possible exam questions

What are the basic concepts that distinguish the Hippocratic system, at its core, from much of the medicine that preceded?

-strictly natural phenomenon -centered on the patient -makes sense of illness in the context of patients environment and lifestyle -diseases manifest differently in different individuals -physicians need to have humility and realism

What did Hippocrates teach us about the art of medicine? More specifically, what did he teach about the expectation for physicians? How have some of the modern physicians you learned about this semester extended these ideas further? (Verghese, Goldman, Berwick, etc.)

1. Alleviate a patient's suffering 2. Reduce the severity of illness 3. Recognize & refrain from treating the untreatable (at least do no harm) -Realism and Humility

Gawandes meaning for Being Mortal

1.The modern experiences of mortality 2.How medicine may have gotten it wrong as it evolved and that it forces the wrong ideas and experiences of life on patients by prolonging their lives and often ignoring the quality of their lives and what matters to them 3.What it is like to be creatures who age and die

What scientists in Adler helped advance our understanding of the heart?

Erasistratus: understood bloodflow and circulation. understood the heart was a pump Nafis: the movement of blood Harvey: put numbers to the amount of blood expelled by heart. wanted to pin down the beating and pulsing of ateries

Who were the other greeks you learned about in Adler & what were their contributions to medicine? What enhanced or stymied medicine at this time?

Herophilus: known for describing organs, organ systems, and nerves. first to describe two parts of the brain(cerebrum and cerebellum). made analogies of systems to things he knew. linked the beating of the heart to the pulse. first to describe male and female urogenital organs. Erasistratus: wanted to explain how organs functioned. was mostly wrong but was the first to understand the heart was a pump. Enhanced or stymied medicine: there were great arguments between both of their students meaning no progress was made in medicine. great fire of alexandria caused significant loss of knowledge. death of cleopatra. quest for knowledge evaporated.

"A Story I Hope Ends Up Being True" by Wendy Stead, MD 1A) Would you consider this to have been a successful encounter between the physician and patient? Why or why not?; 1B) Was there progress with the patient's diagnosis and treatment? 1C) Did healing take place (and what does that mean, then?)? 2) What did the patient do for the doctor that was so meaningful for the writer?

I would consider this a successful encounter between the patient and the physician. I believe this because, the article, describes how the patient was grateful for Dr. Stead having a genuine conversation with him. Even though she could not make progress on his diagnosis and treatment, she healed emotionally, by uplifting his mood. The patient impacted Dr. Stead deeply with their conversation; he gave her a sense of gratitude for the small moments in life. Dr. Stead knew she could not help him with his treatment, but thinking back on their conversation, she realized she helped him mentally. She reflected on how he could have felt versus how he felt; realizing his positive mental state even in his diminished physical state.

"The Good Physician" by Ragina Bhadule, MD 1)Why did Dr. Bhadula do a poor job with her patient, Mrs. K? What was missing? What would she need to learn to be a better physician? How could she learn it? 2)In this context, how would you describe, in your own words, the "art" required to be a physician (or a nurse, nutritionist, occupational therapist, etc., if one of those speaks more to your interests)?

In the text, Dr. Bhadula treated her patient like a name on a list. She had a script set in her head and followed it throughout the visit; rather than trying to interact with Mrs. K on a personal level. Dr. Bhadula needs to learn that there is no step-by-step instruction manual when interacting with a patient and it is important to build a connection with them during their visit. If she had done so, she would have received the same information that Dr. S did, during his interaction with Mrs. K. She can learn how to create a more personable experience for her patients through this interaction she had and from shadowing other healthcare professionals. The more obvious "art" required to be in healthcare as outlined in the text is, "dedication, compassion, and curiosity"(Bhadula). However, Dr. Bhadula's poor interaction with her patient outlined another "art" required to be in healthcare. When working in healthcare, it is important to be able to have interpersonal relationships with your patients. You need to make them feel heard and acknowledged, rather than just another name on your list. The "art" of healthcare not only means to be compassionate, curious, and dedicated, but also empathetic, resilient, knowledgable, and can be interpersonal with patients.

Name and describe a scientist in Adler who helped advanced women's health and wellbeing? (Hint: There are two, can you name them both?)

Soranus: the birthing doctor. wrote 4 books extensivly on pregnancy, birth, delivery, gynecologic disease, infacy, and general patient care. described how to handle a breech birth. authored the first biography of hippocrates. raised the 'art of differntial diganosis' to a new level.

"Learning to Breathe" by Elizabeth Levin, MD 1) What's the balance between support for patients and support for yourself? 2) Now that you've witnessed a few opportunities to experience moments for being mindful (for example, in the MIndful Moments before class) and the input from these kids, how might you envision the benefits of this when working inside Emergency Rooms and Intensive Care Units (or anywhere that we are in service to others)?

The balance between support for yourself and for your patients requires you to know your limits. It is important to know how much you can handle emotionally before you start affecting your patient's emotional mentality. As we saw in the article, Dr. Levin pushed herself past her limits and increased her patient's emotional distress. Knowing your limits will allow you to keep a balanced mind, thus allowing you to further support patients without affecting your mental state. Being mindful and having the ability to take a break from the stress of the real world can be extremely beneficial when working in high-stress environments, like the ICU or ER. With the ability to be mindful you can disconnect from your environment and the stressors affecting your mental state. By doing so, you can, in turn, provide better quality care for your patients and have a more refreshed mental state.

"To Isiah" by Don Berwick, MD, 1) What is the main message of the article? 2) In what ways did Dr. Berwick demonstrate the art of medicine?

The main message of the article and how the article exemplifies the art of medicine coincide. Throughout the article, Dr. Berwick exemplified his relationship with Isaiah, both medically and personally. He used the connection he formed with Isaiah to exemplify that doctors can learn from their patients. From Isaiah, Dr. Berwick learned to, "be worried, but do not for one moment be confused. You are healers, everyone, healers ashamed of miseries you did not cause. And your voice everyone can be loud, and forceful, and confident, and your voice will be trusted" (Berwick). Looking at the lessons Dr. Berwick learned, the main message of the article is that medicine is about more than just treating the patientThehe art of medicine is exemplified by his compassion and continuous drive to help Isaiah.

What physicians have you encountered this semester that have deepened your understanding of the doctor-patient relationship? Who are they & what did they teach you?

Verghese: A physical exam is a ritual. it's a privilege and an important skill beyond diagnosis. benefits the patient and the provider. Being able to connect to patients and performing his "rituals". physician's true role is to observe every aspect of the patient and put them at ease Goldman: completely denial of mistakes-errors can happen everyday-mistakes are inevitable-rewarded for coming clean for our mistakes-"Do You Remember"-We are wrong in our medicine because we do not give ourselves time to think Gawande: 1.) Find your failures 2.) Devise solutions 3.) Implement solutions with help from everyone with humility, discipline, and teamwork, creating systems that work like a pit crew and not cowboys Remen:

Who is Galen? What observations can you make about his impact on medicine? What factors influenced the progress of medicine during Galen's time?

formidble voice and presence in medicine. dominating personality. wrote many books. influenced ruling class in rome and greece. his ideas persisted 1500 years after him. forced medical knowledge idease forwards without hman-related evidence.

How did the advancements of the Renaissance influence Vesalius' contributions to medicine?

he had artists draw anatomical figures for his book.

What did Hippocrates teach us about the art of medicine? More specifically, what did he teach about the expectation for physicians?

humility: risks and limitations of their knowledge of medicine realism: not all knowing and all powerful, not omniscient

What are some of the ways medicine needs healing? Put another way, what are some challenges to the profession of medicine?

impact of medical curriculmu, high volume care reults in less time with patients, use of technology produces results in more charting, adminstrive task, and communication. increased rate of burnout across all medical professions.

Personality, geography and family upbringing shape and influence many scientists in Adler's medical first. Choose one scientist and describe how their personality, geography and upbringing contributed to this person's ability to advance medicine.

vesallius: lived by gallos and took bodies to dissect Paracelcus: mother comitted sucide at age 9

Who was Marcus Varro? What did he do to help medicine evolve?

wrote the book On Farming and revels his ideas for germ theory.