Serious complications can be quite subtle that unless you answer questions, they may be missed. Having someone come in, listen to your heart and lungs, ask a few questions can't really be replaced with machines.
(It wouldn't even need to know what the odd thing represents; just that it's out-of-expectation enough to require someone to come over and check on you! A bit like asking a family's child to watch grandma while you speak to the mom and dad. All you want the child to do, is to freak out and get your attention if grandma does anything other than what she was already doing!)
Doctors not having to manually probe any signs of heart/lung problems each time they're in the room, would mean that they get either get more time to test each patient for consciousness/lucidity; get time to check on more patients; or (my preferred option) are able to make each check-session shorter and less invasive (no need to sit the patient up to listen to their lungs through their back, for example), and thus less disturbing of a patient's sleep quality (because it's easier to go back to sleep after a short conversation, when you haven't had your blood pressure spike from sitting up.)
The thing people don't seem to understand is the fact doctors also monitor consciousness. Depressed mental state is also a sign of blood loss. The patient's neurological state is important information, it has diagnostic and prognostic value.
The most basic way of evaluating a patient's neuropsychological state is to bother them with questions.
It was like they were obsessed with busy work, I couldn’t tell if they didn’t want me there or if this was VIP treatment to them
It was in another country
Plus my boss kept calling me.
The fact that med school + residency means you basically have to put your life on hold throughout all of your 20s while other people are figuring out the whole “being a young adult in the world” thing leads to very… particular emotional development.
Medical school doesn’t particularly encourage questioning the status quo or established practices.
Some of them can recalibrate after a few years in the real world, but many never really escape that bubble. It’s hard to radically change your outlook on life in your 30s (let alone when you now have to repay huge debt, in the case of many American doctors)
Many of premed kids I knew in undergrad (or the high schoolers aspiring to premed) weren’t motivated by scientific pursuits or an altruistic desires - they just had to be the best. They needed to ace every test (and would argue incessantly with the teachers about it), they had to be in the hardest classes, etc. they became doctors because somebody told them it was hard and well respected.
I imagine that those people become doctors that are disconnected from their patients.
- Rich and respected -> doctor
- Rich but not respected -> lawyer, software
- Not rich but respected -> professor
A lot of people are going to be disappointed. Truth is medicine is a decadent profession, worldwide. In some countries, it's in free fall and accelerating to terminal velocity. In some parts of the world, doctors are hated to the point they routinely suffer physical violence.
The US manages to keep it relevant by restricting supply and maintaining its elite status but I'm not sure doctors are still respected there. Plenty of hackers who think they can do it better than the doctors right here on HN. I'm a programmer myself and I know for a fact a computer could do significant parts of the job. Even psychiatry is in danger due to LLMs.
A computer does a massive part of almost any job today, so I’m not sure what exactly this is trying to say about the profession. Wait until you hear that pilots can’t even fly without an airplane. Total conmen.
> Plenty of hackers who think they can do it better than the doctors right here on HN
Of course they would, it's easy to come up with solutions that are simple and wrong, when one has no point of reference. Hackers understand balancing trade-offs in programming languages or architectures, but can't imagine other fields being nuanced or even more complex. If an LLM cant tell you when to use a monorepo, then it far from telling you when a specific drug dosage is right for a patients set of circumstances.
1. I can use that word, I am one too.
It's hard to describe the effect years of this can have on the mind. Things can get so distorted you feel guilty for eating, for going to the bathroom, sleeping, resting. Normal people things like a weekend or a good night's sleep become luxuries to you. You come home and everyone's already asleep. People start out all starry eyed and thinking about making a successful career out of helping people, but as it nears its end people can't wait to just start making fat stacks already.
It functions as a sociopath breeding ground. Basically weeds out your humanity by punching you until you like it, hammering you until you get good at it so that you fit into the system. Some people just quit when faced with that, others try to take it and end up committing suicide. One of the most haunting stories I've ever heard was about young woman asking her attendings about suicide methods after a patient killed himself. They thought she was an interested student who was trying to learn about stuff so they happily dispensed all the information they knew. She efficiently and painlessly killed herself not even a day later.
People who make it out of this process might enjoy good pay and lifestyle depending on the country and the specialty they chose. It definitely costs them, though.
The power to repair people, fend off suffering and death. That's religion level power. It's bound to warp everything around it like a black hole.
It would take a society of exceptional sanity to handle it right.
Disconnected? Probably. But I think that's intended and part of the current medical model. It's not necessarily a bad thing when focusing on long term positive outcomes in aggregate. But it certainly feels inhumane at times to the individual and their loved ones.
But lack of sleep can impair immunity and disturb blood pressure and heart rhythm. Keeping someone with major trauma under stress (like being constantly awake) can make them more likely to die.
When sleep deprived, the brain enters REM sleep even while awake. That's what those hallucinations are.
I have had the misfortune of experiencing this twice in my life so far; the first on a month-long car trip with my buddy and the second while i was the caregiver/caretaker for my Mother. In both cases it was my lack of sleep which made me very difficult to be around.
1) Sleep Deprivation - https://en.wikipedia.org/wiki/Sleep_deprivation
2) Also Related; The medications that change who we are - https://www.bbc.com/future/article/20200108-the-medications-...
So whenever you note that somebody's behaviour has abruptly changed, always ask two questions; a) Are you sleeping well? b) What medications are you taking and what diet are you on?
When someone dies in the hospital what happens in the inquiry? Examine the symptoms of the person who died and how to detect them. Add another check.
If they left someone alone for 2 hours or 4 hours and they passed away during that time, what would the headlines read? "General Healthcare left the patient alone for X hours and didn't even bother to check on their well being."
She's super cute, intelligent and active but also extremely demanding and had a lot of problems with dermatitis, tummy aches, KISS syndrome and other stuff that made her not sleep well and cry a lot (and she's super loud).
It also made me respect single parents 10000 times more than before. I can't imagine handling a situation like that alone.
Fear based decisions don’t always lead to the best outcomes, though I am in no way dismissing the fear :)
Of course it's a trade-off I'd gladly make again but it still sucks that I will never feel as well rested day-to-day as I did before kids.
How odd. Why do hospitals not cluster these interactions together — the "while I've got you here..." experience?
In the case of a pregnancy, I'm assuming these "briefings" are things like trying to teach the new parent things they'll need to know when they go home; or giving them status updates about tests done on their new baby if they're in the NICU, and so forth. These all seem like things that could wait.
Is the point to use the infodumping as an excuse to do the tests?
Honestly, the truth is hospitals are designed to do this. The entire purpose of the place is to have people moved into it so that these constant checks and examinations as well as treatments can be done most efficiently. The idea is to rapidly notice and react to changes in the patient's condition.
In programming terms, the core function of a hospital is to poll and update the patient's state in a loop that runs while consent is given and until cured or dead. The polling frequency is calibrated according to knowledge of the patient's general condition and the specific pathology being treated.
If you know the patient could bleed out and die after some surgical procedure, you want to check periodically that this is not happening. How frequently do you check? Depends on what you predict could happen. If you think the worst that could happen is a small and slow bleeding, then you can check less often. If you think there's risk of major bleeding, then you want to check frequently, possibly even constantly.
As son and father in an end of life situation there was no gap to contemplate or allow us to connect it was drugs injection, food, check if he ate, back again, pick up tray, more drugs, check on his breathing, bathroom break (needed assistance).
Dad was probably OK with it but we never had a chance to just have a moment and possibly say something we never would have. He died at 8:40pm on my birthday of all days as I sat next to him.
We made it clear we wanted to be left alone over night, had reasons for why (neurological issues that are exacerbated by poor sleep) and they largely respected that. Maybe if we didn’t have that excuse it would have been worse. Shit, even the vending machine salads were pretty good. Didn’t love sleeping on a foam bench for 5 days, but we felt quite positive about the delivery center we had our child at in the US.
Even the c-section seemed absolutly brutal, at one point I was convinced one of the surgeons placed his foot on the table for leverage, given how much movement there was to her body.
As if the physical trauma wasn't enough, being in a room with multiple first-time parents struggling to breastfeed as both they and their children cried, then being visited and probed every hour by medical staff with ineffective pain relief, /and/ having work out how to care for your child when the only communication path is basically through an amplitude modulated scream -
Honestly, I've had some low points in my life, I thought I had a high tolerance for physical and emotional pain, but I can only describe what my wife experienced this week as total, crushing anguish.
How anyone can recover from something as savage as childbirth is beyond me. It is no small miracle that she was able to walk, let alone care for two new babies and herself (with my help, but there's only so much I can do to assist with breastfeeding or healing of major trauma).
At one point I asked all the nurses to leave and not come back for 6 hours in very angry tones.