7-7-11 Thursday  + 8 months

Always appreciate the comments – erudite, clever, supportive.

 Status:  Spending most of my days dealing with the routine of taking meds, watching blood sugars, and fixing special meals.  It is indeed a full-time job.

Events: At Hopkins this week for a rescheduled eye check.  Restasis eye drops have been of great help, and I actually make a few tears -tested at 20/25 vision.  Enjoyed chatting with my ophthalmologist (a specialist in graft versus host disease and dry eyes).  We joked that this was the first of July with new residents.  He said he could always tell how the group would be when he lets them decide their own call schedule.  Last year’s group finished in 15 minutes and went out for a beer.  This year’s group took 2 hours – looks like he has his work cut out for him.

  He also talked about how things have changed for these “millennials.” We had both  worked in “every other night” residencies, meaning 36 hours on, 12 hours off, 24/7, for 3 years (when giants walked the Earth).  Of course, we were sleep-deprived, irritable, and mistake prone, but the old saying that the only problem with an every other night program was you missed seeing half the patients.  Now residents have limited work hours, and when it’s time to go home that’s what they do.

  His other interesting take, which I have heard from a number of folks about kids this age, is that there is a sense of entitlement, an ethic that everything a young person does deserves a prize.  He mentioned a recent cartoon showing a young boy running to his mother with a gigantic trophy yelling, “We lost!”  He mentioned a resident he had to have a chat with who wasn’t doing so well. The resident was flabbergasted and in tears because no one had ever been critical before.

 My own anecdote about this generational disconnect occurred when I was giving a course on investigating a food-borne outbreak to a group of new Price-Waterhouse hires.  The purpose was to take them out of their skill set and learn how to think, organize and analyze.  I had given them all the data, and asked them to set it down in an organized fashion (names, ages, day of illness, foods they had eaten, etc.) The entire class of 100 just sat there, and I said, “You can start now.”  No one moved, finally a hand went up, and a young woman said, “We didn’t bring our laptops so we don’t have our Excel spreadsheets.”  I wonder how they’d do on Survivor without laptops.

  And I’m reminded of the famous quote:

“The children now love luxury; they have bad manners, contempt for authority; they show disrespect for elders and love chatter in place of exercise. Children are now tyrants, not the servants of their households. They no longer rise when elders enter the room. They contradict their parents, chatter before company, gobble up dainties at the table, cross their legs, and tyrannize their teachers.”

   It is attributed to Socrates, 2,500 years ago. Plus ca change, plus c’est la meme close.


Comment:  They’ve changed my barium swallow scheduled for next Tuesday to a direct look with an endoscope.  If they find a stricture accounting for my difficulty swallowing (smart money is on that) they may be able to dilate it right then – that would be a relief, but I bet I’ll be a little sore.  Wish me luck as we smack down one more whack-a-mole.





12 Responses to “”

  1. Wendi Says:

    I do hope they can fix that painful swallow issue right then and there! I will definitely need to quote your quote! xo

  2. Tom Linden Says:

    Ah, those kids… when will they learn to be just like us? Glad to hear that you’re progressing nicely. I can hear the upbeat in your literary voice. I hope to see you sometime soon. All the best, Tom.

  3. Henry Miller Says:

    Glad to hear that things sound pretty stable.

    During my (medical) residency, when the chief of surgery (Bill Silen, a legend) said, “the trouble with being on-call every other night is that you miss half the good stuff,” he meant it. After a huge overnight snowstorm, the surgical house staff were sure that the chief would be late for 6am rounds. They were wrong: He got the Massachusetts State Police to send a snowplow for him.

  4. Joe Robertson Says:

    Bruce, it is always very interesting to read you posts. This one about residencies really interested me because my son, Antoine, is interested in becoming a doctor. He’ll be a sophomore in high school next year (already!) and I want to keep him encouraged. He spent a week observing the cardiology unit of our local hospital here in Cannes in March and loved every minute of it. His problem is where and how to go to Med school, since the degrees aren’t transferable between Europe and the US (and he wants to live in the US – he thinks). My suggestion has been to go to med school here and take his residency in the US, but I am no expert on the subject. I thought it would be nice if he could talk to a US doctor about what the normal process is over there, so at least he has an understanding of that. Are you feeling strong enough to have a phone or Skype chat with him? I know he would enjoy what you have to say. If you want to build up some more strength first, no problem. He is only a sophomore, after all :-). Let me know on jg_robertson@yahoo.com

    Oh, and lest I forget: GO BRUCE!!!

    All the best to you and the family, Joe Robertson

  5. Ken and Ruth Says:

    re: The younger generations. You quote Socrates, and we, your less erudite friends, cite “Bye Bye Birdie” and ask, “What’s the matter with kids, today?” Maybe there’s a link between centuries of commentary on and accountability for this “problem.” Could Socrates have been referring to his own three sons? It seems history does, indeed, repeat itself.

    We hope Tuesday will be the day of the whacking of the last mole. Games are supposed to be fun!

  6. Lewis Lefkowitz Says:

    Re: The ’00s generation. Consider sensory overload as one big underlying factor. So much information mis-information and non-information all mixed together in a steady stream; and, consequently, so many choices. Yogi Berra had it right. “When you come to a fork in the road, take it.”

  7. Laurie Samuels Says:

    Love and good wishes for more healing continue to head your way… I hope that the “mole” population continues to decline… and you feel better each day. Laurie

  8. joel steinberg Says:

    You are so right about all of that. Or as my then 8 year old daughter said when one of her softball coaches congratulated the team after a lopsided loss: “If winning doesn’t mean anything, why do they keep score?” At least you are on an even keel (or approximately so) now. Joel S.

  9. courtney =) Says:


    as always, happy to hear of your continual upward progress! and tears are good!

    interesting commentary. as one of those on the cusp between Gen X and the Millennials (no one can seem to agree on what year that Gen X ends), i hate to admit that i agree w/ you. (if given a choice, i would rather consider myself a Gen X-er.) your price-waterhouse story reminds me of my fall semester here at U of I. at every class, our professors would call out a question to the students, silence would ensue (crickets chirping), and i would finally raise my hand to answer. i found that i would often be the first and (several times) the only person to speak up. i didn’t prefer this, b/c good and productive discussions require more than one person to speak (i was definitely not the smartest person in the room).

    thankfully, i figured out early on that i have to work really hard to achieve the things i want.

    continuing to send positive thoughts your way.

    courtney =)

  10. grassflats Says:

    I remember those days. In fact, I remember them with you. Having worked with students and residents for 40 years now, there have been changes in the learners for sure. Not all of them are negative, though. To some extent they reflect the dramatic changes in how we provide health care these days. You and I have talked many times about the changes in on-call time since the days at the General. One change is that many academic institutions no longer see care for the disadvantaged as their responsibility. They have to support large numbers of highly trained specialists and their technology, and you can’t do that on Medicaid payments. I’m sure you and Lew remember that we didn’t even charge patients we saw in clinic. That doesn’t happen any more. Yes, there is a huge sense of entitlement that drives some of us nuts….but there are also smart, multitasking dedicated learners. What has taken a hit is the thoughtful diagnostic process that inspired us. Sometimes I’m not sure what inspires our current trainees; and sometimes I think I’d rather not know.

  11. Lewis Lefkowitz Says:

    Speciality emphasis did its damage, of course. But Medicaid had originallhy taken the city council off the hook for maintaining “The General.” And the members and public officials never again fulfilled their responsibilty to save it through its growing needs after Medicaid reimbursed increasingly smaller proportions of the cost of keeping the standards of care with more expensive technolgy and costly drug development. .

  12. Art Ulene Says:

    Dear Bruce….. It has been a long while since you’ve heard from me, because It has been a long while before I was able to hear from you. Priscilla and I just returned last night from Tanzania, where we had gone to celebrate my 75th birthday — on the summit of Mt. Kilmanjaro. We did not make up there on my birthday, but were quite successful the day after. On July 14th, at an elevation of 19,340 ft, we laughed and joked and danced (seriously) to celebrate our joint conquest. As it turns out, we may have been the oldest married couple to ever summit together (there has been an older man — by four years — and an older woman by three years, but we think that our combined ages may set the record to Kibo (as we Africans love to call the mountain). I just want you to know that you were in my thoughts on that mountain, and it is wonderful to read your messages once again. We send our love to you and Lisa, and our congratulations–because the mountain you have just climbed truly dwarfs the one we climbed. Love, Art

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