodeficiency virus (HIV),
79, 91, 197, 211
“a pussycat,” described as, 197
infection, 79
Hunter, John
and Edward Jenner, 175
experiment, why not try the, 174
gonorrhea and syphilis, 175
Huntington disease
autosomal dominant disorder, 96
basal ganglia cells, destruction of, 97
manifestations of, 96, 97
presymptomatic genetic screening
test for, 97
Woody Guthrie, and, 97
Huntington, George
Index
chorea, 96
On chorea (1872), 96–97
first paper Huntington ever
published, 97
dancing propensities, 96
and chorea, 96
Hutchison disease, 160
Hutchison sign, 117
herpes zoster ophthalmicus, 116, 117
Hutchison, Sir Robert Grieve, 160, 161
Clinical Methods, book (1897), 160
fads, 160–161
ghosts of dead patients, 160
handing the cup of knowledge to the
young, 160
Hutchison disease, 160
from inability to let well enough alone
(quotation), 201
Hygeia, 18, 19
Hypercortisolism, 66
I
Ideal American life span, 103
approximately 85 years, 103
iDoc, 229
smartphone and, 229
Imatinib (Gleevec), 186
to treat chronic myelogenous
leukemia, 186
Imposter syndrome, 64, 65
Inappropriate surgery, 29
Independent practice, opportunities for
concierge practice, 222, 223
frontier practice, 162
Infections
carbapenem-resistant Klebsiella and
Enterobacteriaceae, 219
hospital-acquired, 95, 219
methicillin resistant staphylococcus aureus
(MRSA), 219
multiple-drug resistant tuberculosis, 219
and a “post-antibiotic era,”, 219
Influenza, 17, 78, 99, 212
and deaths during World War I, 17
epidemic (1918), 17
Inspection
as critical observation, 110
and Hippocrates, 110
Intern, 168, 182, 201, 224
origin of word, 80, 135
iPatient
and Health insurer WellPoint, 229
and virtual physician, 228–229
Irritable bowel syndrome, 121
243
J
Jenner, Edward
Inquiry into the Causes and Effects of the
Variolae Vaccine (1878), 88
producing cowpox in human beings, 88
and smallpox, 88, 89, 174
Jordan River, 51
Joubert, Joseph, 153
“To teach is to learn twice,”, 153
Joy in life, true
George Bernard Shaw, 44
Man and Superman, drama (1903), 44, 45
K
Kellogg, John K., 183
enema machine, 183
King George III of England
and American Revolution, 99
and porphyria, 99
Kipling, Rudolph
power of physician, 12–13
privilege of physician, 12–13
Koch, Robert
discovered tubercle bacillus, 192
human and bovine tuberculosis, differences
between, 192
Kolmer, John A
Kolmer test for syphilis, 91
syphilis, and, 91
Temple University School of Medicine, 91
Kos
Greek island of, 49, 135, 150
Hippocrates and, 48, 49, 135, 150, 151
Plane tree on, 135, 150
Krebs cycle, 166
Kübler-Ross, Elizabeth
On Death and Dying, book (1969), 100
death notice in the New York Times, 101
peaceful death, 100
silence that goes beyond words, 100–101
stages of coping with terminal illness, 101
L
Laborists, 25, 225
LaCombe, Michael A.
compassion, 22
professionalism, 22
Laennec, René, 109, 110, 154, 215
action of the heart, 110
paper cylinder, 110
used to perceive action of the heart, 110
stethoscope, 110, 154–156, 215
Lambarènè, Gabon, 47, 219
244
Language of medicine, 167
students learn 15,000 new words, 167
Latham, Peter Mere
instruction, our great book of (on the
wards), 154
lectures, teaching by, 154
“physician extraordinary” to Queen
Victoria (1837), 83, 92
self-teaching, 154
Lecture
as anachronism, 155
flipped classroom, 155
“sage on a stage”, 155
Lewis, Sinclair
Arrowsmith, book (1961), 208
Martin Arrowsmith, 208
Libby Zion, 202
Limeys, sobriquet for British seamen, 85
Lind, James
influence on seafaring, 84
scurvy, first indication, 84
A Treatise on the Scurvy (1753), 85
Lister, Joseph
carbolic acid, 156, 198
contributions to surgical antisepsis, 156
error, public recantation of, 198
lifelong learning, 157
and Listeria monocytogenes, 198
and Listerine, 198
and “Semmelweis”, 198
students, always be, 156–157
Lou Gehrig disease, 87, 97, 217
amyotrophic lateral sclerosis, 87, 97
Low, Dr. C.H., 54, 55
Loxterkamp, David A.
continuity of care, 24–25
physician’s duty, 24–25
M
Mackenzie, Sir James
discovery of premature ventricular
contractions, 184
field of medicine, not so fully explored,
184
observe for myself, 184
use of digitalis, 184
Maimonides, Moses ben
Mishneh Torah, 56
proficient medical practice, 56
Major, Ralph H.
destiny of human race, role of disease in, 98
Disease and Destiny, book (1936), 98–99
Malaria, 19, 99, 128, 175, 183, 186, 187, 227
and deaths annually, 99
Index
Mallon, Mary.See Typhoid Mary
Managed care, 11, 225
and operational decisions, 225
Man and Superman, drama (1903), 45
Mann, Thomas
The Magic Mountain, book (1924), 219
fictional sanitarium in, 219
Manson, Sir Patrick
malaria, 175
quinine, 175
Marshall, Barry
H. pylori, 179
peptic ulcer disease (PUD), 179
and Robin Warren, 179
Martí-Ibáñez, Félix
diseases caused by bacteria, protozoa,
and perhaps viruses, 198
as exotic curiosities of mere historical
interest, 197
New York Medical College,
professor at, 197
Masefield, John, 187
A Moment on the August day, 1897, poem
(1957), 187
Massachusetts General Hospital (MGH),
120, 121, 146
Mayo, Charles Horace, 152
being a teacher and a student, 163–164
education as part of patient care, 163
once you start studying medicine, 153
Mayo Clinic
date of founding, 162
needs of patient come first, 203
Physician Well-Being Program, 33
ranking by US News & World Report, 163
in Rochester, Minnesota, 162, 220
Mayo Clinic Hospital, 163
Mayo Medical School, 163
Mayo, William James, 162
Mayo, William Worrall
father of the brothers Mayo, 220
independent, no one is big enough
to be, 220
teamwork, 220–221
as the essence of Mayo Clinic, 220
McClenahan, John L.
merchants, doctors acting like, 224–225
Transactions and Studies, journal, editor
of, 224
McCune-Albright syndrome, 146
polyostotic fibrous dysplasia, 146
McWhinney, Ian, 73
Medical education, 33, 55, 146, 151,
154–159, 166
debt of medical graduates, 227
Index
in the Flexnerian model has become very
expensive, 159
Flexner’s calls for improvements
medicine should be studied
as a laboratory science, 159
opposition by Osler, 159
teaching by salaried physicians, 159
Medical errors
disclosing to patients, 199
To Err is Human, report (1999), 199
in 10% of hospitalized patients, 199
as a “system problem,”, 199
Medical informatics, 205
Medical Professionalism in the New
Millennium: A Physician Charter,
3, 22
Medical school
Aberdeen University Medical School,
Scotland, 150
in Montpellier, France, 150
In Padua, Italy, 150, 172
University of Pennsylvania School of
Medicine, Philadelphia, PA, 150
Medical wisdom
definition of, 169
medical giants and, 169
Medical Wisdom and Doctoring: The Art
of 21st Century Medicine, book
(2010), 169
definition of medical wisdom, 169
Membership practice, 222, 223
Mercury, 130
as therapy of syphilis, 130–131
Mesmer, Franz Anton, 77
Methylphenidate (Ritalin), 143, 191
to treat attention deficit hyperactivity
disorder, 191
Middlemarch, book (1874), 209
Miller, Henry
healer, becoming, 144–145
healing art, 144
as literary innovator, 144
The Rosy Crucifixion, book
(1949), 144, 145
Misdiagnosis, 104
specialties, among, 104
Mishneh Torah, 56
Missionaries of Charity, India, 51
Mistakes, medical
experience as ghastly mistakes, 139
in hospital admissions, 139
J. Chalmers Da Costa, 139
medication errors, 139
Montaigne, Michel de
art of medicine, 136
245
authority of physician, 136–137
considered a Renaissance “Doubting
Thomas,”, 136
questioned “fixed” medical therapy of the
day, 137
Mosquito, malaria spread by, 175
Mother Teresa
Blessed Teresa of Calcutta, 51
giving back, 50–51
surgeons of India, 50
Multidrug-resistant infections
doomsday organism, risk of
unleashing, 143
gonorrhea, 143
tuberculosis, 143
Multiple mini-interviews (MMI)
compassion and, 22
use in evaluation of medical school
applicants, 11
Multiplier effects with each generation
of those who educate the students who
become teachers, 164
and William the Conqueror
of England, 164
Munthe, Axel, 64
confidence, to inspire, 64
Muscular dystrophy, 119
N
Narcotic prescriptions, 142
physicians writing too many, 142
Nightingale, Florence
in Crimean War, 218
and Elizabeth Blackwell, 218
harm, do the sick no, 218
hospital, first requirement of, 218
“The Lady with the Lamp,”, 219
Nobel Peace Prize
Albert Schweitzer, 46–48, 51, 219
Mother Teresa, 50, 51
Nocturnalists, 25, 225
Nonmaleficence, 149
Non-physicians, patients seeking healing from
counseling social workers, 145
doula, 145
support groups, 145
O
Obstructive sleep apnea, 119
loud snoring and daytime sleepiness in, 119
Occupational obligation, 31
Occupational prestige, 43
of physicians, 43
246
Off-target predictions
computers, world market for, 197
need of the telephone, 197
stocks, a permanent high, 197
On Coca, paper (1884), 142
Sigmund Freud, 142
Operating room, 53, 74, 75, 133, 141
as a cathedral, 141
Oregon Death with Dignity Act, 148
Osler, Sir William
aphorism, word described, 63
best life of the teacher, 155
bubble, iridescent, 164
joy of medicine, 11–12
probability, 62–64
superfluity of lecturing, 155
uncertainty, 62–64
Osmond, Humphry
Aesculapius, 18–19
evidence-based medicine, 18–19
Outcomes
misadventures, 195
unintended consequences
and response to epidemic of childhood
obesity, 195
rise in eating disorders, 195
P
Pachet, Pierre
and Louis Pasteur’s theory of germs, 197
Toulouse University in France, professor
at, 197
Paget disease of bone, 115
Paget, Sir James
Address to the Abernethian Society
(1885), 115
essential characters of disease,
modified, 114
personal qualities of the patient, 114
Palpation, 110
origin of word, 110
Panacea, 18, 19, 59
Paracelsus
the “bombastic one,”, 99
and Celsus, 109
chemicals, use of, 99
closer to the truth, 108
first judgment is false, 108
Jus Jurandum, 99
not to guess, but to know, 8
Philippus Aureolus Theophrastus
Bombastus von Hohenheim, 108
Index
The Seven Defenses of Paracelsus:
(Against Those Who Would Seek to
Destroy Me), book (1535), 109
vow of, 8, 9
Paré, Amboise
cautery of wounds, 190
hope, 190
ointment, 190
scientific experiment, unintended, 190
Parkinson disease, 87, 145, 146, 176
Parkinson, James
An Essay On The Shaking Palsy
(1817), 177
hypothetical statements, 176–177
paralysis agitans, 176
Pasteur, Louis
chance only favors prepared mind, 178
germ theory of disease, 178
Pasteurization, 178
vaccination against anthrax, 178
Patients facing death
and America’s health care budget, 101
and high-tech medicine, 101
wish to die at home vs. in hospital, 101
Peabody, Francis Weld
caring for the patient, 68–69
good physician, the, 68
Pellegrino, Edmund
compleat physician, the, 48–49
Humanism and the Physician, book
(1979), 49
Pelvic pain, recurrent, 121
and childhood sexual abuse, 121
Penfield, Wilder
Egyptians, fatal mistake, 204
pioneer in mapping the cortices of the
brain, 204
standardization
advance, can halt, 204
regression, does not hinder, 204
textbooks, 204–205
The Torch, book (1960), 204
Percussion
and Leopold Auenbrugger, 111
testing for content of wine barrels, 111
Personal risk, 31
versus professional responsibility, 31
Phalen maneuver, 72, 73
Phenacetin kidneys, 131
renal toxicity, 131
Philanthropia, 48, 58
Phillips, William (Bill)
be there, 75
247
Index
couplet by, 75
Physical examination
classic maneuvers in, 110
inspection, palpation, percussion, and
auscultation, 110
Physicians, 2–18, 20, 21, 24–57, 59–66,
68–71, 73–75, 80, 82, 84, 87, 88,
92, 94–98, 100–102, 107–113, 115,
116, 118, 120–128, 131–134,
136–137, 139, 142–146, 148–151,
153, 154, 157–160, 162–167, 169,
171, 173, 175, 179–181, 184–186,
188, 191, 192, 194–204, 210, 213,
215–231, 233
not a mere moneymaker, 66
as scarce resource, 181, 202, 226, 231
Physician writers
Arthur Conan Doyle, Sir, 70, 117, 118
Michael Crichton, 70
Oliver Sacks, 70
Richard Seltzer, 70, 133
William Carlos Williams, 70, 71, 180, 217
W. Somerset Maugham, 70
Pituitary tumor, 119
bitemporal hemianopsia in, 119
Placing hands on patient, 228
vs. tap of fingers on a keyboard, 229
Plague, 16, 17, 30, 31, 85, 98, 145, 219
of Athens, 17, 30
Plane tree
Hippocrates and, 150
on island of Kos, 150
namesake of Planetree movement, 150
Planetree
community of health-care organizations,
135
patient-centered care in healing
environments, 135
sycamore, 135
web site, 135
Plato
personal gain, by physician, 66–77
professionalism, 66–77
Poetry, 70, 217
in medical journals, 217
Porphyria, 99, 119
Post, C.W., 183
Grape-Nuts, 183
Potato blight of Ireland
Irish Potato Famine, 99
and migration to America, 99
Pott disease, 87
Pott fracture, 87
Pott, Percival
clear and precise definitions of disease, 86
A Treatise On Fistula In Ano (1767), 87
Pott puffy tumor (PPT), 86, 87
Prerogatives of physician, 13
Prescription drugs, abused
antibiotics, 143
opioids and others, 143
Preterm delivery, 121
and maternal stress, 121
Primary care physician(s)
best and the brightest, 228
to choose primary care careers, 227
supply of, 227
associated with improved health
outcomes, 227
world needs more, 226
Privilege
of physician, 12–13
Rudyard Kipling and, 12, 13
Problem-based-learning (PBL), 155
McMaster University School of Medicine,
and, 155
Professional courtesy, 181, 225
Professionalism, 222–25, 39, 43, 47
Blueprint to Assess, report, 3, 22
Professional prerogatives
federal law, 226
Medicare patients, 225
and loss of, 225
professional courtesy, 181, 225
Prolonging life vs. prolonging death, 148
Prospective medicine, 63
Protection, 28, 29, 88, 174
as part of care, 29
Providers, 20, 29, 211, 231
physicians called, 231
Puerperal fever, 95, 156, 219
Q
Qsymia
combination of phentermine and
topiramate extended release, 131
treatment of chronic weight management,
131
Quacks, 183
cereal doctors, 183
Quinine
from bark of cinchona tree, 128
used to treat malaria, 128
R
Redish, Joe
lectures on the web, 155
University of Maryland, and, 155
248
Regimen of Health, 57
Regional enteritis, 87
Relman, Arnold S.
professionalism, 23
profit motive, 15
quality of work, 23
social benefits of work, 23
Report of clinical research submitted to a
peer-reviewed journal, 122
Resident work hours, limited.See Libby Zion
Retainer practice, 231
Rhazes
first described smallpox, 134
Muhammad ibn Zakarlya Razi, 134
natural vitality, 134–135
“Right-to-die” legislation, 148
Oregon Death with Dignity Act, 148
Ritalin.See Methylphenidate
Rogers, David E., 14
Root, William H., 47
founder of Alpha Omega Alpha, 47
Rosenbaum, Edward
“The Doctor” (movie), 107
A Taste of My Own Medicine, book
(1988), 107
Ross, Sir Ronald
Anopheles mosquito, 187
malaria, 187
poem by English poet John Masefield, 187
Rubella, 177, 179
maternal, and cataracts, 179
Rubella, maternal, 179
cataracts, 179
Rush, Benjamin
Declaration of Independence,
signer of, 150, 197
Dickinson College, founder of, 197
disease, one in the world, 196
fever, one in the world, 196
University of Pennsylvania Medical
School, professor at, 196
yellow fever epidemic (1793), 31
Russell, Bertrand
power, 20
social sciences, 20
Russell sign
in bulimia nervosa, 112, 113
Gerald Russell, 113
S
Sabin, Florence Rena
believe that answer could be found, 189
impressive record of “firsts,”, 188
Index
and the pathology of tuberculosis, 189
and Sir William Osler, 188
Saint Bartholomew Hospital, 87
Salvarsan, 37, 186, 189
Compound 606, 189
Sanders, Lisa
Every patient tells a story: medical
mysteries and the art of diagnosis,
book (2010), 211
uncertainty, the water we swim in, 210
Yale-New Haven Hospital, attending
physician at, 210
Saunders, Dame Cecily
care of dying and their families, 102
halt the inevitable, to, 102, 103
hospice and, 102, 103
Scabies, 117
“wake” sign, 117
Schiller, Friedrich, 44, 45
Fiesco: or the Genoese Conspiracy,
play (1783), 44
Schweitzer, Albert
Deschapelles, Haiti, 47
and jungle hospital in Lambaréné,
West Africa, 219
Lambaréné, Gabon, 47, 219
service, 47
Science vs. art of medicine, 11
Scientific papers, 134, 217
and creative writing, 217
Scurvy
among British seamen, 85
among soldiers in the forts in the American
West, 85
and feeding infants boiled cow’s milk, 85
infantile, 85
lethargy, gingivitis, and petechiae, 84
in US Civil War, 85
Sea of Galilee, 51
Seegal, David
eyes more lifted to the stars, 164, 165
preceptor trying to instill educative
principles in students, 164
teaching the teachers, 164
Self-assurance, 64, 65
and surgery, 64, 65
Self-reflection, 57
Seltzer, Richard
amputation of a gangrenous leg, 133
Mortal Lessons: Notes on the Art of
Surgery, book (1974), 133
Semmelweis, Ignaz
accoucheur, 94
childbed fever, 94–95
Index
The Etiology, the Concept, and the
Prophylaxis of Childbed Fever
(1861), 95
mortality in the First Obstetrical
Division, 95
washing of doctors’ hands, 94
Seneca, Lucius Annaeus
concealment of disease, 79, 80
men learn while they teach, 152
Moral letters to Lucilius, 153
power of disease, 78–79
Seneca the Younger, 78, 152
Serotonin syndrome, 201
Service
fraudulent billing for, 222
to others, 33
Severe acute respiratory syndrome (SARS),
210, 211
Sexual abuse, 121
childhood, 121
Shamans, 222
Shaw, George Bernard
Man and Superman, drama (1903), 44, 45
true joy in life, 44
Sigerist, Henry E.
social science, medicine as a, 16–17
trust, 15
Silence, 100–101
and historical clues, 123
Sipylus
in Metamorphoses, poem by Ovid, 91
as source of disease name: syphilis, 91
Smallpox
eradication of
last case of, 90
Somalia, 90
existing samples today, 89
“Vector” laboratory in Siberia, 89
milkmaids and, 88
vaccine, 88
Smith, Theobald
great discoveries, 186
and malaria, 186
Snow, John
Broad Street pump, 92
cholera, great outbreaks of, 92
disease propagated, 92
father of modern epidemiology, 92
Sociophysiology, 69
Spence, Sir James Calvert, 14
essential unit of medical practice, 14–15
Sperry, Willard L.
The Ethical Basis Of Medical Practice,
book (1951), 202
249
ethical values, 202
subordinates the claims of an individual
patient, 202
Theological School of Harvard University,
dean of, 202
Spinal stenosis, 117
Spiro, Howard M.
spinning wool, 166
would-be tailors, medical
education and, 166
Yale School of Medicine, 166
Starfield, Barbara
equitable distribution of health, 226–227
primary care, 226–227
Starr, Paul
power, 20–21
reason, the dream of, 20–21
State of New York Upstate Medical
University, 40
St. Christopher’s Hospice, South London,
England, 103
Stethoscope, 27, 34, 73, 109, 155, 215
obsolete, 73
Stevenson, Robert Louis
as both patient and poet, 43
classes of men, 42
standing above the common herd, 42–43
Underwoods: a Child’s Garden of Verses,
book (1887), 43
St. Mary’s Hospital, 162
Students-as-teachers (SAT) programs, 165
Subjective confidence, factors affecting, 64
Suits, the, 230
do notsee office patients, 231
Sumatriptan (Imitrex)
chemically similar to serotonin
(5-hydroxytriptamine), 147
not prescribe the drug for persons with
basilar or hemiplegic migraine, 147
to treat migraine, 147
Surgeon
ideal
emotion, 133
intensity, 141
self-confidence, 133
intense concentration, 141
as the hallmark of successful
surgery, 141
vs. “medical” doctor, 141
surgical challenge, 141
Suśhruta, 28, 29
faith in physician, 28
protecting the patient, 28–29
Swimming and uncertainty, 210–211
250
Sydenham, Thomas
the “English Hippocrates,”, 83
gout, pain of, 82–83
A treatise on gout and dropsy (1683), 83
Syphilis
blamed on various ethnic groups, 91
congenital, 160
as enigmatic and colorful disease, 91
as “great pox,”, 91
maculopapular rash in, 90
new cases in the United States, 89
origins are obscure, 91
primary and secondary (P&S) syphilis, 91
Szent-Györgyi, Albert, 189–191
discovery consists of, 190
isolated ascorbic acid, 190
and Krebs cycle, 190
what nobody else has thought, 190–191
T
Teamwork, 220–221
Mayo Clinic, and, 220–221
Thalidomide, 161
Therapeutic algorithms, 147
dangers of, 147
Thomas, Lewis
better in the morning, most things are, 206
great secret of doctors, 206
Memorial Sloan-Kettering Institute,
president of, 206
New York University School of Medicine,
dean of, 206
Yale Medical School, dean of, 206
Thucydides, 30, 31
courage, 30–31
To Err is Human, report (2001), 199
Touch, 22, 53, 73, 110, 159, 229
can reach us emotionally, 73
Troubled physician and physician’s
family, 33
Trudeau Sanitarium, 219
Trust, erosion of, 15
Tuberculosis
anorexia in, 121
Korea, and, 121
Turner, Ernest Sackville (E.S.), 222
contract practice, 222–223
Typhoid Mary, 203
Typhus, 99, 124
and Napoleon in Russia (1812), 99
Tyrant
Sigmund Freud, 44, 128, 142
Winston Churchill, 44
Index
U
Ulnar nerve palsy, 117
Wartenberg sign in, 167
Ulysses syndrome
abnormal test result, as earliest
manifestation, 207
an odyssey of testing, 207
and elevated prostate-specific antigen
(PSA), 207
and mass screenings for breast cancer or
coronary artery disease, 207
Uncertainty
as an opportunity, 192
in diagnosis, 192
medical, 192
in severe acute respiratory syndrome
(SARS), 211
Understanding how drugs work, 147
Underwoods: a Child’s Garden of Verses,
book (1887), 43
University of Maryland School of Medicine,
74, 75, 124
US Centers for Disease Control and
Prevention (CDC), 91, 142
Usefulness, of physician, 10, 11
V
Vaccine
and cows, 88
smallpox, 88–89
Varenicline (Chantix), 161
Verghese, Abraham
Cutting for Stone, book (2010), 228
iPatient, 228
Vesalius, 81, 150, 172, 173, 189, 192
Vesalius, Andreas
certainty, saying anything with, 172
De Humani Corporis Fabrica, book
(1543), 172
observations, 172
Padua, Italy, 172
and scientific method, 172
Vicarious experience of ailments, 107
Virchow node, 60
Virchow, Rudolph
healing as ultimate goal, 38
physician as advocate, 38–39
practical medicine, 60–61
Virtual physician, 228–229
patients whom they meet online, 229
Vitality
origin of word, 135
vital signs, 135
251
Index
Vitamin D, 161
Vocabulary
and Dorland’s Illustrated Medical
Dictionary, 217
of physicians, 217
words, combinations of Latin and Old
Greek roots, 217
W
Wakefield, Andrew
autism, 177
The Lancet, report in, 177
retracted, 177
measles, mumps, and rubella (MMR)
vaccine, 177
Wake sign, 117
Waltman, Richard E., 230, 231
Medical Economics magazine article
(2011), 230
Wartenberg sign, 117
Web 2.0
Family Medicine: Principles and Practice,
7th edition, 205
and interactive “book” publishing, 205
as the millionth word in the English
language, 205
Western Journal of the Medical and Physical
Sciences, 36
Whitehead, Reverend Henry, 92
and John Snow, 92
White, Paul Dudley, 126
doctor who cannot take a good history, 126
Whole-patient diagnosis, 114–115
and Sir William Osler, 114–115
Williams, William Carlos
Autobiography of William Carlos Williams,
book (1967), 71
as both poet and practicing
physician, 217
humdrum, day-in, day-out everyday
work, 70
physician and poet, 70
real satisfaction in the practice of
medicine, 70–71
Wisdom, medical, 56, 169
Medical Wisdom and Doctoring:
The Art of 21st Century Medicine,
book (2010), 169
Withering, William
digitalis, 128, 191
and folk herbalist, 191
foxglove, 191
Woodward, Theodore E.
common things occur most commonly,
124–125
hoof beats, 124, 125
human side of profession, 74–75
our noble profession, 74, 182
University of Maryland School of
Medicine, 74, 75, 124
zebras, 75, 124, 125
World Health Organization (WHO), 89
and smallpox eradication, 89
World War II
uprooting of established general
practitioners, 221
incentives to retrain as specialists, 221
Writing workshop for residents, 224
Y
Yellow Emperor.See Huang Ti
Yellow fever, 17, 31
Yellow fever epidemic (1793), 31
Z
Zebras, 75, 124, 125
diagnosis, 125
hoof beats behind you, 124
horse, not zebras, 75, 124
Theodore E. Woodward, and, 74, 124
Zion, Libby
death of, 201
drug interaction, 201
limited resident work hours, 201
New York State Bell Commission
Report (1989), 201
serotonin syndrome, 201