A Journey Through Medicine: A Doctor's Lessons from His

A Journey Through Medicine: A Doctor's Lessons from His

A Journey Through Medicine: A Doctor's Lessons from His Patients Reflecting Medical Practice During the Mid and Late Twentieth Century ➛ [KINDLE] ❅ A Journey Through Medicine: A Doctor's Lessons from His Patients Reflecting Medical Practice During the Mid and Late Twentieth Century By Robert A. Green ➥ – Capitalsoftworks.co.uk For those readers who love reading nonfiction medical stories this book is for you Dr Green has written his story chronologically covering over 50 years of medical history Dr Green tells a compelling For those readers who love reading nonfiction Through Medicine: PDF/EPUB ä medical stories this book is for you Dr Green has written his story chronologically covering over years of medical history Dr Green tells a compelling story as you meet the physicians he works with the patients and their families the background details and all the descriptions of places and people He takes you through the thinking process of making a diagnosis and this is the biggest surprise of allhe tells us when his thought process maybe didn't go uite accordingly A Journey MOBI :Þ Yes he made mistakes errors if you will a turn of events but he learned lessons from them all Dr Green is imparting these lessons to the future physicians that will care for all of us LEARN FROM MY MISTAKES but most of all remember to LISTEN RESEARCH OBSERVE and expect the unexpected just so you can be prepared Sometimes things don't go according to plan; this is where we learn our lessons.


2 thoughts on “A Journey Through Medicine: A Doctor's Lessons from His Patients Reflecting Medical Practice During the Mid and Late Twentieth Century

  1. Rachelle Urist Rachelle Urist says:

    Review for September 2015 issue of the Washtenaw Jewish NewsBob Green came to Ann Arbor in 1958 and stayed He was a brilliant physician who specialized in pulmonary diseases He played the violin He was erudite He was also a fine actor and appeared in many Ann Arbor Civic Theatre productions He was a deeply thoughtful mensch Bob died last April shortly before his 90th birthday He is sorely missedAbout ten years before leaving us he compiled a set of medical vignettes organized in chronological order It offers a glimpse into the world of medicine and the inner life of Robert A Green MD The book’s title is A Journey Through Medicine The book’s subtitle A doctor’s lessons from his patients reflecting medical practice during the mid and late twentieth centuryWhat comes through is not just a sampling of late 20th century medicine as experienced by a talented and caring physician but a look at the myriad ways in which medicine is practiced Every MD has her own personality and his own style Physicians consult with one another and medical care carries many imprints Bob Green was an exceptionally astute and sensitive professional The book traces the development of his self confidence which may come as a surprise to those who knew him He seemed born to shine Bob entered Harvard as a freshman after attending public schools in Brooklyn NY He served in the military did residencies in both Pathology and Internal Medicine and as part of his stint with the US Public Health Service he was in charge of a tuberculosis sanatorium in Talihina Oklahoma under the Bureau of Indian Affairs In the mid 1950s he was in charge of the Pulmonary Diseases Section of the VA Hospital in the Bronx In 1958 he came to Ann Arbor to head the Pulmonary Service at the VA Hospital a position he held until 1972 Through those years he taught Internal Medicine at the University of Michigan medical school and for eleven years was the school’s Associate Dean He was esteemed as both doctor and teacher and was honored for both In 2008 he received the last of many awards the Will Ross Medal granted in recognition of significant contributions to the prevention and control of lung disease It is the most prestigious award bestowed by the American Lung Association Bob had a literate and literary approach to life This is evident in the various aphorisms he coined in his teaching “Frame that Asymmetry” was taken from William Blake’s poem The Tyger The injunction was meant to help students recognize the need to examine the why and how of asymmetries in the human body Do they spell disease? Genetic oddities? In dealing with cases of tuberculosis he noticed the strange euphoria that often preceded death He concluded that this phenomenon might explain the death arias in for instance La Traviata and La Boheme While working in Talihima Oklahoma he conducted autopsies in a local mortuary whose undertaker became his friend and helpmeet This undertaker bore a physical resemblance to Santa Claus But when the jolly undertaker turned out to be racist Bob found himself contemplating Hamlet “There are things in heaven and earth Horatio than are dreamt of in your philosophy”Bob did not need the bard to tailor old saws He was eminently capable of crafting his own memorable phrases Take the saying “When you hear hoof beats think of horses not zebras” a standard admonition meaning “don’t get too fancy” Medical students are taught to recognize patterns Bob underscored the dangers of showing off esoteric knowledge when making diagnoses To the horseszebra saying Bob added “but if you see an euine animal with stripes it is likely to be a zebra than a horse in striped pajamas” underscoring the fact that patterns like rules bear exceptions He also appreciated and adopted the colorful language of some of his folksier colleagues After stumbling toward an accurate diagnosis one farm raised fellow physician said “Even a blind hog turns up an ear of corn every now and then” Bob Green drummed into his students the singularity of each patient and the importance of physical examination in diagnosis He had little patience for brazen pronouncements made by hifalutin doctors Twice he mentions the radiologist in Boston who displayed a stethoscope with the label “A medieval instrument formerly used in the diagnosis of chest disease” As far as Bob was concerned hands on examinations including stethoscope and palpation were not out of date no matter how sophisticated the MRI or the CT or PET scans He emphasized the importance of reading a patient’s history He was wary of pretention He shunned omniscienceHe listened to patients He asked uestions When patients presented with mysterious symptoms he inuired about personal crises or accidents or allergies He also stressed the importance of trusting what the patient says When a patient was certain that a certain treatment would kill her—even though the treatment was known to be benign—Bob learned to respect his patients’ instincts In regard to the oft used notion of “patient compliance” a term that can be abused Bob was adamant that the doctor and patient must work together He did not believe it was the doctor’s place to issue injunctions Bob Green considered the “personhood” of his patients not just their illnesses He writesMedicine is a hard master Hippocrates said it millennia ago Life is short the Art is long opportunity fleeting experience misleading judgment difficult His warning was surely correct particularly when judgment is clouded by emotion or bias But then he added “The physician must not only be prepared to do what is right himself but also to make the patient the attendants and externals cooperate” And this is where I might disagree with my sage mentor Hippocrates Sometimes “to do what is right” is not to “make the patient” cooperate but instead to listen to a patient’s own instinctsIn his book Bob Green takes us through many cases leads us through diagnostic conundrums and shows us how he solved many of his medical puzzles He explores the challenge and adventure of each process He calls his method “the logical principled approach” stressing the importance of films x rays especially old films and the benefits of comparing old and new films to see the trajectory of a condition Is the shadow in the lung new? Or was it there a year ago? Every case is a teaching tool and each is a free standing story But the reader does well to read them all straight through to get the sweep of the journey Since most of us at some time or another are confronted with “med speak” and find ourselves trying to pronounce the names of ills and pills that once gave pause it is amusing to read this easy prose that so effortlessly combines medicalese with collouialisms Here’s a good example “I diagnosed his condition as recurrent pneumonia complicated by hypertrophic pulmonary osteoarthropathy HPO” I laughed after reading that sentence Then upon seeing what follows “The name is a mouthful” I laughed even harder There are many multisyllabic medical terms one can look up let’s hear it for iPhone dictionary apps although one can read and enjoy the book without knowing how to pronounce or define every Latinate word For Ann Arborites there’s additional fun in coming across familiar names Bob consulted with Dr Barry Gross “an exceptional diagnostician” Dr Milton Gross too is cited for his proficiencyDr Bob Green repeatedly invokes the Hippocratic principle do no harm He cites several cases where leaving well enough alone doing nothing would have been preferable to pro active care But he also leaves us with examples of his outsize caring that saved patients from harm The book has been touted by physicians as a must read for every medical student I would add that the book is well worth reading by anyone who may ever need medical care It is sobering to recognize the trials and tribulations of our physicians It is important to recognize too that doctors benefit when their patients assert themselves For patients who have established a collaborative relationship with their physicians medical treatment can be a shared venture


  2. Melissa Storm Melissa Storm says:

    Let me approach this article purely as a review of a great story that I recently read Yes the story for once is a personal memoir not my usual fiction It was written by a local to my native Ann Arbor author a man with a whole world of experiences Let me tell you just a little bit about this charming book and what it meant to meTo start you must allow me to self disclose as someone who has a severe mistrust of physicians and of modern day medicine in general When an ailment settles upon me my first course of action is always to do nothing—if something must be done I will try a home remedy or search online for a treatment option But I will never visit a doctor My extremeness in this scenario is a large part of what motivated me to agree to read and review Dr Robert A Green’s “A journey through medicine A doctor’s lessons from his patients reflecting medical practice during the mid and late twentieth century” I liked the idea of reading about a physician humbled one admitting that as my father likes to say “medicine is a practice they haven’t got all of the answers yet”A departure from my normal menu of classics classics and classics “A Journey through Medicine” was a breath of fresh air I enjoyed the vignette arrangement which allowed me to pick up and put down this book easily at my leisure I found myself learning while I read and not the normal points from my novels such as gads of information about the French Revolution or about turn of the century etiuette but about topics that—had I not read this book—I probably never would have learned anything about In fact midway into the text I posted as my personal status update on Facebook “I think that the doctor book I am reading just might be making me smarter I think I could now possibly diagnose miliary tuberculosis” While I was only joking please don’t come to me if you are actually sick the memoir definitely had a didactic uality to itSome of the anecdotes were a bit too technical for my non medical mind but many others could have been easily understood by the layest of laypeople My favorite story is entitled “Panic” and can be found on page 88Early in his career as a pulmonary specialist Dr Green was working at an Indian Hospital servicing a population that mid century was strongly affected by tuberculosis in Oklahoma Since only two other doctors besides himself were available at this facility he had to be prepared to handle any case that came into the hospital One day a young white farmer called him asking for help since his usual doctor could not be located and his wife was going into labor with their first child Dr Green allowed the couple admission into the birthing suite at the Indian Hospital When the baby was born it had a “deathly white pallor”Panicked Dr Green prepared to deal with the seriously dangerous condition of asphyxia pallida—a severe lack of oxygen caused by a pre birth illness which usually means that the infant may become seriously ill or die After being bombarded by a fleet of racing thoughts in attempts to identify the best course of action Dr Green “finally realized that the ‘problem’ with this child was it was white Up to now he had been delivering only dusky healthy reddish dark skinned Indian babies and the contrast with this blond Caucasian infant was startling” That made me laugh audibly during my reading session which normally has a morgue like uiet to itDr Green’s admission of error and willingness to try new approaches coupled with his genuine concern for patients sometimes even years after having treated them helped me to see that perhaps not all medical professionals deserve my mistrust While having read this memoir probably won’t send me running to a doctor next time I am bed ridden with some ailment or another it will help me to consider the alternative just a little bit longer before readjusting my hot water bottle curling up in a ball and trying to sleep it off


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2 thoughts on “A Journey Through Medicine: A Doctor's Lessons from His Patients Reflecting Medical Practice During the Mid and Late Twentieth Century

  1. Rachelle Urist Rachelle Urist says:

    Review for September 2015 issue of the Washtenaw Jewish NewsBob Green came to Ann Arbor in 1958 and stayed He was a brilliant physician who specialized in pulmonary diseases He played the violin He was erudite He was also a fine actor and appeared in many Ann Arbor Civic Theatre productions He was a deeply thoughtful mensch Bob died last April shortly before his 90th birthday He is sorely missedAbout ten years before leaving us he compiled a set of medical vignettes organized in chronological order It offers a glimpse into the world of medicine and the inner life of Robert A Green MD The book’s title is A Journey Through Medicine The book’s subtitle A doctor’s lessons from his patients reflecting medical practice during the mid and late twentieth centuryWhat comes through is not just a sampling of late 20th century medicine as experienced by a talented and caring physician but a look at the myriad ways in which medicine is practiced Every MD has her own personality and his own style Physicians consult with one another and medical care carries many imprints Bob Green was an exceptionally astute and sensitive professional The book traces the development of his self confidence which may come as a surprise to those who knew him He seemed born to shine Bob entered Harvard as a freshman after attending public schools in Brooklyn NY He served in the military did residencies in both Pathology and Internal Medicine and as part of his stint with the US Public Health Service he was in charge of a tuberculosis sanatorium in Talihina Oklahoma under the Bureau of Indian Affairs In the mid 1950s he was in charge of the Pulmonary Diseases Section of the VA Hospital in the Bronx In 1958 he came to Ann Arbor to head the Pulmonary Service at the VA Hospital a position he held until 1972 Through those years he taught Internal Medicine at the University of Michigan medical school and for eleven years was the school’s Associate Dean He was esteemed as both doctor and teacher and was honored for both In 2008 he received the last of many awards the Will Ross Medal granted in recognition of significant contributions to the prevention and control of lung disease It is the most prestigious award bestowed by the American Lung Association Bob had a literate and literary approach to life This is evident in the various aphorisms he coined in his teaching “Frame that Asymmetry” was taken from William Blake’s poem The Tyger The injunction was meant to help students recognize the need to examine the why and how of asymmetries in the human body Do they spell disease? Genetic oddities? In dealing with cases of tuberculosis he noticed the strange euphoria that often preceded death He concluded that this phenomenon might explain the death arias in for instance La Traviata and La Boheme While working in Talihima Oklahoma he conducted autopsies in a local mortuary whose undertaker became his friend and helpmeet This undertaker bore a physical resemblance to Santa Claus But when the jolly undertaker turned out to be racist Bob found himself contemplating Hamlet “There are things in heaven and earth Horatio than are dreamt of in your philosophy”Bob did not need the bard to tailor old saws He was eminently capable of crafting his own memorable phrases Take the saying “When you hear hoof beats think of horses not zebras” a standard admonition meaning “don’t get too fancy” Medical students are taught to recognize patterns Bob underscored the dangers of showing off esoteric knowledge when making diagnoses To the horseszebra saying Bob added “but if you see an euine animal with stripes it is likely to be a zebra than a horse in striped pajamas” underscoring the fact that patterns like rules bear exceptions He also appreciated and adopted the colorful language of some of his folksier colleagues After stumbling toward an accurate diagnosis one farm raised fellow physician said “Even a blind hog turns up an ear of corn every now and then” Bob Green drummed into his students the singularity of each patient and the importance of physical examination in diagnosis He had little patience for brazen pronouncements made by hifalutin doctors Twice he mentions the radiologist in Boston who displayed a stethoscope with the label “A medieval instrument formerly used in the diagnosis of chest disease” As far as Bob was concerned hands on examinations including stethoscope and palpation were not out of date no matter how sophisticated the MRI or the CT or PET scans He emphasized the importance of reading a patient’s history He was wary of pretention He shunned omniscienceHe listened to patients He asked uestions When patients presented with mysterious symptoms he inuired about personal crises or accidents or allergies He also stressed the importance of trusting what the patient says When a patient was certain that a certain treatment would kill her—even though the treatment was known to be benign—Bob learned to respect his patients’ instincts In regard to the oft used notion of “patient compliance” a term that can be abused Bob was adamant that the doctor and patient must work together He did not believe it was the doctor’s place to issue injunctions Bob Green considered the “personhood” of his patients not just their illnesses He writesMedicine is a hard master Hippocrates said it millennia ago Life is short the Art is long opportunity fleeting experience misleading judgment difficult His warning was surely correct particularly when judgment is clouded by emotion or bias But then he added “The physician must not only be prepared to do what is right himself but also to make the patient the attendants and externals cooperate” And this is where I might disagree with my sage mentor Hippocrates Sometimes “to do what is right” is not to “make the patient” cooperate but instead to listen to a patient’s own instinctsIn his book Bob Green takes us through many cases leads us through diagnostic conundrums and shows us how he solved many of his medical puzzles He explores the challenge and adventure of each process He calls his method “the logical principled approach” stressing the importance of films x rays especially old films and the benefits of comparing old and new films to see the trajectory of a condition Is the shadow in the lung new? Or was it there a year ago? Every case is a teaching tool and each is a free standing story But the reader does well to read them all straight through to get the sweep of the journey Since most of us at some time or another are confronted with “med speak” and find ourselves trying to pronounce the names of ills and pills that once gave pause it is amusing to read this easy prose that so effortlessly combines medicalese with collouialisms Here’s a good example “I diagnosed his condition as recurrent pneumonia complicated by hypertrophic pulmonary osteoarthropathy HPO” I laughed after reading that sentence Then upon seeing what follows “The name is a mouthful” I laughed even harder There are many multisyllabic medical terms one can look up let’s hear it for iPhone dictionary apps although one can read and enjoy the book without knowing how to pronounce or define every Latinate word For Ann Arborites there’s additional fun in coming across familiar names Bob consulted with Dr Barry Gross “an exceptional diagnostician” Dr Milton Gross too is cited for his proficiencyDr Bob Green repeatedly invokes the Hippocratic principle do no harm He cites several cases where leaving well enough alone doing nothing would have been preferable to pro active care But he also leaves us with examples of his outsize caring that saved patients from harm The book has been touted by physicians as a must read for every medical student I would add that the book is well worth reading by anyone who may ever need medical care It is sobering to recognize the trials and tribulations of our physicians It is important to recognize too that doctors benefit when their patients assert themselves For patients who have established a collaborative relationship with their physicians medical treatment can be a shared venture

  2. Melissa Storm Melissa Storm says:

    Let me approach this article purely as a review of a great story that I recently read Yes the story for once is a personal memoir not my usual fiction It was written by a local to my native Ann Arbor author a man with a whole world of experiences Let me tell you just a little bit about this charming book and what it meant to meTo start you must allow me to self disclose as someone who has a severe mistrust of physicians and of modern day medicine in general When an ailment settles upon me my first course of action is always to do nothing—if something must be done I will try a home remedy or search online for a treatment option But I will never visit a doctor My extremeness in this scenario is a large part of what motivated me to agree to read and review Dr Robert A Green’s “A journey through medicine A doctor’s lessons from his patients reflecting medical practice during the mid and late twentieth century” I liked the idea of reading about a physician humbled one admitting that as my father likes to say “medicine is a practice they haven’t got all of the answers yet”A departure from my normal menu of classics classics and classics “A Journey through Medicine” was a breath of fresh air I enjoyed the vignette arrangement which allowed me to pick up and put down this book easily at my leisure I found myself learning while I read and not the normal points from my novels such as gads of information about the French Revolution or about turn of the century etiuette but about topics that—had I not read this book—I probably never would have learned anything about In fact midway into the text I posted as my personal status update on Facebook “I think that the doctor book I am reading just might be making me smarter I think I could now possibly diagnose miliary tuberculosis” While I was only joking please don’t come to me if you are actually sick the memoir definitely had a didactic uality to itSome of the anecdotes were a bit too technical for my non medical mind but many others could have been easily understood by the layest of laypeople My favorite story is entitled “Panic” and can be found on page 88Early in his career as a pulmonary specialist Dr Green was working at an Indian Hospital servicing a population that mid century was strongly affected by tuberculosis in Oklahoma Since only two other doctors besides himself were available at this facility he had to be prepared to handle any case that came into the hospital One day a young white farmer called him asking for help since his usual doctor could not be located and his wife was going into labor with their first child Dr Green allowed the couple admission into the birthing suite at the Indian Hospital When the baby was born it had a “deathly white pallor”Panicked Dr Green prepared to deal with the seriously dangerous condition of asphyxia pallida—a severe lack of oxygen caused by a pre birth illness which usually means that the infant may become seriously ill or die After being bombarded by a fleet of racing thoughts in attempts to identify the best course of action Dr Green “finally realized that the ‘problem’ with this child was it was white Up to now he had been delivering only dusky healthy reddish dark skinned Indian babies and the contrast with this blond Caucasian infant was startling” That made me laugh audibly during my reading session which normally has a morgue like uiet to itDr Green’s admission of error and willingness to try new approaches coupled with his genuine concern for patients sometimes even years after having treated them helped me to see that perhaps not all medical professionals deserve my mistrust While having read this memoir probably won’t send me running to a doctor next time I am bed ridden with some ailment or another it will help me to consider the alternative just a little bit longer before readjusting my hot water bottle curling up in a ball and trying to sleep it off

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