Medicine, books and insanity

Posted at Dec 14, 2008 4:39 pm

It looks like I’ll be starting work in mid-January after I come back from my two weeks in Atlanta. This trip was planned months ago and I can’t change it now. Don’t really want to anyway because I’m looking forward to seeing my friends (and making some money, finally).  I wish I could relate some experiences of the medical system from the doctor’s perspective but that will have to wait.  However, speaking as a patient and the mother of three little patients, I must report that I am pleasantly surprised. Whatever you might say about the bureacracy here(and you could say a lot)  medical care in Israel is not broken at all, like so many people warned me. Quite the opposite, in fact. We have been to several doctor’s appointments since we got here, had bloodwork, X-rays and specialist referrals and I have found myself repeatedly impressed by the efficiency and dedication of everyone I’ve met.  In every case, actually, I thought it superior to what I have experienced in the States.  Now granted, I did not require a complicated procedure or a specialized test like an MRI or PET scan so I cannot attest to the wait times or out of pocket costs associated with higher levels of care. But the computerized charts and radiology slides which Obama mentioned in one of the debates are already a reality here. Hopefully, in a few months I can report on the other side of the coin but, in my experience, satisfied patients make for more relaxed doctors.  I used to hate seeing families in the ER after they had been waiting for three hours.

I am on page 400 -something of Wally Lamb’s novel, I Know this Much is True.  Which is less than half-way through that 900 page beast.  I still can’t decide if I like it, actually.  The writing is excellent, of course.   I wouldn’t be on page 400 if it wasn’t.  It’s just that I hate the narrator so much. And yet he is so fascinating, I just can’t look away.  More importantly, his schizophrenic twin has my attention.  I will never get tired of the wire taps embedded in his teeth and the tin foil "mind shield."  I had a hard time turning away from psychiatry because I love this stuff so much.  What really intrigues me is the fact that the delusions of paranoids follow identical patterns, within a given societal context. How does that happen? I only spent a month on the psych ward but the notes I took were all the same.  The same exact thoughts over and over.  It’s terrifying, actually.

I had an experience on the wards once, which I will never forget. I was in my fourth month of clinicals and had just started on the inpatient unit.  With all the naive excitement of a 3rd year med student I was thrilled when I was assigned to talk to "Jim" a "frequent flier" on 11W.  He was very open with me, shared all his thoughts on the aliens which were taking over the Earth, the TV messages, the conspiracies.  I took it all down, pages of this stuff.  I was so pleased that he was sharing his paranoia, and even wondered aloud why he felt he could trust me, and why he refused to speak to any of the psychiatrists in the hospital.  
"You’re new," he replied candidly. "The aliens haven’t gotten to you yet."
  I wrote this down as well and then forgot about it.  When I greeted Jim on my rounds the next morning he didn’t respond, but glared at me with such an intensity that I found myself backing away.  "Have they gotten to me–?" I began, and stopped, as his narrowed eyes scanned and then dismissed me.  
I never heard another word out of Jim during the remainder of my short stay on 11W and I never forgot how small he made me feel.


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