The Medical Record
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A collection of personal essays, “The Medical Record” is an exploration of my life in medicine. It has three primary goals. First, to portray an accurate account of my training and practice as a female physician, with all its difficulties and rewards, through interrogating real and false narratives about myself in particular and women in medicine in general. By contrasting what I believe to be an objective recitation of facts with the subjective story as I experienced it, I hope to show how the loss of narrative in the practice of medicine has left us unable to care for ourselves or others. Second, my stories illustrate how physicians are their own worst enemies, offering themselves and their peers none of the compassion and understanding given to patients. Through examination of how I dealt with my own illnesses, and how those illnesses were handled by my superiors and peers, the dysfunctional way in which physicians deal with human fallibility becomes clear. We create and believe false narratives about both ourselves and our patients, and this influences our expectations and outcomes. Lastly, I want to emphasize the importance of story in caring for patients. We have lost a valuable tool by resorting to reimbursement and metric-based check-lists for our patients’ histories, and this has affected our empathy and compassion as well as hampered our ability to think outside protocols for the correct diagnosis. Recognition and understanding of these things came at a great cost to me. By sharing these stories, I would like to change the adversarial way that society views physicians, and alter the way in which doctors and patients see each other. Only then can we have the health care system we both deserve and desire.
Table of Contents
Introduction -- Entry 1 - Chief complaint/history of the present illness -- Chapter one -- Entry 2 - Review of systems -- Chapter two -- Entry 3 - Past Medical History -- Chapter three -- Entry 4 - Social and Family History -- Chapter four -- Chapter five -- Chapter six -- Entry 5 - History of the Present Illness, Part II -- Chapter seven -- Entry 6 - Assessment and Plan -- Chapter eight -- epilogue