Elle’s Montgomery response   1 comment

Hi All:

In his book, _A Whole new mind: Why right-brainers will rule the future_, Daniel Pink shares two patient’s stories–they have similar beginnings but very different endings.

Patient 1: worked at the post office and left work feeling sick, lethargic, and achey; a post office nearby had received Anthrax in an envelope, so he went to the emergency room where a physician checked his symptoms against a check list for Anthrax poisoning. The patient did not have the required number of symptoms. He was sent home with the doctor’s assurance that he had not been exposed to Anthrax.

Patient 2: Like Patient 1, this man worked in the post office and felt sick while at work. He knew that a nearby post office had been attacked with Anthrax, so he went to the ER. The doctor used a check list to determine that the man had not been exposed to Anthrax, BUT she then said, “I can see from your body language that you are really scared, so I am going to run a test for Anthrax, and keep you here for observation.”

Patient one died later that evening of Anthrax poisoning. Patient two learned from the tests that he did have Anthrax poisoning. He was treated and lived.

Pink attributes the difference between the doctors to right brain versus left brain thinking.  Kathryn Montgomery addresses this in _How doctors think_  in her assertion that both “scientific knowledge and a collection of well practiced skills are essential” (2006, p. 33) to taking care of patients rather than simply working in a lab.

I am struck by the contradiction between what we expect of doctors and what is required of them to be the second kind of doctor. In order to save the Anthrax patient, the doctor had to ask the right questions of herself, but we expect doctors to have the answers. A doctor questioning his or her evaluation–an eval based on science–would not engender confidence. Yet, the example in Pink and the multiple examples in Goopman attest to the fact that doctors who question themselves, their biases, their prior knowledge, the patient’s own medical record are the doctors who save lives.

How can doctors be trained to have the confidence needed to practice medicine and be taught to rely on empathy and instinct? Can these dualities be taught or must one be a right brained person to possess this ability?


Posted August 30, 2010 by jblakescott in Uncategorized

One response to “Elle’s Montgomery response

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  1. For me, your first question raises the additional question, “What is instinct?”

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