The cornerstone of all medical science and practice is internal medicine. Its principles should be readily available to all adults, especially in today's chaotic medical environment, which is full of complexities, inefficiencies, and difficult access issues. Take advantage of Dr. Goodman's expertise based on his 33 years' experience in virtually every medical situation and setting. [Editor's note: Dr. Goodman no longer contributes to Silver Planet, but we have made his archived blog entries available as a service to our readers.]
One of the more pleasant aspects of my professional life is to read excellent medical journals and publications. I read, skim, or speed read quite a few, mostly in my own specialty of internal medicine. (And, yes, "internal medicine" IS a specialty. I have never liked the term primary care medicine and almost never use it. I consider it to be a meaningless nonmedical term of economic convenience for those who do not know the essence of medicine.)
It is fascinating to read in these terrific journals about new advances and better understanding of disease mechanisms. It is also gratifying to read reviews or validations about established concepts. I still read the print editions, preferring ink and paper, but just about all the journals are now accessible on the Internet as well.
Journal reading makes me a better physician, as it keeps my mind sharp and always open to new concepts. It helps make me a real internal medicine physician, who must constantly ask himself and his colleagues not just WHAT disorder a patient might have, but also WHY the patient might have it. For example, it is not enough to diagnose hypertension, asthma, or stroke. A physician must constantly ask himself or herself why a patient has this or that, why it got worse, etc. The journals I read set the tone and pace for me as I approach the mysteries of each patient.
I digress a bit now to state what might be obvious: a journal editor sets the tone and pace of his or her journal. In my opinion, one of the best editors is Joseph Alpert, MD, professor of medicine at the University of Arizona College of Medicine (in Tucson), and editor-in-chief of the American Journal of Medicine, also affectionately known as the "Green Journal," because of its distinctive dark green cover. Always one of the foremost internal medicine journals, it is now better than ever, due in large part to Dr. Alpert's dedication to clinical matters, including the primacy of the history and physical examination as the cornerstone of all medical practice. Dr. Alpert also incorporates common sense into our complex world, where bad science and unsubstantiated opinions frequently interfere with good science and evidence-based judgments.
I share with you now some words of wisdom from Dr. Alpert. In the July 2008 issue of the American Journal of Medicine (Vol. 121, No. 7), his commentary piece "12 Guides to Health, Happiness, and Longevity (with Apologies to P.J. O’Rourke)” offers ”strategies to enable patients to live longer and feel happier during their journey to old age."
In summary form, including some of my own parenthetical comments, this is what Dr. Alpert wrote:
Words of wisdom, indeed, from Dr. Alpert, a superb physician-educator. And to his thoughts, I take the liberty of adding a few of my own:
Enjoy life. Have a sense of purpose. Maintain your dignity. To the extent that you can, help others to do so as well, but do not depend on the medical profession alone to bring these entities to you. Do not use medical resources to unnecessarily prolong your time in this world or to determine the exact time of your departure for "the world to come." Or, put more bluntly: While it is reasonable to expect the medical profession to gain inspiration from the divine spirit of the universe, it is not proper to expect the medical profession to take on the role of the divine spirit—that from which both life and death ultimately derive.
Eli Goodman, MD
Medical Insights Blog