How Doctors Think Quotes
"But my intuition told me that the picture didn’t entirely fit."
"You have to be prepared in your mind for the atypical and not so quickly reassure yourself, and your patient, that everything is okay."
"You want to be just at the peak, where you think and perform the best."
"You have to give her the benefit of a doubt."
"It just seemed impossible to absolutely conclude it was all psychiatric."
"What distinguished my learning from the learning of my young trainees was the nature of the deficiency, the type of flaw."
"Statistics cannot substitute for the human being before you; statistics embody averages, not individuals."
"Medicine is, at its core, an uncertain science."
"The doctor is supposed to be emotionally neutral and evenhanded with everybody, and we know that’s not true."
"Every physician, even the most brilliant, makes a misdiagnosis or chooses the wrong therapy."
"I forced myself to go in and offer a few words of encouragement."
"I needed to reclaim my balance and this was the only way I knew how."
"The secret of the care of the patient is in caring for the patient."
"We have to detach ourselves from anguish that could impede our work."
"To become immune to feeling, as Peabody indicated, is to diminish the full role of the physician."
"The hardest thing about being a doctor is that you learn best from your mistakes."
"I’m having what I call explosions, feeling hot all over, which make my skin crawl."
"It is impossible to catalog all of the stereotypes that you carry in your mind."
"You don’t want to have to make a mistake to learn with each stereotype."
"Patients and their families swim together with physicians in a sea of feelings."
"Rachel slowly lifted the baby and pressed her against her breast. She could feel the rapid fluttering of the infant’s heart against her own."
"The mayor of Phu Tho said that the children of Vietnam were a national treasure, precious and to be guarded."
"Rachel was spent from the journey. Shortly after putting the baby to sleep, she collapsed in her bed."
"The resident explained to Rachel that Shira’s pneumonia was so severe that it was preventing her from getting enough oxygen to cope with even the most minor stress."
"Rachel felt as if she were on one of those amusement park rides that spins you around in circles, turns you upside down, then flings you to the edge of the rail so your eyes blur, your stomach heaves, and your mind goes blank."
"Rachel, the mother, had to do everything she could to stop death from wrenching her daughter away."
"Rachel realized then what all doctors and nurses should know, that every clinical event has a core of uncertainty. No outcome is ever completely predictable."
"The oxygen level in Shira’s blood was still low. 'We’ll try Hi-Fi,' the ICU doctor told Rachel."
"Rachel had not slept for days, had eaten little. She had been cast into the ocean of illness, a vortex of calamity sucking her down deeper and deeper."
"Rachel explained this to the resident. He nodded kindly and said he understood."
"Rachel prayed for the courage to engage that uncertainty. She would learn everything possible about Shira’s case, and, respectfully, question each and every assumption about the diagnosis and treatment."
"Rachel thought how the Sabbath was the time when these reservoirs were refilled."
"I have made the same cognitive errors that Shira’s doctors did, despite all my training and all my good intentions."
"ECMO stands for extracorporeal membrane oxygenation. It is a process whereby Shira’s blood would be freshened with oxygen outside her body."
"I want you to write three prescriptions a week for the next month."
"I don’t know what more I can do, Dr. Delgado."
"Could be your testosterone is running on empty."
"identify the men in your practice with low testosterone who may benefit from clinical performance in a packet."
"improved sexual function," "improved mood," and "increased bone mineral density."
"Who doesn’t sometimes doze off after dinner?"
"Normal" testosterone levels refer to what is normal for men in their twenties.
"A disease that can attack a person in perfect health, in the full vigor of early maturity, and in some insidious, mysterious way, within a few months, destroy life, is surely a subject important enough to demand our best thought and continued study."
"The more aggressive the disease, the more aggressive the treatment."
"Just because you can’t treat someone any longer for his cancer doesn’t mean that you stop treating him."
"You have to show them a path that doesn’t violate any principles of their life or their obligations to their family."
"Their choice has to be consistent with their philosophy of living."
"You can’t practice defensive medicine like this, particularly when it involves subjecting a person to major surgery."
"Fundamentally, it’s not about the hospital... what matters most is the doctor."
"But what matters most is the doctor. And, I tell people that a physician might be the right doctor for you but not the right doctor for another individual."
"Sometimes veering too far from widely tested therapies can result in unnecessary toxicity and suffering."
"Which path they take pivots on clinical facts and the dimension of character—their own and their doctors’."
"In most cases, a physician arrives at the correct diagnosis and offers appropriate treatments. But not always."
"Recall that most misguided care results from a cascade of cognitive errors."
"Different doctors have different styles of practice, different approaches to problems. But all of us are susceptible to the same mistakes in thinking."
"Telling the story afresh can help you recall a vital bit of information that you forgot."
"Our thoughts about our unrelieved symptoms often focus on the worst-case scenario."
"For some, articulating such fears is exceedingly difficult to do because of magical thinking—the notion that saying it might make it real."
"A thoughtful doctor listens closely to these worries."
"The imperative from hospital and managed care administrators is to be economical."
"When you or your loved one asks simply, 'What else could it be?' you help bring closer to the surface the reality of uncertainty in medicine."
"I believe when you say something is wrong, but I haven’t figured it out."
"The statement 'Nothing is wrong with you' is dangerous on two accounts."
"Many doctors, as we have seen, dislike patients whom they stereotype as neurotic and anxious."
"All of this takes time, and time is the greatest luxury in today’s medical care."
"There is no better way to care for those who need my caring."
"Doctors' freedom to prescribe reflects the core of professional autonomy."
"Fear of failure drives oncologists to pursue aggressive treatments."
"Evidence-based medicine seeks to integrate individual clinical expertise with the best available external evidence."
"The ethical marketing of drugs requires transparency and prioritizes patient well-being over profits."
"The gestalt of a diagnosis emerges from the accumulation of evidence, not from a single indicator."
"The art of medicine lies in its practice as much as in the scientific knowledge it employs."
"Misdiagnosis can stem from a variety of cognitive biases, including representativeness and outcome bias."
"Technical skill and guided thinking are both essential in the complex decision-making process of medical practice."
"The satisfaction of search effect can lead to premature closure in diagnostic reasoning."
"Understanding a patient's story is as crucial as interpreting their symptoms."