Posts Tagged ‘Medical School’


July 1, 2010

The first time I heard my heart “speak” was in 1977. I figured that it couldn’t speak English, but I knew that it made some type of sound that an expert could understand. I mean, every time I had ever been to see a doctor, one or more people has placed a stethoscope against my chest. Something’s got to be ratting around in there, right?

On my first full day at the University of Alabama at Birmingham (UAB) Hospital my Cardiologist, Dr. Lionel Barjaron, asked if he could “tape” my heart. I was sort of expecting something to do with medical tape, but they lay me on a table and did the usual Stethoscope against the chest routine. But this stethoscope was attached to a microphone, and that was attached to a tape recorder. They thanked me half a dozen times, and told me that the tape would go to the medical school for the doctors-in-training to listen to. My strange plumbing gave off sounds that would tip a doctor to a problem, and obviously the vast majority of hearts are healthy and don’t produce the sounds they were looking for.

“You want to hear what it sounds like?” Dr. Barjaron asked, and turned on a speaker. “WOMB-too,” it kept repeating over and over, the first sound exactly like the word womb and the second sound like the word tooth with the th left off.

And though I hadn’t realized it, this was not the first time I had ever heard my heart speak. I was told that the heart beat – the “lub-dub” sound we are all familiar with – is caused by the valves slamming shut after the heart chambers fill with blood.

A week later it was the same room, and the same stethoscope/microphone.

“We have to do this again?” I asked. It hadn’t hurt, but I figured the recording had been a one time event.

“You’ve had surgery, and now your heart is making different sounds,” Dr. Barjaron responded. “We’d like to record those, too.” As proof he turned the speaker on again. “You hear the difference?”

“Not really,” I said. To me, it was the same “WOMB-too” as before.

“You just haven’t had any lessons on what to listen for, but to me it sounds a lot different from a week ago,” the Cardiologist assured me. “You’ll just have to trust me on that one.”

Maybe it picked up Dr. Pacifico’s  accent, I thought, thinking about my surgeon’s Brooklyn born voice.

So for a while my heart’s voice lived in my body, but also on a tape at the UAB Medical School. It’s probably gone now; that was 1977, after all. And while I own a stethoscope and have heard both healthy and sick hearts speak, I don’t know what they are saying. It’s a subtle language, the language of the heart, and can be easily misinterpreted.

But my heart can say whatever it wants, as long as it just keeps on talking.

Trust me, this won’t hurt a bit!

November 23, 2009

Here’s an excellent article from Harvard Health Publications about do it yourself heart surgery! No medical school education needed and no experience required!
Try it! It’s fun!

No Doctors, no Reform

July 7, 2009

Health care reform in the United States keeps tripping over one fact: We don’t have enough Primary Care Physicians, or PCPs. The PCPs are your “family doctors,” the M.D.’s who aren’t specialists. Really, they specialize in the entire body, providing all types of care and referring to a true specialist when needed. And we don’t have enough of them. In fact, we’re doing as well as we are because the older doctors who are in Primary Care are still working.

No matter what kind of incentives, bonuses, or recruitment tools you offer, there is no quick fix for this problem. Medical school and residency requirements mean that even if you could wave a magic wand and make being a PCP the most attractive medical job in the world, it would still take eight to ten years for the new M.D.’s to start flowing into the system. So we’re going to be here for a while. There’s a proposal – not an official one, but more like a “Wouldn’t it be nice if…” idea – to offer more training to Nurse Practitioners (NPs) and allow them to take on the responsibilities of a Primary Care doctor.  The Happy Hospitalist says no way: NP does not equal PCP, not even close.

So what’s causing the shortage? Debt. When the average doctor knows that he’ll graduate medical school owing $150,000 or more in student loans, who can blame him for specializing? Especially when you know that Medicaid pays 20% to 30% less than what Medicare will pay, and less than half what a private insurer would pay? “In God we Trust, all others must pay cash,” the old saying goes and you can bet that debt collection agencies know that verse very well. No wonder nearly half of all doctors won’t see a patient with Medicaid/Medicare.

So if you think you can “fix” the Healthcare system,  here’s a good place to start.

Do a good deed!

January 14, 2009

First of all, I have to admit to “thinking in the box”, so to speak. Here I am trying to promote Congenital Heart Defect research, and I had never thought of this idea before yesterday.

In my moment of clarity, I picked up the phone and called the Dean of Nursing at my alma mater and volunteered to be a “guinea pig” if any of the classes were studying CHDs. They don’t even have to be studying Heart Defects; perhaps there is a class teaching proper diagnostic procedures. If that’s whet I’m asked to do, I’ll probably throw the students for a loop! As Jack Nicholson said in the movie Batman, “Wait until they get a load of me!”

I know what you’re thinking – I just want to meet nurses! Trust me, I already know many nurses, and most of them count me as a friend. To be serious, if you live near a medical school or nursing school and have any kind of chronic illness, give them a call and see if you can volunteer to participate in one of their classes.

One thing that could be done – you may have to suggest it – is a simple Question and Answer session with the students. Let them ask you what your life is like, and answer honestly. How else are they supposed to learn?

Whenever I go to see my Adult Congenital Cardiologist he always brings a medical student or a younger associate into the examining room. My doctor does the primary examination and then the other person examines me.

“Can you hear the shunt?” my doctor will usually ask, and the student finally admits that no, it can’t be heard. I try not to chuckle, because it is a trick question. If you can hear my shunt, trouble’s brewing.

I don’t mind a poking and prodding a bit. In fact, most CHD Survivors don’t have a problem with it. We aren’t standing on every street corner, and if the younger doctor can learn something – anything – from me, that’s wonderful. He may not know enough to help me, but one day in the future a case may come into his ER that no one can figure out.  When he puts his stethoscope on the patient’s chest and hears a strange beat, hopefully he’ll remember that guy with that weird heart defect that he examined back in medical school.