Dr. Sanders focus on sight and vision and their importance to medicine and the art of diagnosis in Chapter 5. What did you see in this chapter that was surprising? Please reflect on the chapter, what you found interesting, and comment on at least one other student's comments. (whoever posts first, please make a 2nd shorter post responding to a classmates ideas)
Post before leaving on retreat.
First, and probably the most obviously surprising, was that blind physicians exist. I thought that doctors need their sight like dancers need their legs. I find it absolutely insane that Dr. Wainapel is a working doctor. Sanders describes how Wainapel is able to diagnose patients with a pat down and a brain, but I initially found it hard to believe that Wainapel can perform his job as well as Sanders put it. However, Sanders did note the limitations of Wainapel's job, as she mentioned that Wainapel was lucky he to work in rehabilitation instead of surgery. Obviously, Wainapel has run into some problems in diagnosing patients, but I am glad that our health care system has not become so bigoted that it prevents intelligent individuals from doing what they love.
ReplyDeleteSecondly, I found it surprising that one has to learn how to integrate “seeing sickness” with treating sickness. Sanders describes her encounter with a woman named Jennifer who nearly undergoes respiratory arrest because of Sanders’ inability to fully understand Jennifer’s sickness. Despite years of schooling, Sanders was unable to understand that Jennifer was minutes away from respiratory arrest, and another doctor had to step in to help. I find it hard to understand why the connection between sickness and treatment is so difficult. I understand (or rather I do not) that the experience must have been traumatizing for Sanders. I believe that Sanders’ first encounter with a seriously ill patient left her in emotional shock and impaired her doctor skills. In other words, experienced doctors may be desensitized to the traumatic experiences of the hospital, and it does not get in the way of their judgment like it might for an intern.
I enjoyed the Sherlock Holmes reference, and how it tied in with the “gorilla video.” I have seen that video, and I also missed the gorilla. I found it interesting that nearly everyone misses the gorilla while focusing their attention on counting passes. These results just underline Sanders’ point that doctors (as well as anyone else) see what their attention is focused on. Our brains prioritize everything we see. Sanders has shown that doctors need to have a very open mind when given a difficult case. While Winapel cannot see, other doctors neglect “seeing” because their attention is diverted. I do not find this surprising at all, as it happens to everyone. Doctors, like anyone else, have to learn to guide their observations, and realize that what they think is important may not always be the case.
The story of the veteran was not as interesting as the others in the chapter, but it was very apt to Sanders’ point about expectancy. It supports Sanders point that one can neglect a single thing, a rash, because of inattention or of expectancy (in this case of Lyme disease). However, this case was solved by Dr. Berger, a new member of the faculty, who pointed out that Kowalski fit the pattern of a very uncommon disease. It’s awesome that Dr. Berger knew this rare disease, and also shows how one can miss a seemingly meaningless detail (like the gorilla) while looking for something important (all those tests for bacterial infections). For me, the moral of chapter 5 is to observant, not for what you think is important, but for anything and everything. Every patient has a disease for a rational reason.
I will comment on another student’s comments soon.
First post... yay....
ReplyDeleteI found it really interesting that Dr.Wainapel's patients did not realize that he was blind. I find it really weird that they either do not care or are too oblivious to notice that he was blind. I know it may sound not p.c. to say that he is any less of a doctor because he is blind, but I really think that being able to actually see a patient is very important. Like the author of EPTAS says, she only found 4 other doctors who were blind and most of those people were therapists. I find it really strange that after at least a solid charter of the author talking about how important physical exams are and really looking at the patient, she then goes on to talk about how there can also be blind doctors. I guess it's good that she is giving multiple perspectives, but I think it is also a little contradictory. The whole story about the woman with the knee and wrist issues just doesn't jive with the main point that I think the author is trying to make. Doctor Wainapel may be very good at his job, but I don't think that it is appropriate for him to "fake people out" and have books and whatnot in his office. That just doesn't make any sense to me. Maybe I'm just too judgmental.
The main thing that struck me about this chapter was the story of Dr. Stanley Wainapel and his practice as a blind physician. When I first thought about a blind physician, I immediately shunned the idea as impossible. A doctor's main tool is observation of the patient, and that obviously includes taking visual clues from both the patient's appearance as well as behavior and movement. I thought of all the things a blind doctor could miss--a bruise, a rash, or any of the many physical manifestations that a disease can take. A doctor's job will always be to harness as many clues as possible from a patient in order to correctly diagnose, so how could a doctor who was missing a large portion of his diagnostic tools successfully practice?
ReplyDeleteAs I continued to read, I started to realize how quickly I had jumped to conclusions without much thinking. Reading the account of Dr. Wainapel examining a woman's aching joints, using only his hands to feel the bones, reminded me of one of the previous chapters that talked about the power of touch and the physical exam in medicine. If a large portion of a physical exam involves touch, why shouldn't a blind doctor be able the same exam? If anything, having the sense of sight put out of use would serve as a way to sharpen other senses, and make a doctor rely less on the readily obvious, and more on the slightly more obscure.
This being said, there are clearly areas of medicine in which a doctor cannot rely on a sense of touch and other means of observation to make a diagnosis, like (as the book mentions) surgery. Although being blind does place a significant restriction on the way a person can live his or her life, it doesn't change their logical skills and their ability to draw conclusions from observations made with other senses, like Dr. Wainapel did with the sense of touch and a woman's aching legs.
I also have to agree with what Leah said, that although Dr. Wainapel may be a perfectly capable doctor, it's questionable that he hides his blindness from his patients. Although he claims it doesn't have anything to do with his ability to diagnose, I do believe that there should be some transparency between the doctor and the patient, especially when the patient could perhaps aide the doctor in this case, by pointing out visual cues that the blind doctor might've missed.
I agree with what Virginia said about how strong the power of touch is and how all the senses are connected. I do think that he is a capable doctor and that he can do a satisfactory job in his profession, but like I said, I wonder whether his inability to see compromises the health of his patients. Like Virginia was saying, Dr. Wainapel could easily miss blemishes that are really obvious to someone who is not blind.
ReplyDeleteI found the results of the Yale study on human perception surprising. The fact that more doctors’ first impressions of how sick a patient was were wrong than right is a bit worrisome. As Dr. Sanders said, how sick a person looks can be deceiving: a patient could look very sick and not have a serious illness, or could look fine but actually have a life-threatening illness. A first impression can be very important, but should by no means be the basis of a diagnosis. A first impression can cause an emotional response that could possibly hinder a doctor in making smart decisions: this happened to Sanders when her fear for the dangerously ill patient petrified her, and prohibited her from taking further steps to look for concrete measures and abnormalities that could lead her to a diagnosis. This example
ReplyDeleteillustrates how a first human perception can be useless unless followed by detailed observations.
Unfortunately, many doctors do not have amazing deductive powers, and have to rely on normal skills. This is why keen observation of detail is so important: doctors must be able to recognize a pattern of details and link it to the correct diagnosis.
I agree with Leah’s concerns of Doctor Wainapel’s system. However brilliant of a thinker and doctor he may be, I think seeing and observation is a vital part of diagnosing patients. He might never catch an integral visual aspect of the patient’s symptoms, despite a thorough physical exam. However, he was appointed director of the Department of Rehabilitation Medicine - he must be doing something right.
What i found to be interesting in that chapter was how studying art helped students make better diagnoses on patients. I guess it makes sense that developing a critical eye through art is the same as developing a critical eye for patients. At Leah, i dont think that he's trying to fake people out by having books, i think that it just helps the patients feel more comfortable by having a "normal" doctor. Also, it helps Dr. Wainapel out when people dont look down at him or his practice simply because of his disability, so in a way having books in the office helps his confidence, too.
ReplyDelete- this is Dan Cohen's, period 4 response.
ReplyDeleteThis was an extremely interesting chapter. I always have thought that having something as debilitating as being mostly blind would inhibit a doctor's ability to practice medicine. He certainly would have trouble passing the MD exam every few years that is required to keep practicing medicine. Also, I wondered how does the blind doctor stay current with latest news (including studies)? The fact that there is a competent, blind doctor out there is amazing and the story not only pointed out how complicated and multi-displinary being a physician is but also pointed out some of the complex techniques and thought processes behind making an accurate diagnosis. Thanks.
Although blindness may help Stanley Wainapel discover serious medical problems in a patient through his other senses that may be overlooked by doctors with vision if the patient looks physically healthy, I don’t think he should be a professional doctor. We as humans rely on our vision so much and far less on our other senses, but in reality (at least in medicine), vision is crucial to diagnosis and rudimentary doctor-patient interactions. I don’t think I would want to find out that I had a blind doctor. How could he not miss anything if so many conditions rely on sight for detection and diagnosis? So while there are some advantages in medicine to being blind, I think so much more relies on vision and that the benefits and accuracy of vision clearly outweigh these benefits. As both Leah and Virginia mentioned, there is definitely a better connection between a patient and a doctor if the doctor can see the patient. In some ways, a loss of vision can sometimes produce a barrier between the patient and doctor when they communicate. I agree with Leah and Virginia that even though Dr. Wainapel seems remarkably intelligent and capable, he should not be a doctor (especially not a surgeon). Without vision, you lose the ability to see simply rashes and lesions and swelling, and much more that can become light threatening. Also, I find it a little scary that Wainapel didn’t tell any of his patients that he was blind. I think I would feel a little cheated and angry if my doctor hid his blindness from me. Therefore, vision is also important for building up trust.
ReplyDeleteI find it difficult to believe that there is a “certain look” to all patients that are sick. Everyone is different physically, mentally, and socially, so I don’t think it’s fair to try to categorize all sick people into a single category represented by “the sick look.” I do think it’s possible, even likely, that doctors improve over time in being able to distinguish the sick from the healthy.
I thought it was interesting that you could technically “see” objects and completely ignore them, reject them from even entering your memory. I actually have seen the gorilla video a few times before, and I admit that the first time I watched the video I had NO idea that a gorilla had entered the screen and left. I find this fascinating and at the same time scary... What if we completely missed seeing a visible medical problem because we weren’t looking for it?
In chapter five, Dr Sanders examines the role of vision in making diagnosis. The most interesting part is when she paid a visit to Dr Marvin Chun and was asked to watch a game between a white and black team. She was asked to keep track of how many times the ball was passed between players in the white team. At this end of the experiment, she found that to her surprise she did not see a black gorilla in the video, this phenomenon is called “inattention blindness” when we are preoccupied with an attentionally demanding task and fail to notice another object or event. In other words, we see what we want to see and what we expect to use. We also tend to falsely believe that we do not experience inattention blindness. The “inattention blindness” not only affects a doctor’s ability to pick up other important clues in the physical examination,but also affects our daily activities. Text-messaging during driving, for example, is associated with an increase in motor vehicle accidents. Inattention blindness, however, is not always bad. Paying attention to one thing means that we do not pay attention to others. In a library when everyone is chatting noisily, we need inattention blindness to focus on our studying. Without a way to block out irrelevant stimuli, we may not be able to function.
ReplyDeleteI agree with Jlor that looking at art provides good training in picking up details. What makes a painting impressive is the artist’s ability to capture details of the objects or scenes that he is painting. Similarly, what makes a book enjoyable is the writer’s ability to describe detail that other miss. Paying attention to detail is a trait shared by good doctors, writers,and artists.
First of all, I was surprised that the blind doctor, Dr. Wainapel was even able to practice as a physician. In his particular field, that of chronic diseases, sight isn't nearly as essential as it is for an emergency room doctor, but nonetheless, we rely on our eyes for so many visual cues that I can't even imagine a blind person doing such a thing. I also had brief doubts as to whether or not that was even legal. I definitely agree with Alyssa in that I personally would not want a blind doctor, because try though he might, it's really difficult to forge a connection with someone when you can't see them. I also agree with Leah; deceiving his patients doesn't seem right. At the same time, though, if he didn't deceive them, they probably wouldn't want him as a doctor, and as long as they don't suspect anything is wrong he's able to do his job as normally as possible.
ReplyDeleteThe inattention blindness segment of this chapter was also very interesting, and helped reinforced an assertion of an earlier chapter, which was that doctors see what they're looking for, and that it's difficult to consider alternate possibilities once one has already reached a tentative diagnosis. This chapter suggests that such a close-minded approach makes it not only difficult but impossible to spot important clues if they’re outside of what you’re already considering, which is kind of a scary thought.
Also in this chapter we finally learned the background behind Dr. Sanders' obsession with the term "Sherlockian investigation," which she really should have explained in the introduction or something.
Like many others in the posts before me, I have to agree that the most surprising thing in this chapter was Dr. Wainapel. Right away it begged the question for me: how is a doctor who can't see his patients able to work with them and make an accurate diagnosis? As I continued reading and I learned how he was able to perform the physical primarily through touch and conversation, I began to realize something. Perhaps it's good for Dr. Wainapel's patients that he is blind. I remember learning a long time ago how those who are blind tend to have much stronger senses of touch, and as I thought of this I thought of how the doctor might be able to feel and detect minute details others might need an x-ray to see. Of course there are cases when it's imperative that a doctor be able to see test results (which are often in picture format and difficult to relay fully), but in Dr. Wainapel's case, I think he's absolutely fit to perform checkups with patients, perhaps more so than many other doctors.
ReplyDeleteI find it surprising, like everyone else, that a blind doctor is able to be a successful doctor. Even though a blind person isn't any less apt to make a diagnosis with the information available, it seems that a visual observation can lead to a quicker diagnosis, perhaps saving the life of the patient. In no way am I advocating that blind people shouldn't be doctors, but it seems that a blind doctor would be significantly impaired. Dr. Wainapel seemed to have adjusted well to blind doctor work. He did this to the extent that his patient wasn't even able to tell he was blind. so, even though he was impaired by a disability, he was still a successful doctor.
ReplyDeleteIn chapter 5, Sanders discusses how the narrow focus of many doctors prevents them from noticing crucial things about the patient. She uses Wainapel, a physician who is mostly blind, as an example of someone whose experience has helped him gain strong observational skills. His ability to make deductions and conclusions by utilizing his other senses seems to compensate, at least to a certain extent, for his inability to see very well. Although severe impairment of vision obviously imposes limitations on a doctor’s ability to diagnose, Wainapel’s poor eyesight provides him a different perspective from which he can make observations. Even equipped with all five of the senses, younger, less experienced doctors have a tough time broadening their range of focus. They may jump to conclusions based on what is directly visible from the patient. This persistent search for clues and symptoms that fit a specific hypothesis may ultimately prove to be a fatal error.
ReplyDeleteIn the video Chun showed Sanders, the reason why we don’t notice the gorilla the first run through is simply that we are not focusing on it. Adhering to the command given at the beginning of the video, we focus continuously and solely on the white team and the ball they pass. By doing so, we are actively ignoring any other form of movement that may pose as a distraction. It also doesn’t help that the gorilla is black, and blends in very well with the black team. If we did happen to notice the gorilla walk across the scene, we wouldn’t be able to turn our eyes toward it without losing count of how many passes the white team throws. I agree with Aaron that “inattention blindness” is not only an effect of trying to direct one’s attention toward a specific object, but also that it is necessary to maintain concentration on that object. In this test, it is shown that we can only truly focus on one task at a time. It also reveals that, by focusing on that one task, we shut everything else out. Consequently, doctors shoulder the burden of having to both focus unwaveringly on one object of interest at a time and keep in mind the bigger picture at the same time.
Following the general trend here, Dr. Wainapel's story was definitely striking. Many symptoms of problems seem like they would have to be seen to be caught - and any of these symptoms could be key to diagnosing a patient. Taking this into consideration, I was really surprised by Wainapel's situation. What if he missed such a visual clue, and this hindered him from making the correct diagnosis? But then again, touch is also a huge factor in learning about a patient. Perhaps if one of his senses is lacking then, his others may be stronger? So, maybe he is more observant, through his touch? But even taking this into account, a completely blind doctor - especially one who hides his blindness - would make me a little insecure. As Alyssa said, what if he missed a rash or a bruise, and thus completely misdiagnosed the patient? As qualified as he seems in all other respects, I wouldn't want Dr. Wainapel as my doctor; nothing can compensate for such a huge gap in one's observational abilities.
ReplyDeleteI agree with Alyssa that Dr. Winapel should not be a doctor. While he can easily diagnose tangible diseases, he is unable to see any visual red flags for a patient. I disagree that Dr. Winapel is unable to make a strong connection with patients without his sight, as connections are based off what both individuals attribute to those connections. Perhaps everyone Dr. Winapel strongest connections with people are with his patients, as they are the only ones he can communicate with so closely. However, I again assert my agreement with Alyssa that Winapel should not be a doctor. Since vision is so important for doctors, it is a cruel fact that one without vision would be at a huge disadvantage for everyone (patient and doctor).
ReplyDeleteI thought that the Yale study was really interesting. So many doctors spend a very short time with their patients in the examination room (as we heard in the earlier chapters) and if they are sticking to their initial impressions for a diagnosis, then they will definitely be much more likely to be incorrect. You can rarely tell how sick someone is just by looking at them. You can't see lung cancer but you can see the chicken pox for a common cold much more easily, so when a doctor sticks to their first impression they will later find out they took the wrong path in diagnosing. This does not mean they will not eventually reach the correct diagnosis, but that valuable time is lost.
ReplyDeleteI thought what Leah said about the contradiction between the value of seeing the patient and not seeing them is very valid. Obviously everyone has obstacles they need to overcome in life and being blind with the dream of being a physician is a big one. Though I agree it was a little contradictory and strange I also thing that the fact that he is still able to be an effective doctor is kind of inspirational.
In Chapter 5, Dr. Sanders used an anecdote about Sherlock Holmes to demonstrate what she feels is a distinction important to medicine: the difference between simply seeing and noticing what you see. I thought that this was an interesting distinction, because it makes the point that while vision is a very valuable sense and one that we use all the time, the very fact that we use it all the time sometimes makes us think that it is less fallible than it is. It seems like part of becoming a doctor is learning a new way of seeing, as the Yale dermatology professor who Dr. Sanders quoted said. Doctors must learn to recognize the patterns of different diseases. However, learning these patterns biases people’s vision: as Sanders says elsewhere, people usually only see what they are looking for. Being aware of these biases of vision might help doctors avoid the trap of noticing only what they’ve been accustomed to noticing, while ignoring other details that might be relevant.
ReplyDeleteI agree with Jlor and Aaron that using art as a tool to train doctors in observation seems like a really good idea. It might be easier for doctors to learn the important skills of noticing details and then trying to make sense of what they see outside the context of normal medical school classes, where it seems like the emphasis is on memorizing tons of information. Also, art’s unfamiliarity to the students and lack of “diagnostic patterns” could help them learn to draw conclusions based on what they actually see, not just based on what they think they should see.
When i first read that Dr Winapel was blind and a good and successful doctor, i had faith that that was true, and that being blind did not get in the way of his medical career and ability to help others. However, as i read on about how important vision is in diagnosing patients I realized that a blind doctor could not be the best thing for a patient. When i read that a doctor is performing physical exams on patients the moment they step into the doctor's offices, i realized how important vision is. Without being able to see and notice physical problems with the patient that the patient might not have noticed him/herself and did not mention to the doctor, the doctor could possible falsely diagnose a patient. This makes me feel that a medical career more directed towards listening and speaking, such as psychiatry is a better job for a blind person.
ReplyDeleteI also agree with virginia though. she said that lacking the ability to see could also help make his other senses more acute. With these senses being more acute, they could make up for his blindness and help him possibly see things in a new way that other doctors do not see.
I found the Yale class in the art museum to be very interesting. The class emphasizes that sight is not necessarily what is important in diagnosis, instead it is the power of observation. Medical students needed to be able to notice what was in the picture, and simply staring at it mindlessly was not enough. I think this is part of the reason why Dr. Wainapel was able to be so successful in his field. When I first heard his story, I was doubtful that he could carry out his duties to the full extent. But the Yale class demonstrates that sight is not enough, and Dr. Wainapel has the skills of observation that the class tries to teach. Though he does not see his patients, he can draw out information through touch and reach accurate conclusions. His field allows him to do this; as the book mentions, he would not have been a successful surgeon. But the chapter seemed to emphasize that sight alone is not sufficient, or even necessary, to make accurate diagnoses. As Leah articulated though, I think it is Dr. Wainapel’s responsibility to notify his patients of his vision loss. Patients have the right to choose whom they would like as a doctor, and vision should be a factor in this decision. In regards to Alyssa’s point however, I think that Dr. Wainapel should be permitted to practice as long as he does not deceive his patients. Since he has chosen a field in which time is not an issue and he does not need to guide his hands through sight (he is not a surgeon), he can be successful. Perhaps he should be sure to confer with other doctors more and make sure that someone who can see checks his patients, but he seems perfectly sufficient to be working in his field.
ReplyDeleteI thought the most interesting part of the chapter was the story of Michael Kowalski. Although he had all the common symptoms of a disease, his doctors were unable to diagnose it simply because they weren't connecting his symptoms correctly. I find it somewhat hard to believe that the doctors would overlook one symptom that they found and merely attributed to another minor infection, even though it was the symptom that made them figure out the diagnosis in the end. I also thought it was interesting the way Sanders described finding illnesses. Once she started medical training, she claims to have started seeing ailments and illnesses in random people on the street. Although it was interesting, I don't think it was as surprising as she thought it was, since once you start looking for something you'll see it everywhere. As many people have said before me, I find it surprising that more of Dr. Wainapel's patients don't notice that he is blind, but while some people don't think he should be deceiving his patients, as Natalie said, as long as he is able to do his job normally and well I think it's fine.
ReplyDeleteLike many people have said, I was most surprised to read about Dr. Wainapel's success in medicine despite his blindness. I agree that sight is a critical aspect of examining a patient, but I disagree that he should not be allowed to practice. I don't think anyone has the right to declare that, because as long as his patients are receiving the best possible care, there is no reason to discriminate against him. I will say that if he were my doctor, I would want him to have a partner or team that could double-check and expand his physical observations. I could actually very much see a blind doctor in a position like the fictional Dr. House: having a team to do examinations/tests, and putting together the results into a diagnosis. This would be primarily a cerebral job (like Dr. Wainapel says much of his job is) and it would have nothing to do with sight, only with the doctor's ability to think.
ReplyDeleteI was also pleasantly surprised at the story about the Yale medical students learning to observe details by describing paintings. I think too often doctors can become so absorbed in the world of medicine that they forget how many things there are to learn outside of it. By taking the students into a context where they did not think they were being tested in medicine, they were able to change mindsets and learn an important skill that, it turns out, is very valuable for being a doctor.
What I found really interesting about this chapter was the fact that Dr.Wainapel was able to effectively diagnose the woman by physically examining her even thought he was blind. I was also generally surprised that blind physicians even existed. Before reading this I would have thought that was impossible and that even if a blind physician were to exist that most people wouldn’t be comfortable having someone who couldn’t see be responsible for their health. In response to Nour’s point about the later description regarding how important vision is in diagnosing patients, it also made me think that a blind physician might not be the best choice for a patient.
ReplyDeleteIn this chapter, I thought the information about the pathway between the eyes and the brain was very interesting. I have not previously considered the path of creating a progression of images that we observe into inferences about what is going on. For most people, seeing and thinking are morphed into one action, as we often make assumptions just with the proof of our sight. I really liked the story about Dr. Irwin Braverman—a dermatology professor at Yale—and how he chose to teach his students. He had them look at paintings in a museum and describe what they saw. This lesson had the purpose of connecting a series of images into a description of what is happening in the painting. I think that this example ties into the story about Dr. Stanley Wainapel. Because Dr. Wainapel is blind, he is unable to transfer visual images into thoughts, so he is forced to use his other senses. The two stories connect because they both emphasize the fact that seeing is not the only way to compose complex thoughts.
ReplyDeleteI agree with Alyssa and the fact that technically seeing something is not enough to create a cerebral thought. I think that this point that Alyssa states proves that medical professions are very active ones; simply observing is not sufficient.
I was amazed at Dr. Wainapel's ability to pursue a career as a doctor despite his disability. I am impressed by his ability to not only persevere in this field, but also identify his limitations. Wainapel chose his field knowing that he would not be able to rely on vision to pick up on cues such as how 'sick' the patient is or immediately diagnose particular manifestations of the disease. I agree with Katrina and Natalie in that Wainapel's reliance on his sense of touch is an interesting way of overcoming his challenge. Like many before me, I also agree with Alyssa that I would not be as comfortable with a blind doctor. This is mainly because I don't know enough about anatomy to be able to trust that doctors can make a diagnosis just be feeling joints. However, my faith in vision was questioned when Sanders brought up the gorilla movie phenomenon; that noticing isnt really seeing. This chapter proves that doctors cannot rely on solely one technique, but must incorporate all five senses in addition to background knowledge and deductive reasoning to treat a patient.
ReplyDeleteLater in the chapter, I was surprised by Sanders' discussion of what 'sick' looks like. I assumed that even I could perceive when a person is sick, and never considered it as a medical tool. I thought that it would be common sense that understanding that the person looks sick is the first step, and cannot be the only step, and didn't feel that Sanders needed to spend an entire section hammering this point in.
Dr. Wainapel was able to be successful in the medical profession regardless of his lack of sight. I was amazed. However, the way that the author described that sight was perceived as essential for practicing medicine. I disagree with the idea that Dr. Wainapel could not effectively examine a patient. As long as a person could be nearby to point out any visual discolorations or simple descriptions, Wianapel could easily examine the patient with thier hands. The doctor trained all through medical school with this disability, and therefore most likely has learned to compensate for thier disability. Nonetheless, I can understand some patients' worry with a blind doctor. I would beg the question that touch without the perspective sight offers would be ineffective in helping patients.
ReplyDeleteThe reference to the gorrilla video experiment was interesting. I had heared about this experiment and was fascinated by it. Noticing something does not *require* sight. A doctors mind can be an effective treatment tool.
One of the parts of this chapter that I thought was interesting was the idea of using paintings to teach medical students to be more observant and come to conclusions about what they were seeing using very specific clues. I guess that paintings work better than patients for teaching students this particular skill, because paintings represent a very specific message that the painter tries to show the viewer using clues and symbols to get the point across. Also, deciphering a painting's message is probably much less stressful than trying to diagnose a patient, as the only real consequence of getting the painting's message wrong is a bad grade. Diagnosing a patient wrongly, however, could potentially have disastrous consequences and the fear that comes with knowing that could impede a doctor's ability to think clearly and thus solve the problem. This issue comes up when Sanders sees Jennifer and immediately observes that something is very wrong but can't figure out what. She doesn't even realize that Jennifer needs immediate help because she is so paralyzed by the fact that she doesn't know how to cure her.
ReplyDeleteI also thought that the gorilla video highlighted another very interesting problem for diagnosticians--people only focus on what they expect to see. Anything outside of that, anything unexpected, is either not considered important or not even seen until someone knows to look for it. However, my guess is that after a doctor has a near miss with a certain disease or condition, they don't miss it again. Thus, those who know to look for unexpected factors, as Sanders said, are usually either the most or least experienced doctors. The very least experienced doctors have no expectations, no experience with the most common situations, and so they observe everything and consider everything. The most experienced doctors, on the other hand, have probably had so many near misses and unexpected situations that they have relearned how to look for just about everything.
I agree with Natalie that people have a tendency to only see what they are looking for, which makes it impossible at times to see anything else. That really is a scary thought.
Like others have said, the most surprising thing to me was that blind physicians exist. When the author was talking about how sight was very important in the diagnoses, it made me think that perhaps a blind physician wasn't a good idea. But I thought about it and I agree with "Hoffy" (or pat) about how as long as someone is there to point out the visual symptoms, and with Dr. Wainapel's abilities to diagnose people using touch I think I've reconsidered.
ReplyDeleteI think that the idea of a blind physician is brilliant. Sanders makes an excellent case to the importance of the physical exam and the success of Dr Wianapel definitely exhibits this idea. Physical touch and the ability to listen seems to play just as much if not more of a role in the diagnostic process as sight. in fact, on could argue judging from the past that sight could actually hinder the ability to come to an educated and rational diagnosis based on the patients story and their symptoms. sight can distract the doctor from the patients story and their physical symptoms and lead them to use the easiest and fastest way to diagnose a patient, that is through seeing. This idea of a blind physician sheds light on necessary physical exam and the rehabilitative power of touch.
ReplyDeleteI agree with sarah about how interesting using a painting as a type of training for medical patients to mimic the diagnostic process. its interesting to think that in many ways imagination, broadmindedness and even creativity play an imperative role in such a fact strenuous profession as medicine.
I agree with many of my classmates that i find it surprising that blind physician exist. However, Dr. Sanders uses their existence as a compelling argument for the physical exam. i was also surprised by the degree to which the physical exam is NOT based on sight. it seems as though being able to see your patient would be a serious impediment to success in this field.
ReplyDeleteI also agree with sarah that the use of paintings and other visual art in the training of doctors is a very interesting way to simulate making a diagnosis. the story about the inspiration for sherlock holmes was the most interesting demonstration of this, because it makes a great deal of sense that a doctor, who needs to be able to take in a great deal of minute details and combine them into a diagnosis would have such observational abilities.