Quotes of All Topics . Occasions . Authors
We should not be discouraged or depressed by our shortcomings. No one is without weakness. As part of the divine plan, we are tested to see whether we master weakness or let weakness master us. Proper diagnosis is essential to proper treatment. The Lord gave us this remarkable assurance: "Because thou hast seen thy weakness thou shalt be made strong" (Ether 12:37). But wishing for strength won't make us strong. It takes faith and work to shore up a weakened cord of integrity.
But when it has been shown by the researches of Pasteur that the septic property of the atmosphere depended not on the oxygen, or any gaseous constituent, but on minute organisms suspended in it, which owed their energy to their vitality, it occurred to me that decomposition in the injured part might be avoided without excluding the air, by applying as a dressing some material capable of destroying the life of the floating particles. Upon this principle I have based a practice.
The various systems of doctrine that have held dominion over man have been demonstrated to be true beyond all question by rationalists of such power-to name only a few-as Aquinas and Calvin and Hegel and Marx. Guided by these master hands the intellect has shown itself more deadly than cholera or bubonic plague and far more cruel. The incompatibility with one another of all the great systems of doctrine might surely be have expected to provoke some curiosity about their nature.
The big thing that's happened is, in the time since the Affordable Care Act has been going on, our medical science has been advancing. We have now genomic data. We have the power of big data about what your living patterns are, what's happening in your body. Even your smartphone can collect data about your walking or your pulse or other things that could be incredibly meaningful in being able to predict whether you have disease coming in the future and help avert those problems.
The UFO was bouncing around the 747. It was a huge ball with lights running around it... Well, I've been involved in a lot of cover-ups with the FAA. When we gave the presentation to the Reagan staff, they had all those people swear that this never happened. But they never had me swear it never happened. I can tell you what I've seen with my own eyes. I've got a videotape. I've got the voice tape. I've got the reports that were filed that will confirm what I've been telling you.
Agency, or the power to choose, was ours as spirit children of our Creator before the world was. It is a gift from God, nearly as precious as life itself. Often, however, agency is misunderstood. While we are free to choose, once we have made those choices, we are tied to the consequence of those choices. We are free to take drugs or not. But once we choose to use a habit-forming drug, we are bound to the consequences of that choice. Addiction surrenders later freedom to choose.
There are really two things that drive New Year's resolution success. Number one is telling somebody about your goal. Chances are, they'll either join you in pursuing it or at least support you. Number two is to be concrete and specific. You don't want a goal like "becoming a better person," because there's no objective way to judge that. It's got to be something like "I'm going to call my mother once a week." Or "I'm going to cut my body mass index to 25." It can't be fudgeable.
The fundamental act of medical care is assumption of responsibility. Surgery has assumed responsibility for disease which is largely acute, local or traumatic. This is responsibility for the entire range of injuries and wounds, local infections, benign and malignant tumors, as well as a large fraction of those pathologic processes and anomalies which are localized in the organs of the body. The study of surgery is a study of these diseases, the conditions and details of their care.
If we had nothing but pecuniary rewards and worldly honours to look to, our profession would not be one to be desired. But in its practice you will find it to be attended with peculiar privileges, second to none in intense interest and pure pleasures. It is our proud office to tend the fleshly tabernacle of the immortal spirit, and our path, rightly followed, will be guided by unfettered truth and love unfeigned. In the pursuit of this noble and holy calling I wish you all God-speed.
Just look at the list of who the lowest-paid people are. Pediatricians are at the bottom. You would also look at internists. You would look at psychiatrists. You would look at family physicians, HIV specialists. People who take care of chronic illnesses by seeing people carefully over time, those are the people who get the least money. The people who have the most are people like orthopedic surgeons, interventional cardiologists. And my point isn't that there is something wrong with heroism.
People underestimate the importance of dilligence as a virtue. No doubt it has something to do with how supremely mundane it seems. It is defined as "the constant and earnest effort to accomplish what is undertaken."... Understood, however, as the prerequisite of great accomplishment, diligence stands as one of the most difficult challenges facing any group of people who take on tasks of risk and consequence. It sets a high, seemingly impossible, expectation for performance and human behavior.
In the past decade or so, the women's magazines have taken to running home-handyperson articles suggesting that women can learn to fix things just as well as men. These articles are apparently based on the ludicrous assumption that _men_ know how to fix things, when in fact all they know how to do is _look_ at things in a certain squinty-eyed manner, which they learned in Wood Shop; eventually, when enough things in the home are broken, they take a job requiring them to transfer to another home.
Have faith to keep all the commandments of God, knowing that they are given to bless His children and bring them joy. [You] will encounter people who pick which commandments they will keep and ignore others that they choose to break. I call this the cafeteria approach to obedience. This practice of picking and choosing will not work. It will lead to misery. To prepare to meet God, one keeps all of His commandments. It takes faith to obey them, and keeping His commandments will strengthen that faith.
The ordinary patient goes to his doctor because he is in pain or some other discomfort and wants to be comfortable again; he is not in pursuit of the ideal of health in any direct sense. The doctor on the other hand wants to discover the pathological condition and control it if he can. The two are thus to some degree at cross purposes from the first, and unless the affair is brought to an early and happy conclusion this diversion of aims is likely to become more and more serious as the case goes on.
Sadly, many individuals don't know where to find God, and exclude him from their lives. When spiritual needs arise, they may look to the left, the right, or round about. But looking to other people on the same level cannot satisfy spiritual shortages. When the immortal spirit is starved, hunger persists for something more filling. Even when material success comes, there is a hollow ache - if living well falls short of living worthily. Inner peace cannot be found in affluence accompanied by spiritual privation.
A realistic expectation also demands our acceptance that one's allotted time on earth must be limited to an allowance consistent with the continuity of our species... We die so that the world may continue to live. We have been given the miracle of life because trillions and trillions of living things have prepared the way for us and then have died-in a sense, for us. We die, in turn, so that others may live. The tragedy of a single individual becomes, in the balance of natural things, the triumph of ongoing life.
Being able to influence the outcome, being able to do something about it, to be able to stop the bleeding. You're not being useful if you're just standing there going "Oh, that's awful!" You're only useful if you actually do something about it and I think that goes for everything. If you actually do something about what's in front of you, then you are actually contributing and you haven't got time to be self-centred or sorry for yourself. You should be doing something about the person you really should feel sorry for.
Go back to the '30s, '40s, '50s, and it was the discovery of heroic interventions, the ability to cure people with penicillin or do an operation to stop disease that was what saved the day. Primary care physicians couldn't do all that much that really demonstrated a difference. The people who control and work with you to control your blood pressure, they're not rewarded for doing that or to be innovative about doing that. So, the result is half of Americans have uncontrolled high blood pressure, despite seeing clinicians.
Once you start to ask patients about their priorities, you discover what they're living for. Once you uncover that, it helps you, as a doctor, decide what to fight for. And when we do that, we often end up identifying limits to the kind of care that people want. One's assumption is that these people are going to live shorter lives, but what we're doing is protecting quality of life. In doing so, you sometimes end up helping people live longer. Certainly, you help people live better days and with more purpose in their lives.
Nothing is known in our profession by guess; and I do not believe, that from the first dawn of medical science to the present moment, a single correct idea has ever emanated from conjecture: it is right therefore, that those who are studying their profession should be aware that there is no short road to knowledge; and that observation on the diseased living, examination of the dead, and experiments upon living animals, are the only sources of true knowledge; and that inductions from these are the sole bases of legitimate theory.
Having made a sufficient opening to admit my finger into the abdomen, I passed it between the intestines to the spine, and felt the aorta greatly enlarged, and beating with excessive force. By means of my finger nail, I scratched through the peritoneum on the left side of the aorta, and then gradually passed my finger between the aorta and the spine, and again penetrated the peritoneum, on the right side of the aorta. I had now my finger under the artery, and by its side I conveyed the blunt aneurismal needle, armed with a single ligature behind it.
If you make a habit of sincere prayer, your life will be very noticeably and profoundly altered. Prayer stamps with its indelible mark our actions and demeanor. A tranquillity of bearing, a facial and bodily repose, are observed in those whose inner lives are thus enriched. Within the depths of consciousness a flame kindles. And man sees himself. He discovers his selfishness, his silly pride, his fears, his greeds, his blunders. He develops a sense of moral obligation, intellectual humility. Thus begins a journey of the soul toward the realm of grace.
My own son has a congenital heart condition, where his life was saved by a cardiac surgeon stepping in at 11 days of life to save his life. But he is now 21 years old because of constant monitoring and working with him with a primary care physician. that's the only reason now that he's getting to live a long and healthy life. That's what we're not rewarding. They don't have the kind of resources and commitment that we are giving to people like me. I have millions of dollars of equipment available to me when I go to work every day in an operating room.
I consider the differences between man and animals in propensities, feelings, and intellectual faculties, to be the result of the same cause as that which we assign for the variations in other functions, viz. difference of organization; and that the superiority of man in rational endowments is not greater than the more exquisite, complicated, and perfectly developed structure of his brain, and particularly of his ample cerebral hemispheres, to which the rest of the animal kingdom offers no parallel, nor even any near approximation, is sufficient to account for.
Studying music encourages self-discipline and diligence, traits that carry over into intellectual pursuits and that lead to effective study and work habits. An association of music and math has, in fact, long been noted. Creating and performing music promotes self-expression and provides self-gratification while giving pleasure to others. In medicine, increasing published reports demonstrate that music has a healing effect on patients. For all these reasons, it deserves strong support in our educational system, along with the other arts, the sciences, and athletics.
The first [quality] to be named must always be the power of attention, of giving one's whole mind to the patient without the interposition of anything of oneself. It sounds simple but only the very greatest doctors ever fully attain it. ... The second thing to be striven for is intuition. This sounds an impossibility, for who can control that small quiet monitor? But intuition is only interference from experience stored and not actively recalled. ... The last aptitude I shall mention that must be attained by the good physician is that of handling the sick man's mind.
In the end, people don't view their life as merely the average of all its moments-which, after all, is mostly nothing much plus some sleep. For human beings, life is meaningful because it is a story. A story has a sense of a whole, and its arc is determined by the significant moments, the ones where something happens. Measurements of people's minute-by-minute levels of pleasure and pain miss this fundamental aspect of human existence. A seemingly happy life maybe empty. A seemingly difficult life may be devoted to a great cause. We have purposes larger than ourselves.
I talked to over two hundred patients and family members about their experiences with aging, serious illnesses, and the big unfixables. But I also spoke with scores of physicians, and especially geriatricians, palliative care doctors, hospice nurses, and nursing home workers. The biggest thing I found was that when these clinicians were at their best, they were recognizing that people had priorities besides merely living longer. The most important and reliable way that we can understand what people's priorities are, besides just living longer, is to simply ask. And we don't ask.
One of the reasons people might be fallible, why we might fail to do what we try to do isignorance, that we have a limited understanding of the laws of the world - the physical laws that govern the world and of all the particulars of the world upon which those laws work. And then there's ineptitude, meaning that the knowledge is available, but individuals fail to apply it correctly. The third source is "necessary fallibility." That is, we're never going to be omniscient, there is some knowledge that we will simply never achieve, and there are limits to what we will be able to do.
I had bought two male chimps from a primate colony in Holland. They lived next to each other in separate cages for several months before I used one as a [heart] donor. When we put him to sleep in his cage in preparation for the operation, he chattered and cried incessantly. We attached no significance to this, but it must have made a great impression on his companion, for when we removed the body to the operating room, the other chimp wept bitterly and was inconsolable for days. The incident made a deep impression on me. I vowed never again to experiment with such sensitive creatures.
The air of caricature never fails to show itself in the products of reason applied relentlessly and without correction. The observation of clinical facts would seem to be a pursuit of the physician as harmless as it is indispensable. [But] it seemed irresistibly rational to certain minds that diseases should be as fully classifiable as are beetles and butterflies. This doctrine ... bore perhaps its richest fruit in the hands of Boissier de Sauvauges. In his Nosologia Methodica published in 1768 ... this Linnaeus of the bedside grouped diseases into ten classes, 295 genera, and 2400 species.