Faculty Bibliography

Danielle Ofri reviews "Working Stiff: Two Years, 262 Bodies and the Making of a Medical Examiner," by Judy Melinek and T. J. Mitchell

Mr. V. needed to take 90 of those pills each month for the high dosage that his blood pressure required. Representative No. 4 asked me to list all the blood-pressure medications that Mr. V. had been on in the past, including dates of initiation and relevant lab values, a request of epic proportions in his case

Countless times it is only during physical exams that patients have brought up their true concerns - domestic violence, suicidal ideation, job loss, eating disorders, sexual concerns - things that seemed awkward during the computer-dominated Q&A of the first half of the visit. Even if the physical exam may have less diagnostic utility as in years past - though this is certainly a debatable point - it still plays a critical role in medicine

A 2005 outbreak of the norovirus stomach bug in a nursing home highlighted the role of medical personnel in spreading communicable disease. The most disturbing aspect of the case was that medical staff members continued to come to work while ill, well into the outbreak, despite strenuous and public exhortations to stay home

The bottle of Maalox sat perched on the triage desk in the emergency room. It was mint flavor, or maybe lemon -- I don't recall exactly -- but it shimmered temptingly. I had just finished with a new admission, and my stomach had been groaning ominously for hours. It was after midnight, the whole night was still ahead of me, and I was getting desperate. I scribbled the last of my medication orders and snagged the Maalox bottle, popping the top and chugging two revolting capfuls on my way to the elevator. A survey of British doctors back in the '90s found that 87 percent of G.P.'s said they would not call in sick for a severe cold (compared to 32 percent of office workers who were asked the same question). In Norway, a 2001 survey revealed that 80 percent of doctors had reported to work while sick with illnesses for which they would have advised their own patients to stay home. Two-thirds of these illnesses were considered contagious. As much as we empathize with our patients, part of protecting our inner core may require drawing an unconscious demarcation between "us" and "them." I can recall, as a resident, the palpable relief of leaving the hospital at the end of a long night, something I generally thought about in physical terms -- getting out of grubby scrubs, the promise of a hot shower and edible food. But it was more than that: There was also the awkward relief of leaving behind the graphic reminder of what could befall my own body. Somewhere, deep down, I needed to convince myself that we doctors were a different species from our patients