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THE HERALD OUTLOOK Saturday February Page 13 Outlook op Lifestyle Doctors speak on doctors By DR CHARLES GODFREY Without doubt there is a need to know more about doctors who bey are bow they think what causes their actions why they medicine and when did your friendly family doctor change into another person At this unique time in the history of healing it has become more and more urgent to know about this special group of people to whom we have handed great power yet revile as agents of cupidity stupidity and culpability John Pekkanen has attempted to answer some of these questions by going behind the masks of the men and women who practise medicine and recording what they have to say for themselves In M Doc tors Talk Themselves press 294 pages he exposes what lies beneath the images we have of our health providers The author looks at doctors from the standpoint of their education the patients they treat the money they earn and the multifaceted problems associated with clinical practice Death and dying the pocratic oath the politics and greed of bad medicine and the pro blems associated with malpractice are all laid bare on the examining table in this book which consists of a series of anecdotes by physicians speak anonymously kanen surgically removes tissue from the corpus of medicine and sends each specimen to you the pathologist so you can make a decision as to the cause of the parlous state of medicine In doing so there is presented a litany of overwork over stress and overachievement as part of the process of becoming a doctor During those formative years the is subjected to- a denial of sleep self indulgence and frivolity even to the point of depression Pekkanen records a common pattern of grin ding hours of stressful frenzy to demonstrate that men are judged equal until they have proven themselves inferior But he adds that women are judged inferior until they have proven themselves equal in the medical game In order to pass the qualification hur die graduates sometimes have to work to hours a week Several doctors remarked they became inefficient after hours anti social after 60 and downright malevolent after 801 Having qualified the physician has to face the sick without the shield of a staff physician Ac cording to this report patients fit into clear categories the self pitiers the help rejecting crocks the dependent dingers the selfdestructive and the entitled Some a minority are normal people with terrible diseases Interwoven with a series of stories about the inability of the healthcare system to care for the needy are sensitive empatbetic accounts of the soft triumphs that go with good medical care well done These precious moments give a glimpse of the enormous satisfaction that derives from be ing a caring professional which counterpoints the obvious frustra tion of dealing with inconsiderate ignorant patients who are fre quently the vector of their own he did not think he would ever be totally comfortable with having the ability to say now it time to die The book is based on American testimony and the chapter on malpractice sounds horrendous to a Canadian reader However it is acknowledged that Canadian medicine does follow American in some ways and the examples of excesses that are cited here may osmose north of the 4Mb parallel As for medical train ing in Canada an association of residents and interns PAIRO has been able to negotiate with hospitals and universities a more civilized lifestyle for students with a human schedule for service Un fortunately in some cases the demands of patient care override the carefully setout schedule for hours on duty It s a fascinating book somewhat like overhearing a frag of a conversation on the sub way before alighting You leave wanting to know bow it will end And It important you know how it all works out because you are part of the solution or is it the pro blem However this patchwork approach while absorbing loses some of the synthesis mat is necessary to what is driving the world of medicine In this area the book misses the im pact that Paul Starr provided in bis work The Social Transformation of American But there is sufficient meat in BID to absorb the reader as be senses some of the magic that is and some of the frustrations that are turning physicians from the selfless care givers Into bottom line Charles Godfrey is direc tor of rehabilitation medidne at Wellesley Hospital In Toronto and archivist for Faculty of Medidne at University of Toronto Alzheimer Disease serious concern for elderly Alzheimer Disease is a serious concern for our aging population Alzheimer Disease is an incu rable brain condition that strikes both men and women usually over the age of It is initially characterized by minor forgetful- ness As memory loss increases changes also appear in mood and behavior Judge ment physical coordination speech and concentration will also be affected Degeneration usually continues until the pa requires full time nursing care In Canada now there are about 300000 people suffering from the disease By the year 2000 that number is expected to nse to 500000 Each year people die from the disease al though it is often not named as the cause of death The Alzhei mer patient usually succumbs to such illnesses as pneumonia or infection Research shows that changes in the brain that occur in Alzheimer Disease are the pres ence of neurofibrillary tangles within nerve cells the appear ance of plaques that appear to cause disruption of electrochemi cal signals between nerve cells a deficiency in the neurotransmit ter acetylcholine and the pres ence of aluminum For more information about Alzheimer Disease contact your local Alzheimer Society or the Alzheimer Society of Canada Your Choice Yonge Street Suite 302 Toronto Ontario M4T 1X2 925 EVOCATIVE STORIES Some of most evocative stories are when doctors talk about death and dying Here tbe de meaning episodes of much of medical practice are swept aside as it is realized how much of the physician dies with each patient The premature baby who requires multiple hospital visits to relieve the water on tbe brain finally reaches the termination of medical technology and cannot be revived again A nurse held the babyB hand while I removed its ven tilator Then the nurse and doctor stand silently as the infant slips away Or internist who is begg ed by a young father to do something about tbe malignant melanoma that has spread to his brain The doctor froze when be saw the family approaching him and broke down crying and almost collapsed to bis knees He said that YMS COMPUTERS No Business is too small to computerize Call now for a personal analysis of your business needs Cellular Phones 5198534534 Fax Machines 21 Mill St West C ACTONL7J1G3 Tranng Prepared by the International Institute the association of professional drycleaners launderers MirrorMirror Plastic trims that give a ror like effect can be found on many garments today The effect is produced by coaling the back of the mm with a reflective or shiny coating Some of these coatings are solu or partially removed by drycleanmg causing the mirror to become frosted or cloudy The trim may be attached to the fabric with an adhesive In some cases the adhesive solves in solvent and this causes a separation or removal of the trim during In other cases the trim is clamped on with metal prongs which can snag the fabric during cleaning and tumbling operations If the mm is damaged when the care procedures recom mended on the care label are used the drycleaner is not responsible The item should be returned to the retailer for an adjustment BARRAGERS CLEANERS ft LAUNDROMAT Four Location To Sane Blmgtn BimgfraCluntrs Bnnatn Ctouwn Slamrack Ctunera GMiUMn Gnrgtlm Effete It an investment irate each week at the time you reganjiess whether you need soft water WATER SOFT AS PETALS AT YOUR COMMAND water you use itnevw regenerates too latBOPij ft urllbleW electrons