Everyone, even the visitors, seems pressed for time. … The Hippocratic adage, “Art is life long, Life is short” is speeded up to a blur.
Everyone is too busy, urgently doing something else, and there is no longer enough time for the old meditative, speculative ward rounds or the amiable conversations at bedside. The house staff, all of them … are careening through the corridors on their way to the latest “code” … or deciphering computer messages from the diagnostic laboratories, or drawing blood and injecting fluids, or admitting in a rush the newest patient. The professors are elsewhere, trying to allocate their time between writing out their research requests (someone has estimated that 30 percent of a medical school faculty’s waking hours must be spent composing grant applications), doing or at least supervising the research in their laboratories, seeing their own patients (the sustenance of a contemporary clinical department has become significantly dependent on the income brought in by the faculty’s collective private practice), and worrying endlessly about tenure (and parking). About the only professionals who are always on the wards, watching out for the unforeseen, talking and listening to the patient’s families, are the nurses, who somehow manage, magically, to hold the place together for all its tendency to drift toward shambles.
Lewis Thomas. The Fragile Species. Charles Scribner and Sons. New York. 1992.
George Dunea, MD, Editor-in-Chief