Diagnosis Narratives and the Healing Ritual in Western Medicine by James Peter Meza

Author:James Peter Meza [Meza, James Peter]
Language: eng
Format: epub
Tags: Social Science, Anthropology, General
ISBN: 9781351804981
Google: GjZlDwAAQBAJ
Publisher: Routledge
Published: 2018-07-17T04:44:46+00:00

The constant conversation and gesturing about surgical techniques was always part of the daily discourse in the life of a resident. They are learning their craft – surgical skills. They also have to learn cognitive skills. On Friday mornings, there is a conference at the residency office attended by a couple of attending physicians and the residents, followed by an unstructured learning session for residents led by the chief resident. The typical format for this would be to review board questions from a board exam preparation book.

The pretense for the meeting was to study. They asked questions from a textbook. They would intersperse clinical case discussions with test questions and socializing:

In contrast to the admiration and banter with their own faculty, they discussed the strengths and weaknesses of private attending physicians with an almost mocking perspective. They said things like, “He went crazy on me” or “That was when I was the most uncomfortable, when we went in to see a guy dying from cancer and [this particular attending physician] said, ‘Hey you’re dying of cancer. How’s life, huh, big guy?’ ” or “He’s the best one to be on call with. He’s an Iron Curtain.”

They were also joking about the attending, and one of the residents had asked a particular community attending, “How do you do a hydrocoele?”4

The attending replied, “I open the scrotum. I take it out.” The resident was aghast that he didn’t have any particular procedure and was unfamiliar with a particular named procedure that Dr. Patel uses. When the resident questioned the community attending, he reportedly said, “I don’t know what you’re talking about.”

In addition to sharing surgical techniques and medical management knowledge, the topic discussed the most was the amount of surgical experience each of them had, and how they could get more experience. A junior resident said, “I beat him by an hour [arriving at the hospital], so I did the surgery and I was actually leaving by the time the senior resident got there.” Another resident pointed out, “The next senior should get there late, because I want a chance to have opportunities [to do such big surgery] myself.”

Another resident said, “I saw an autotransplant. It was a sweet case. It failed miserably.” This willingness to gain experience without benefit to the patient was echoed by another resident’s comment, “We have to do a stat prostatectomy before they diagnose the lung cancer.”5 The residents talked about a retroperitoneal varicocele6 repair and the senior residents said, “What’s the plan for that case? I plan on scrubbing, but if one of you guys wanted to do it, I’ll walk you through it.”

“He let you do one of those?”

The senior resident said, “Those guys [at an affiliated hospital] are open surgeons, so they are more comfortable letting you do things that are open, because they know that they can get you out of trouble. They are less comfortable letting us use the robot. That’s totally different with Dr. Jeffries.” They talked about the different robotic surgeries

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