Lessons from the first chapter in the bible of medicine

My first thoughts on the first chapter of Harrison’s principle of internal medicine have always been that there isn’t anything to learn from it. I pushed myself to read it for the first time. My hope was to get my cup a little bit fuller than it was before I read this chapter.

The chapter turned out to be like an advice from an experienced physician and a much needed first class in med school.

These are the lessons I learned worth sharing of:
  • Medicine is called an art since it's a combination of medical knowledge, intuition, experience, and judgment. Each doctor is an artist since we use each of the above mentioned qualities in a different way.
  • "The title doctor is derived from the Latin docere, 'to teach,' and physicians should share information and medical knowledge with colleagues, students of medicine and related professions, and their patients." 
  •  Instead of treating the disease, treat the patient.
  • Everything must preferably be in favor of the patient. As we continue practicing, we seem to lose focus of this after a few years.
  • Although diagnostic tests play a crucial part in detecting a disease, it should not be replaced by a detailed history and physical examination.
  • "Adverse drug reactions occur in at least 5% of hospitalized patients, and the incidence increases with the use of a large number of drugs."
  • Do not take away hope from any patient.
  • "Physicians should instill confidence and should be reassuring but should never be arrogant."
  •   "Physicians must never forget that patients are individual human beings with problems that all too often transcend their physical complaints. They are not "cases" or "admissions" or "diseases."" In my opinion this is mostly forgotten when one enters internship. I understand that it is difficult to show one’s humane side always, but it is not impossible.
  • It is important that physicians control their emotion (positive/negative.)
  • The different “omics” are:

o   Genomics: Study of genes.
o   Epigenomics: Study of changes in chromatin and histone proteins and methylation of DNA sequences that influence gene expression.
o   Proteomics: Study of proteins in living things.
o   Microbiomics: Study of bacterial flora of a person.
o   Metagenomics: The genomic study of environmental species that interact with humans.
o   Metabolomics: Study of metabolites that influence a patient’s health.

In conclusion, I think that the field of medicine is slowly losing its humane side. It upto doctors and other medical professionals to bring back what we have lost in time.

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