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« AFGOs | Main | A Cost of Cognitive Deficits »

June 06, 2013


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Bill Kleine

The good doctor. It is always very tempting to take the easy way. The specialist gives a definitive opinion. How easy it would be to simply go with it. I analyze medical records for a living. Some doctors are cooks--they follow a recipe. Others are like chefs, they weigh the subtle carefully. If the recipe was wrong, it's not the cooks fault. A "doc in the box" would be much better at that sort of medicine. No, hard as it is for me to believe I know my "master chef" makes mistakes every day, but it is life and death when you're dishing up portions of poison for a living. I do not know if Van is religious, but I am certain he has great faith; an inner certainty his decisions were weighed with care, compassion, dare I say love? Cooks have no passion for their work; they just flip the burgers. I can tell you many ICD's never record an event. A recent patient had a profound event during a gallbladder surgery. They wanted to implant immediately, but told her the event may have been triggered by the anesthesia [unclear etiology sounds better than "I don't know"] and left the decision to her. She decided with her feet. Years later, she's refused curative tumor surgery. I'm doing a second review because we denied her for failure to pursue medical treatment. It is good patients are now encouraged to be involved in our care, but we are not qualified to prepare a delicate chiffon; we aren't even qualified to flip the proverbial burger. I know just how much I don't.

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