Chapter 7 "Surgery and Satisfaction".
Doctor A
Back ground information:
Dr. for many athletes. A famous Doctor.
Dr. office environment:
The waiting room was a Jam packed and delay to attend the patient.
Dr. attitude towards the patient:
Listening the patient story.
Dr. willingness to listen to the patient:
Paying attention but not to much because the Dr. was confused with the diagnosis.
Author's attitude towards the doctor:
Pressed with many answers.
Doctor B
Dr. attitude towards the patient:
Carefully examination to the patient and secure in his diagnosis.
Dr.willingness to listen to the patient:
Paying Complete attention.
Author's attitude towards the doctor:
Wondering about procedures and about recovery period.
Doctor C
Back ground information:
Renowned hand surgeon in The Unite States.
Listen in magazines like ''The Best Doctor''
Dr.office environment:
Waiting room packed with all the walls filled with plaques.
Dr. attitude towards the patient:
Not paying too much attention.
Dr.willingness to listen to the patient:
With out willingness because the Dr. was talking with the resident.
Author's attitude towards the doctor:
Waiting for a good answer.
Doctor D
Back ground information:
Consider a hotshot.
Dr. attitude towards the patient:
Trying to find the information and paying attention.
Dr.willingness to listen to the patient:
Interested in what patient was saying.
Author's attitude towards the doctor:
Analyzing the information about the diagnosis.
Doctor E
Dr. attitude towards the patient:
Focused in the case.
Dr.willingness to listen to the patient:
Paying attention to the story.
Author's attitude towards the doctor:
Agree with the doctor diagnosis and advises.
Doctor A
Back ground information:
Dr. for many athletes. A famous Doctor.
Dr. office environment:
The waiting room was a Jam packed and delay to attend the patient.
Dr. attitude towards the patient:
Listening the patient story.
Dr. willingness to listen to the patient:
Paying attention but not to much because the Dr. was confused with the diagnosis.
Author's attitude towards the doctor:
Pressed with many answers.
Doctor B
Dr. attitude towards the patient:
Carefully examination to the patient and secure in his diagnosis.
Dr.willingness to listen to the patient:
Paying Complete attention.
Author's attitude towards the doctor:
Wondering about procedures and about recovery period.
Doctor C
Back ground information:
Renowned hand surgeon in The Unite States.
Listen in magazines like ''The Best Doctor''
Dr.office environment:
Waiting room packed with all the walls filled with plaques.
Dr. attitude towards the patient:
Not paying too much attention.
Dr.willingness to listen to the patient:
With out willingness because the Dr. was talking with the resident.
Author's attitude towards the doctor:
Waiting for a good answer.
Doctor D
Back ground information:
Consider a hotshot.
Dr. attitude towards the patient:
Trying to find the information and paying attention.
Dr.willingness to listen to the patient:
Interested in what patient was saying.
Author's attitude towards the doctor:
Analyzing the information about the diagnosis.
Doctor E
Dr. attitude towards the patient:
Focused in the case.
Dr.willingness to listen to the patient:
Paying attention to the story.
Author's attitude towards the doctor:
Agree with the doctor diagnosis and advises.
Chapter 6 " The Uncertainty of the Expert "
1.They think psychiatrists in moderns day can't recognize well when patients have ADHD even and frame the patients according what the results show. They don't think more than the result what is really happen with the patient.
2.Make up affect Doctors practices because not everyone can do it constantly that's why they have to ask frequently about everything to everybody.
3. They discuss about what is the best way to do the procedure and why? They also where discussing why is teach is this way and not the opposite.
4.This procedure is made for prevent patient who have two- to- one died because there are no way to specifically know how can survive with that problem doctors still making the surgery.
5.Lock would ignore the other Doctor idea and still looking for his own conclusion about the case because he have self confident and don't frame patients.
6.That physicians usually don't stop to think about why they miss diagnosis or lost patient. Most of the doctor don't recognize specials cases because they frame the patients according the symptoms.
7.He need to be clear that logic doesn't work in every case and he has to recognize until when you can look for the problem using logic.
8. That can be a good or bad factor depending of the case they have. Uncertain can make a patient feel confidence about the treatment and the doctor knowledge or the opposite of it.
1.They think psychiatrists in moderns day can't recognize well when patients have ADHD even and frame the patients according what the results show. They don't think more than the result what is really happen with the patient.
2.Make up affect Doctors practices because not everyone can do it constantly that's why they have to ask frequently about everything to everybody.
3. They discuss about what is the best way to do the procedure and why? They also where discussing why is teach is this way and not the opposite.
4.This procedure is made for prevent patient who have two- to- one died because there are no way to specifically know how can survive with that problem doctors still making the surgery.
5.Lock would ignore the other Doctor idea and still looking for his own conclusion about the case because he have self confident and don't frame patients.
6.That physicians usually don't stop to think about why they miss diagnosis or lost patient. Most of the doctor don't recognize specials cases because they frame the patients according the symptoms.
7.He need to be clear that logic doesn't work in every case and he has to recognize until when you can look for the problem using logic.
8. That can be a good or bad factor depending of the case they have. Uncertain can make a patient feel confidence about the treatment and the doctor knowledge or the opposite of it.
Chapter 5 "A New Mother's Challenge"
I personally think that religion role in medicine is an attribution of each person.The same think could happen to two persons and they going to come up with different conclusion according each person reasoning.
"God is like a best friend for me. A friend you can always call upon". Page 129.Rachel brief believe that God saved Shira life.That means that she believed religion can change conditions and diagnosis in medicine.
"After hearing Rachel's story, I saw a third way in which faith can function". Page 130. Groopman think that religion can be useful making people reflect and analyze in the worst situation they went through including terminal diagnosis.
I personally think that religion role in medicine is an attribution of each person.The same think could happen to two persons and they going to come up with different conclusion according each person reasoning.
"God is like a best friend for me. A friend you can always call upon". Page 129.Rachel brief believe that God saved Shira life.That means that she believed religion can change conditions and diagnosis in medicine.
"After hearing Rachel's story, I saw a third way in which faith can function". Page 130. Groopman think that religion can be useful making people reflect and analyze in the worst situation they went through including terminal diagnosis.
Chapter 4 Gatekeepers
6.) Page. 90
One of the principal focus on primary care is make the patients who have unhealthy behavior like smoke, do not eat healthy or do not exercise realize about it and make them recognize that this are making them sick. After that Doctors try to help them to become it healthy, according each patient environment and kind of unhealthy behavior.
7.) Page. 94
When doctors do not know some patients social context could create a barrier between their and the patients.The patients can not understand doctors explanation, generating a hard time to the doctor or a discussion.
8.) Page. 96
Dr. Bigby had been reject for son patient as a black doctor, and sometimes people think that she is the the janitor women because those people focus on her skin color ignoring that she is a doctor.
6.) Page. 90
One of the principal focus on primary care is make the patients who have unhealthy behavior like smoke, do not eat healthy or do not exercise realize about it and make them recognize that this are making them sick. After that Doctors try to help them to become it healthy, according each patient environment and kind of unhealthy behavior.
7.) Page. 94
When doctors do not know some patients social context could create a barrier between their and the patients.The patients can not understand doctors explanation, generating a hard time to the doctor or a discussion.
8.) Page. 96
Dr. Bigby had been reject for son patient as a black doctor, and sometimes people think that she is the the janitor women because those people focus on her skin color ignoring that she is a doctor.
Chapter 3 "Spinning plates"
Case #1
Patient's name: Nathan Talumpqewa
Doctor's name: Harrison Alter
Summary of the Anecdote:
Nathan was a 10 years old boy who laid in pain, when a classmate tried to take a piggy ride. When the doctor exterminate him, found a fracture in the lower level of Nathan thoracic vertebra.
Summary of the explanation:
Dr. Alter never had seen a case like Nathan case and he refer him to a pediatrician said that was nothing for worry about, and this words made Dr. Alter do not think in another diagnosis.
What is the point?
The point is that both doctors misdiagnose Nathan who really had lymphoblastic leukemia.They find out later when the patient went back to the emergency room, because the patient was in pain again.
Case # 2
Patient's name: Blanche Begaye
Doctor's name: Harrison Alter
Summary of the Anecdote:
Blanche was an old woman, who came to the emergency room, because she could not breath well. She said to the doctor that she probably had a cold.The doctor diagnose her with "subclinical viral pneumonia".
Summary of the explanation:
Dr. Alter diagnose the woman with the condition mention it before , while the symtomps were no completely clear, because he had seen a lot of patient with a viral pneumonia on this days and he immediately associated her with the other patients.
What is the point?
The point is that this doctor misdiagnose the old lady, because he use heuristic called
" aviability", and in the lately days he saw many cases of pneumonia, That is why he fit the patient in the same conditions as the others.
Case # 3
Patient's name: Maxine Carlson
Doctor's name: Pat Croskerry
Summary of the Anecdote:
the patient was a woman who went to the emergency room, because she was having sharp pain in her belly. She went three times and the third one she was refer to a gastroenterology who finally diagnose her with irritable bowel syndrome.
Summary of the explanation:
This woman was misdiagnose three times and until she went to the emergency room with an internal bleeding, because she had a rupture ectopic pregnancy.
What is the point?
The point is that many this misdiagnose the woman problem, because none of the doctor she saw came up with something different.They limit their thinking, assuming that every thing was explore.
Case # 4
Patient's name: A man
Doctor's name: Harrison Alter
Summary of the Anecdote:
The man was complaining about a sore throat.The resident prescribe him antibiotic, but the doctor thought that was no necessary the prescription, and diagnose him with a virus causing sore throat.
Summary of the explanation:
Dr. Alter check the patient again to make sure about the diagnosis, but while he was touching the man neck he found something else, an abscess in the man neck.
What is the point?
The point is that it is important make sure about the diagnosis inquiring about what someone else found .
Case # 5
Patient's name: Middle aged man
Doctor's name: Pat Croskerry
Summary of the Anecdote:
The patient had been diagnose a man with a kidney stone. The symptoms were vomit and blood in the urine.
Summary of the explanation:
Dr. Alter suspect about this diagnosis, and he find out that was a dissecting abdominal aortic aneurysm.
What is the point?
The point is that it is important think about what organs are near where the pain is, to be able to thing in more options when doctors have to diagnose.
Case #1
Patient's name: Nathan Talumpqewa
Doctor's name: Harrison Alter
Summary of the Anecdote:
Nathan was a 10 years old boy who laid in pain, when a classmate tried to take a piggy ride. When the doctor exterminate him, found a fracture in the lower level of Nathan thoracic vertebra.
Summary of the explanation:
Dr. Alter never had seen a case like Nathan case and he refer him to a pediatrician said that was nothing for worry about, and this words made Dr. Alter do not think in another diagnosis.
What is the point?
The point is that both doctors misdiagnose Nathan who really had lymphoblastic leukemia.They find out later when the patient went back to the emergency room, because the patient was in pain again.
Case # 2
Patient's name: Blanche Begaye
Doctor's name: Harrison Alter
Summary of the Anecdote:
Blanche was an old woman, who came to the emergency room, because she could not breath well. She said to the doctor that she probably had a cold.The doctor diagnose her with "subclinical viral pneumonia".
Summary of the explanation:
Dr. Alter diagnose the woman with the condition mention it before , while the symtomps were no completely clear, because he had seen a lot of patient with a viral pneumonia on this days and he immediately associated her with the other patients.
What is the point?
The point is that this doctor misdiagnose the old lady, because he use heuristic called
" aviability", and in the lately days he saw many cases of pneumonia, That is why he fit the patient in the same conditions as the others.
Case # 3
Patient's name: Maxine Carlson
Doctor's name: Pat Croskerry
Summary of the Anecdote:
the patient was a woman who went to the emergency room, because she was having sharp pain in her belly. She went three times and the third one she was refer to a gastroenterology who finally diagnose her with irritable bowel syndrome.
Summary of the explanation:
This woman was misdiagnose three times and until she went to the emergency room with an internal bleeding, because she had a rupture ectopic pregnancy.
What is the point?
The point is that many this misdiagnose the woman problem, because none of the doctor she saw came up with something different.They limit their thinking, assuming that every thing was explore.
Case # 4
Patient's name: A man
Doctor's name: Harrison Alter
Summary of the Anecdote:
The man was complaining about a sore throat.The resident prescribe him antibiotic, but the doctor thought that was no necessary the prescription, and diagnose him with a virus causing sore throat.
Summary of the explanation:
Dr. Alter check the patient again to make sure about the diagnosis, but while he was touching the man neck he found something else, an abscess in the man neck.
What is the point?
The point is that it is important make sure about the diagnosis inquiring about what someone else found .
Case # 5
Patient's name: Middle aged man
Doctor's name: Pat Croskerry
Summary of the Anecdote:
The patient had been diagnose a man with a kidney stone. The symptoms were vomit and blood in the urine.
Summary of the explanation:
Dr. Alter suspect about this diagnosis, and he find out that was a dissecting abdominal aortic aneurysm.
What is the point?
The point is that it is important think about what organs are near where the pain is, to be able to thing in more options when doctors have to diagnose.
2/21/14
Chapter 2 "Lesson from the Heart"
Case #1
Patient's name: Evan McKinley
Doctor's name: Pat Croskerry
Summary of the Anecdote:
Evan went to the ER with chest pain and after some test Dr. Croskerry dosen't found anything wrong with him.Dr. Croskerry miss the diagnosis because He thought that the patient look young and healthy.
Result: Heart Attack
Type of Dr. error: Representativeness
Case # 2
Patient's name: Charles Carver
Doctor's name: Donald Reldemier
Summary of the Anecdote:
The patient went to the emergency room with fatigue and swell belly, the intern noticed alcohol in the patient , and assume that the men was an alcoholic and diagnose him with alcoholic cirrhosis.
Result: Wilson diase
Type of Dr. error: Atributibe
Case # 3
Patient's name: Joe Stern
Doctor's name: Myron Falchuck
Summary of the Anecdote:
The patient was having heart burn and indigestion.The doctor indicate some antacids, but the patient four month later went back to the doctor office, because he was not feeling well. The doctor indicate and endoscopy and found that the patient had cancer.
Result: Gastric lymphoma.
Type of Dr. error: Affective.
Case # 4
Patient's name: Brad Miller
Doctor's name: Jerome Groopman
Summary of the Anecdote:
The patient had pain in his left knee, and the doctor found a tumor in the knee. They did chemotherapy. During the chemotherapy section the doctor did not check the patient well and the patient got and infection.
Result: Osteosarcoma
Type of Dr. error: Affective
Case # 5
Patient's name: Young man
Doctor's name: Karen Delgado.
Summary of the Anecdote:
A young man was found sleeping in the stair of a library, and when he arrive to the emergency room the doctor thought that was a homeless looking for food, and she send him to the waiting room, but an inter found that he was really sick and when the doctor check him. He was in a diabetic comma. This doctor does not give this patient priority, because she judge him as homeless in her first impression.
Result:Diabetic comma.
Type of Dr. error:Attributive.
Case #6
Patient's name: Ellen Barnet.
Doctor's name: Karen Delgado.
Summary of the Anecdote:
Ellen was having estranges hot flashing and she describe herself like a kooky but Dr. Delgado didn't let her self make an other mistake and evaluate the patient extensively and found the right diagnosis.
Result: Endocrine Tumor.
Type of Dr. error:Attributive.
Chapter 2 "Lesson from the Heart"
Case #1
Patient's name: Evan McKinley
Doctor's name: Pat Croskerry
Summary of the Anecdote:
Evan went to the ER with chest pain and after some test Dr. Croskerry dosen't found anything wrong with him.Dr. Croskerry miss the diagnosis because He thought that the patient look young and healthy.
Result: Heart Attack
Type of Dr. error: Representativeness
Case # 2
Patient's name: Charles Carver
Doctor's name: Donald Reldemier
Summary of the Anecdote:
The patient went to the emergency room with fatigue and swell belly, the intern noticed alcohol in the patient , and assume that the men was an alcoholic and diagnose him with alcoholic cirrhosis.
Result: Wilson diase
Type of Dr. error: Atributibe
Case # 3
Patient's name: Joe Stern
Doctor's name: Myron Falchuck
Summary of the Anecdote:
The patient was having heart burn and indigestion.The doctor indicate some antacids, but the patient four month later went back to the doctor office, because he was not feeling well. The doctor indicate and endoscopy and found that the patient had cancer.
Result: Gastric lymphoma.
Type of Dr. error: Affective.
Case # 4
Patient's name: Brad Miller
Doctor's name: Jerome Groopman
Summary of the Anecdote:
The patient had pain in his left knee, and the doctor found a tumor in the knee. They did chemotherapy. During the chemotherapy section the doctor did not check the patient well and the patient got and infection.
Result: Osteosarcoma
Type of Dr. error: Affective
Case # 5
Patient's name: Young man
Doctor's name: Karen Delgado.
Summary of the Anecdote:
A young man was found sleeping in the stair of a library, and when he arrive to the emergency room the doctor thought that was a homeless looking for food, and she send him to the waiting room, but an inter found that he was really sick and when the doctor check him. He was in a diabetic comma. This doctor does not give this patient priority, because she judge him as homeless in her first impression.
Result:Diabetic comma.
Type of Dr. error:Attributive.
Case #6
Patient's name: Ellen Barnet.
Doctor's name: Karen Delgado.
Summary of the Anecdote:
Ellen was having estranges hot flashing and she describe herself like a kooky but Dr. Delgado didn't let her self make an other mistake and evaluate the patient extensively and found the right diagnosis.
Result: Endocrine Tumor.
Type of Dr. error:Attributive.
2/14/14
Chapter 1 "Fresh-and-blood Decision-Making
While you read
Answers:
1.He used flash card.I like to use this strategy to memorize formulas.
2.People with more money get more amenities in health care.
3.Medical school have to teach their student how to think with shortcuts.
4.A paper case is details about a patient that medical student resolve in a linear way. The opposite is a short cut.
5.The irony is they teach medical student a different way to think than a doctor use in a real life.
6.“flesh -and- blood decision making” Refer to identified an important point or sign for get a good diagnosis independently of examinations is important that the physician be able to get the sign a related with the patient state.
7.Is how a person can relate his knowledge with a situation to solve problem.Physician have to think while they act and economist think and then act.
8.Is the process of win knowledge by educate guess.Is doctors use heuristics most often they can safe more lives.
9. A stable emotional state.
10.
Chapter 1 "Fresh-and-blood Decision-Making
While you read
Answers:
1.He used flash card.I like to use this strategy to memorize formulas.
2.People with more money get more amenities in health care.
3.Medical school have to teach their student how to think with shortcuts.
4.A paper case is details about a patient that medical student resolve in a linear way. The opposite is a short cut.
5.The irony is they teach medical student a different way to think than a doctor use in a real life.
6.“flesh -and- blood decision making” Refer to identified an important point or sign for get a good diagnosis independently of examinations is important that the physician be able to get the sign a related with the patient state.
7.Is how a person can relate his knowledge with a situation to solve problem.Physician have to think while they act and economist think and then act.
8.Is the process of win knowledge by educate guess.Is doctors use heuristics most often they can safe more lives.
9. A stable emotional state.
10.
11. An optimum level of tension an anxiety that sharply focuses in the mind an trigger quick reactions.
12. Doctors have to get a balance between cognition and emotion to help patients.
12. Doctors have to get a balance between cognition and emotion to help patients.
2/10/14
Introduction
Vocabulary
Page Number Synonym/ Definition
Consultation 1 To visit the Doctor.
Mollify 1 Calm.
Regurgitate 1 Sick up/ Regorge.
Perilous 2 Full of danger or risk.
Manifestation 3 An event or action.
Recitation 3 The act of reciting from memory.
Maladies 3 A disease or ailment.
Salient 3 Most noticeable or important.
Consummate 4 Complete in every detail.
Queried 7 Questioning.
Intrigued 7 Curious.
Infallible 7 Incapable of making mistakes or being wrong.
Layman 7 Person without professional or knowledge in a particular subject.
Intuition 9 Quick understanding to interpret but without using reasoning.
Commodity 9 Something that is bought and sold.
Emaciated 11 Abnormally thin or weak.
Winnowed 11 Blow a current of air through (grain) in order to remove the chaff.
Sedated 15 Calm, dignified, and unhurried.
Endoscopy 15 Look inside.
Celiac disease 15 Is an autoimmune disorder of the small intestine.
Rapport 19 Relationship in which the people concerned understand each other's.
Stigma 19 Mark of disgrace associated with a particular circumstance.
Coalesced Come together and form one mass or whole.
Fallible 24 Capable of making mistakes or being erroneous.
Chunking the Text
Chunk #1 Subtitle: Ann Story Pg. 1-3
Chunk #2 Subtitle: The inspiration Pg.3-10
Chunk #3 Subtitle: The Ann story answer Pg.10-16
Chunk #4 Subtitle: The investigation Pg.16-26
Questions:
1.) Which sections (chunks) were the most difficult for you to read? Why were they so difficult?
A: All sections were difficult for me to read because they have medical terminology that is hard to understand.
2.) When you came across a section that was difficult what process did you go through? How did you try to make it easier for yourself?
A: I started to underline the words and then translated.
3.) Were you able to finish the entire chapter? How long did it take you to read each page?
A: Not at all.Each page took me more or less 12 minutes.
4.) How much time did you devote to reading the text? How often would you read, and for how long? What was your reading process?
A:I think a least 6 hours.
Journal entry about articles related with Celiac disease.
Like Anne Dodge. Donna Sawka was a other woman with celiac disease but she were diagnosis with it after thirty year she started to suffer the symptoms like bloating, chronic diarrhea and stomach ache. As Anne Doctors frame her with a irritable bowel syndrome and they also thought that she was a suffering long term inflammation for spider bite.Other person who lived a similar story that we saw before was Jonathan Papernick almost the same symptoms as Anne and Donna he was getting sick every time he tried to eat and after many visits to different Doctors. He knew that he has a disorder in his yeast level and his apartment was no helping him because the walls were black mold and that was affecting his immune system making his life miserable.
Fortunately those three persons found some specialist who could find the correct diagnosis and help their with the respectives disease.
Introduction
Vocabulary
Page Number Synonym/ Definition
Consultation 1 To visit the Doctor.
Mollify 1 Calm.
Regurgitate 1 Sick up/ Regorge.
Perilous 2 Full of danger or risk.
Manifestation 3 An event or action.
Recitation 3 The act of reciting from memory.
Maladies 3 A disease or ailment.
Salient 3 Most noticeable or important.
Consummate 4 Complete in every detail.
Queried 7 Questioning.
Intrigued 7 Curious.
Infallible 7 Incapable of making mistakes or being wrong.
Layman 7 Person without professional or knowledge in a particular subject.
Intuition 9 Quick understanding to interpret but without using reasoning.
Commodity 9 Something that is bought and sold.
Emaciated 11 Abnormally thin or weak.
Winnowed 11 Blow a current of air through (grain) in order to remove the chaff.
Sedated 15 Calm, dignified, and unhurried.
Endoscopy 15 Look inside.
Celiac disease 15 Is an autoimmune disorder of the small intestine.
Rapport 19 Relationship in which the people concerned understand each other's.
Stigma 19 Mark of disgrace associated with a particular circumstance.
Coalesced Come together and form one mass or whole.
Fallible 24 Capable of making mistakes or being erroneous.
Chunking the Text
Chunk #1 Subtitle: Ann Story Pg. 1-3
Chunk #2 Subtitle: The inspiration Pg.3-10
Chunk #3 Subtitle: The Ann story answer Pg.10-16
Chunk #4 Subtitle: The investigation Pg.16-26
Questions:
1.) Which sections (chunks) were the most difficult for you to read? Why were they so difficult?
A: All sections were difficult for me to read because they have medical terminology that is hard to understand.
2.) When you came across a section that was difficult what process did you go through? How did you try to make it easier for yourself?
A: I started to underline the words and then translated.
3.) Were you able to finish the entire chapter? How long did it take you to read each page?
A: Not at all.Each page took me more or less 12 minutes.
4.) How much time did you devote to reading the text? How often would you read, and for how long? What was your reading process?
A:I think a least 6 hours.
Journal entry about articles related with Celiac disease.
Like Anne Dodge. Donna Sawka was a other woman with celiac disease but she were diagnosis with it after thirty year she started to suffer the symptoms like bloating, chronic diarrhea and stomach ache. As Anne Doctors frame her with a irritable bowel syndrome and they also thought that she was a suffering long term inflammation for spider bite.Other person who lived a similar story that we saw before was Jonathan Papernick almost the same symptoms as Anne and Donna he was getting sick every time he tried to eat and after many visits to different Doctors. He knew that he has a disorder in his yeast level and his apartment was no helping him because the walls were black mold and that was affecting his immune system making his life miserable.
Fortunately those three persons found some specialist who could find the correct diagnosis and help their with the respectives disease.