By Nahum Kovalski
In past, I have spoken of my great honor of having worked with giants in the medical field. I’m not talking about world-renowned researchers or Dr. Oz. I’m talking about physicians who put the patient first. First before what? It could be anything. It could be their personal life, their professional life, their ego and so much more. I’ve tried to learn from these doctors, and I have stumbled too often along the way. But if I have reflected a small part of what they taught me, I consider that a success.
It should be already clear that I consider medicine far more than another profession. I do not agree with doctors’ own feelings that they deserve special treatment. Quite the contrary, I believe that medicine is a calling which demands sacrifice. In fact, I think medicine is a perfect example of the lesson that we are taught by Judaism, in regards to privilege. Unlike that of many other religions, past and present, there was a sense that a higher standing in the community/culture/religion, came with privileges that others did not have.
The key is that those privileges more than outweighed the added responsibility. To be a king in ancient times did have of course the responsibility of managing the finances and defenses of one’s country, and this is by no means a small task. The question is what benefits came with this role? In Jewish law, a king was bound by the same morality, if not more, than any other regular individual.
In Jewish tradition, any leader has responsibilities that clearly outweigh their privileges. The classic example is Moses. What greater Jewish leader is there in our history, and yet I, at least, would never want to switch places with him. He interacted with G-d in a unique way amongst all of mankind throughout history. But the toll that it took on him, beat him down over the years. And he was not even granted entry into Israel. His own two sons, according to the Midrash, were lost to him, his marriage faded away and he was denied Aliyah. I think it’s fair to call this a tragic life despite the tremendous privileges he was granted.
I’m not asking doctors to live in poverty and celibacy, and I am not expecting doctors to forgo any personal benefits. As I said, it is not that I deny doctors’ privileges – it is that their responsibilities should always clearly supersede those privileges. Ego, for example, is a privilege that all doctors should forgo. Yes, I live in the land of candy canes, and I can see Lucy dancing in the sky with diamonds. I personally think that ego is something that should be tested for, in all potential doctors, and if it is above a relatively low level, this should be reason for denial of entry to medical practice.
I don’t know if I heard this from someone or if I read this somewhere, but I personally like a particular quote that says “a man who has no enemies has never spoken the truth”. There is an assumption that each one of us will have a certain perspective that by its own nature will clash with some of those around us. And if you are honest about that perspective, you will come to serious rifts in your relationships.
I have lost good friends over time because of such rifts. They are still good people, with good hearts who strive to do right. Yet, we saw certain things in such a fundamentally different way that it made it very difficult to continue that friendship. In some cases, the rifts were professional. These are much easier to imagine. I fundamentally disagree with the professional perspective of probably far too many people. But if the disagreement is significant, I personally limit my communications with such people.
One of my habits is to read the medical and technology literature on a daily basis. Specifically, in terms of the medical literature, I decided quite a number of years ago that it would be appropriate for me to share a select group of abstracts with colleagues. I felt that this select group of summaries of up-to-date research were important enough for almost any doctor to be aware of. Despite someone even being a sub-specialist, I personally believe that there are still some general principles of medicine that they should be up-to-date on.
Given the explosion of information in the medical field just in the last few years, it is hard enough to stay up-to-date in one’s own field. This is why I share this newsletter of abstracts with anyone who wishes it, for free. It is very time-consuming to assemble this list of abstracts. But I now consider it a personal responsibility to do so, as I know that there are at least some people who depend on this newsletter to keep them up-to-date on certain topics that they literally do not have the time to read about.
I came across an abstract this morning from the Lancet, which is considered one of the top journals in the medical field. I will jump to the conclusion of this abstract that says that people with minor strokes or even just suspected transient strokes [called TIAs], should start taking aspirin immediately.
Let me be clear that the first thing that such a person should do is immediately go to the hospital. At the very least, the patient should speak to a doctor before taking any medication. Even a simple aspirin can interact with other medications and cause serious complications. But it is fair to say that this kind of information is something that anyone with an M.D. should know.
To quote further from the research, the reduced risk of a disabling or fatal stroke after this initial mini-stroke was reduced by 93% in the first two weeks. This is the kind of information that could change a person’s life in the most dramatic way. A stroke is one type of disease that can drastically reduce the quality of life of a person. If such a stroke occurs because no one thought to tell the patient to start taking an aspirin every day, that is tragic.
The moment I read this abstract, I shared it with a list of people, including those who I regularly do not interact with, for reasons noted above. I don’t expect a response from any of these people, I definitely don’t expect a thank you, and I don’t even expect a reciprocal sharing of critical information. I would hope for at least the last item, i.e. reciprocal sharing of information. I am just as much in need of updates to expand my knowledge base, as everyone else.
There are few of us whose egos don’t need a bit of deflation. And my ego gets the best of me too often. I try to battle it back by mimicking great doctors I’ve known. I consider the sharing of this one abstract as critical in saying to myself and others, that a patient’s welfare should always take precedence over our personal issues. Not to share such information with someone because of any personal or professional grudge would be, in my opinion, malpractice in the worst moral of ways.
The general public should read about this, specifically the need for aspirin after a mini stroke. You should discuss this with your doctor and be prepared, despite the fact that I wish that everyone never know of such things.
I think it is also important to point out that the conclusion from this research is based on 16,000 patients [which is a lot] collected together from 12 different independent research trials. Collecting data on this scale, manipulating it and extracting its key conclusions is something that can only be done because of modern-day computing. As we enter the age of self quantification, where soon, the majority of people will constantly monitor their own health in some way, it will be even more important to use advanced computing to dissect out critical conclusions from masses of data.
The medical findings that we will uncover by analysis of all of this new data, will change the face of medicine. And in a couple of generations, doctors [in whatever form they still are] will wonder how we functioned without modern technology, just as we today find it hard to imagine that we ever got along without our mobile phones.
I certainly hope that in our attempt to create a fully digital physician, made purely of silicon and with all the capabilities of a super advanced artificial intelligence, that we also do not create Artificial Ego.
Thanks for listening.
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