Teaming Up
A young girl with a ruptured appendix; a middle-aged man with a massive heart attack; a mother of three with a scary lump in her breast. Or perhaps it's your mother who fell on the pavement and broke her hip. Or your son who just attempted suicide at college. Or your husband, whose spleen began leaking after an automobile accident. These are everyday events in the world of medicine, but they are all personal crises that quickly make most other everyday things seem trivial.
At those moments of treacherous illness, what matters most is that the patient is in the trusted hands of expert, caring doctors. Ones who explain what's going on, who are there with round-the-clock ministrations if need be, and who secure the best possible outcome. This is the expected way, honoring no clock or self-interest. And this is the stuff of medicine that makes nice people want to be doctors.
There is no greater thrill than seeing a sick patient heal. No greater joy than knowing hard-earned human efforts made a difference. But to achieve that in today's world, doctors can't fly solo anymore. For one thing, by today's rules no docs should be working around the clock; they need to be spelled by rested colleagues. Beyond that, however, medical advances have led to an ever finer carving of medical disciplines into specialties and sub-specialties, driven by scientific discovery, which has brought good results in the curing or quelling of human disease.
Uberdocs. But this is recent history. Surgery was medicine's first one-on-one therapeutic specialty, flowering over the past 100 years. It was enabled not only by understanding infection and its prevention through clean hands, masks, rubber gloves, and sterilized instruments but also by the discovery of anesthesia. Without anesthesia, doctors dared not penetrate the belly or chest or drill into the skull. But with it, and accompanied by postoperative teams specialized in intensive care, surgeons began to cure many diseases that, left to their natural course, were killers. The surgeon became the uberdoctor, the center of hospital life, and the ultimate healing hands.
Further medical advances ushered in other disciplines to rival surgery, using less blunt instruments. The internist, for example, started as the learned diagnostician who grasped the disease, pontificated on its outcome, and called in surgeons as needed. In those good old days of the solo doctor making house visits late into the night, his signature black bag was actually pretty empty--and what was there often did more bad than good. It was Oliver Wendell Holmes Sr., the renowned Boston physician and father of the famous Supreme Court justice, who summed it up in a speech before the Massachusetts Medical Society in 1860. After deriding the use of emetics, cathartics, blistering agents, and opium, he told his colleagues that if the whole existing formulary of drugs and potions available to them were sunk to the bottom of the sea, it would be all the better for mankind--and all the worse for the fish.
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