How Doctors Think

Introduction
I choose the book "How Doctors Think" because I wanted to see how doctors thought and how their decisions are influenced. This book is a non-fictional novel detailing events doctor and patients experience. Doctors encounter many pre-diagnoses before they narrow down to one the diagnosis that best fits the patient's symptoms.

Description
In "How Doctors Think", Jerome details how doctors diagnose patients. He explains that doctors diagnose because of perception, past experiences, and communication. He expands on the crucial moments where the doctors make snap decisions and sometimes misdiagnose the patient. Some sudden diagnoses are correct and the patients go on living; however others are incorrect and put patients in critical positions.
Each chapter details a different patient presenting different symptoms, causing the physician and the readers to hazard guesses as to the particular disease state that the patient is experiencing. Once the diagnosis has been chosen, the treatment is initiated, and the physician then watches the patient to see if the patient improves. If the patient does not improve, the physician then modifies his diagnosis to a different one, and changes the treatment accordingly. Once again, the physician has to wait and watch to ensure that the symptoms are decreasing or subsiding.
This book proves that medicine is not an exact science even though we know much more than we did even five years ago. The fact that the physicians often made several diagnoses before arriving at the correct one establishes that both the physician and the patient need to remain patient when encountering a unusual set of symptoms.




Critical Opinion
The medical information given in this book is up to date and as far as I can tell, in my non-medical opinion, accurate. The information that is not medical is also current.

Personal Opinion
I would recommend this book to my classmates. The book was interesting to read because it allowed me a glimpse of how doctors think and how they are led to the diagnosis of the patient. It also showed me how doctor-patient relationships are developed. I agree with the author's opinion that when physicians make hasty decisions in order to make their patients feel better more quickly, it often results in erroneous diagnoses. Doctors often see many patients during their day, and do not always have the luxury of taking a long time to make a diagnosis on each patient.


Personal Vocabulary
1- Atrium- central hall with glass roof; open central courtyard; cavity or chamber in the body
2- Ventricle- Two lower chambers of the heart; any four interconnected cavities in the brain; small cavity or chamber in the body
3- Xiphoid- a small cartilaginous extension to the lower part of the sternum, which is usually ossified in the adult human
4- Bolus- a dose of a drug given quickly by intravenous injection; a very large pill; a soft round ball, usually chewed food
5- Ambu- a bag valve mask that is used to help a patient's breathing. Usually used before a mechanical ventilator is used.
6- Menopause- the time in a woman's life when menstruation diminishes and ceases, usually between the ages of 45 and 50
7- Obstetrics- the branch of medicine that deals with the care of women during pregnancy and childbirth, and for some six weeks following delivery
8- Atherosclerosis- a common arterial disease in which raised areas of degeneration and cholesterol deposits form on the inner surfaces of the arteries.
9- Gestalt- a set of elements such as a person's thoughts and experiences considered as a whole and regarded as amounting to more than the sum of its parts
10- Chondrocalcinosis- a rheumatologic disorder with varied clinical manifestations due to precipitation of calcium pyrophosphate dihydrate crystals in the connective tissues
11- Hematologist- a branch of medicine that deals with the study of blood, blood-forming organs and blood diseases.
12- Synovium- a thin layer of tissue that lines the joint space.
13- Staph- It is a type of infection caused by a Staphylococcus bacterium. Some strains of the bacteria are resistant to strong antibiotics.
14- Adriamycin- a chemotherapy drug that is used to treat bladder, breast, head, neck cancer and leukemia
15- 5-Azacytidine- demonstrated to have a wide range of anti-metabolic activities when tested against cultured cancer cells and to be an effective chemotherapeutic agent for acute myelogenous leukemia. However, because of 5-azacytidine's general toxicity, other nucleoside analogs were favored as therapeutics. The finding that 5-azacytidine was incorporated into DNA and that, when present in DNA, it inhibited DNA methylation.





Personal Reflection
I learned that a doctor's work is harder than it seems in providing care to patients. Sometimes television glamorizes the medical field and the roles of doctors, nurses, and other health care workers. Unfortunately, much of the practice of medicine is inexact, and certainly not always glamorous. I also discovered that while medicine can be rewarding in it's own right, it can also be incredibly frustrating. The continual re-evaluation of a single diagnosis when a patient does not respond to the treatment is consuming.
There are several different specialties within the medical field that have caught my attention-oncology and obstretrics and gynecology.
I learned that I may want to become an Oncologist. I did not have my mind made up about this different specialty until I read about oncology in this book. Oncology seems like a challenging specialty. I think that I would enjoy the special rewards in treating a patient and changing their life. Technically speaking, life-changing events would occur when treatment is successful.
The other specialty that I find interesting is obstretrics and gynecology. My grandfather is a retired OB-Gyn physician. He loved delivering babies best, as he found the miracle of birth most intriguing. He also told me that most of the time, an OB-Gyn physician treats healthy patients.
I realize that these two specialties are very different. Both will be rewarding in their own way. Once I am in medical school, my perceptions may change completely, and I may pursue a completely different specialty.
Each doctor's specialty seems rewarding, but each are different and some are not really of interest to me. As I read the book, my perceptions about oncology changed. I initially thought that oncology would be very sad and depressing, but my ideas were changed while reading the book. The author showed me that oncology treatments can save patient's lives and cancer is not always a death sentence.
I would certainly recommend this book. I like the mystery of medicine, and this book engaged my interest in medicine to a greater degree.

Jerome Groopman does a great job in describing his experiences with medicene in his early years, till now. He shows us how many doctors go through a thought process with each patient and how this repetitive process can lead to miss diagnosing. We get a true feeling of what it's like being a doctor and what they go through on a daily basis. This book isn't only for students going into a medical field, and medical workers, but anyone who has been to a doctors office and wanting to learn more about their practices. I must admit though it is filled with many medical terms and situations which can be confusing if you aren't familiar with them. But overall it's an interesting book worth the read.

This book is a must read for all doctors in practice. Dr. Groopman is sympathetic to the needs of the patient and to the failings of the current way of teaching medicine in this country today.

This book is just what my doctor ordered; it affirmed my feelings about 'new' medicine. It lets us know that doctor's are human beings, and they can make errors. It also explains the need for people to question their doctors, and to keep questioning until a doctor listens!

This book could be an insightful read for the non-physician, but as a training physician, it felt repetitive. Actually it felt as if I was sitting through one of my "patient communication" courses or physical diagnosis courses. The writing was below average and a far cry from his other works.

Revealing the process a physician uses to arrive at a diagnosis (be it the right one or wrong one), this book would be great for those thinking about medical school or just want to understand how the medical thought process works.

The book reminds us of many of the pearls we learned in medical school such as if we listen close enough to our patients they will diagnose themselves. I wouldn't recommend this book to any one of my peers but wouldn't mind if some of my future patients read it. It could help empower patients in their care.