Eye docs versus ear docs

I hope that this article is not misleading. I am not writing about doctors who take care of the ears or doctors who give eye care. More importantly, I hope to relate the importance of ear doctors who listen and take a good medical and social history from a patient versus the eye doctors who just want to review the laboratory and diagnostic results without listening and performing a thorough examination of the patient.

When I was in medical school, and also during my residency in medicine, there were a limited number of diagnostic and laboratory tests that you could order on a patient. However, we were taught that a good history and examination made it possible to lead toward an accurate diagnosis of what was ailing the patient. I recall one of my mentors and teachers, Dr. Clarence Dennis, a great surgeon, telling me that when a patient presents with an acute abdomen (an abdomen that is tender to touch and swollen), just one question to the patient would help make a life-saving diagnosis. That question was, “Are you hungry or have you lost your appetite?” If the patient answered yes to the second part of the question, you could believe that something serious was happening, such as appendicitis, infected gall bladder, intestinal infection such as diverticulosis, etc. On the other hand, if the patient related that he or she was hungry with abdominal pain, more than likely, the abdominal condition was of a less serious nature, such as gastritis caused by food poisoning or infected fallopian tubes, and presented with no surgical conditions. Now this question to the patient is not written in stone. However, I can tell you it has helped me to make lifesaving diagnoses, and I have the patients to prove it. Dennis also insisted that we listen for bowel sounds for at least five minutes. If active bowels sounds were heard, it was also an indication that the acute abdomen was not a surgical candidate.

The ear doc is one who establishes a good relationship with the patient. He or she knows the family history, work history and mental and religious background. In other words, the patient becomes spirit and blood, rather than just flesh and blood. As you know, I made house calls on my patients, and you can’t imagine how often it allowed me to make an adequate diagnosis from just what I discovered and observed in the home that may have caused a medical condition. For example, the patient may have been taking an over-the-counter medication that I observed on his or her nightstand. This medication may have been the cause of symptoms. In other words, the eye doc would miss this important information and probably would prescribe a drug to relieve a drug to relieve the symptoms that were caused by another drug that the patient didn’t reveal to him. It is therefore important, when going to a doctor, to take all of your medications with you, as well as the herbs, vitamins, etc., so he or she will not be misled.

Wisdom and opinions from older and wiser docs

• “There are only two sorts of doctors: those who practice with their brains and those who practice with their tongues.” Sir William Osler (1849-1919), Canadian physician.

• “Take care of your health. You have no right to neglect it and become a burden to yourself and perhaps others.” Samuel Johnson (1709-1784), English author.

• “Life is not to live, but to be well.” Marcus Valerius Martialis (c. 38 AD-104 AD), Roman scholar.

• “No matter how complex or specialized medicine may become in the decades ahead … there always will have to be the equivalent of the family doctor.” Dwight Harrison Murray (1888-1974) American physician.

Finally, it was the Swiss physician and alchemist Paracelsus (1493-1541), who wrote, “Every physician must be rich in knowledge and not only of that which is written in books. His patients should be his book; they will never mislead him.”

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