Jerome groopman biography
He has learned many of the lessons in this book the hard way, from his own mistakes and from errors his doctors made in treating his own debilitating medical problems. Interesting Finds Updated Daily.
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Interesting Finds Updated Daily. He has published more than scientific articles. Groopman lives in Brookline, Massachusetts. Are You an Author? Help us improve our Author Pages by updating your bibliography and submitting a new or current image and biography.
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The book is loosely laid out in the same manner that a physician works through a problem with a patient — the history, the physical exam, the lab tests, the differential diagnosis which is also spread throughout the booktreatment and other factors that may influence a physician with respect to a patient. The first time was during my second year of medical school and I re-read my review of it, remembering how confusing just the process of arriving at a differential diagnosis can be.
Last year when I read the book, I read it almost as a patient more than a physician. Now, in the middle of my third year of medical school, I understand more about the process of arriving at a differential diagnosis and the book had significance to me in a way it did not before.
The main lessons that I gleaned from the book: I think that this discounts the importance of psychological problems — seeing them as a catch-all for things that the physician cannot explain — and creates a rift between the patient and physician where the physician, failing to diagnose the patient, turns to psychiatry. I also thing that he did not take into account one major thing — disbelief of the patient. I saw an intern groan and moan about this patient who had a number of complaints and appeared to be annoying her — the patient turned out to have metastatic colon cancer.
How Doctors Think
I think that this plays a large role in the patient — physician interaction and should be studied more closely. I loved this book, I hope he writes more. I plan to read it again in a few years. Dec 17, Katie Bananas rated it it was amazing Shelves: This book was so good.
It illustrates the importance of the patient-doctor relationship in the aspects of psychological well being, diagnosis, and treatment of patients. I found that the audiobook was so effective in its delivery and reading of the book. I was very engaged with a constant eagerness to learn. Groopman emphasizes prime mistakes seen in medical practices of doctors in different specialties. At some point in the last chapter, he states: This is such a true statement when it comes to medical practice and building relationships with patients. It's crucial to listen to the patient without interruptions to record their stated symptoms accurately to avoid making rushed decisions to arrive at an unnecessary diagnosis that could be very well avoided.
Aug 02, Sue rated it it was amazing Recommends it for: Every doctor, every potential patient. A must read for every doctor who practices medicine and for those patients who forget that doctors are practicing medicine and make errors in judgment and he explains why these mistakes are made in a very very entertaining way.
The book served as a reminder that a patient needs to be the captain of their own ship, challenging the inflated notion of even the most respected doctor The chapter "A New Mother's Challenge" was probably one of the best examples of how and why doctors err and how t A must read for every doctor who practices medicine and for those patients who forget that doctors are practicing medicine and make errors in judgment and he explains why these mistakes are made in a very very entertaining way.
The chapter "A New Mother's Challenge" was probably one of the best examples of how and why doctors err and how the caregiver is oftentimes in the best position to solve the mystery. Who will be their advocate? Jan 18, Musab Abed rated it really liked it. A book that helps clinicians to assess the way they think, and to try eliminating the diagnostic errors by diagnosing the doctors' thinking pitfalls anchoring, attribution and availability types of errors. In my opinion; stereotyping is the most common cause of diagnostic errors. The more expert clinician would be better in diagnosisbut - unfortunately- due to the more 'stereotypes' they had!
Jun 23, Sarah rated it liked it. My book club read this book last month. We found it interesting, but repetitive. Recognizing these fallibilities--understanding how a doctor is trained to think-- enables patients to be more proactive, to ask better questions, and thus help themselves by helping the doctor find the correct My book club read this book last month. Recognizing these fallibilities--understanding how a doctor is trained to think-- enables patients to be more proactive, to ask better questions, and thus help themselves by helping the doctor find the correct diagnosis or best treatment.
Groopman organizes his points around lots of interesting anecdotes, so I didn't find this book dry at all, just somewhat repetitive. If you're interested in the medical field at all or perhaps have had an illness that resisted easy diagnosisI definitely recommend it. You don't have to read the whole thing unless you really get into it. I read this book after having a fascinating experience this spring with traditional Chinese medicine TCMin which my acupuncturist solved a medical mystery for which Western medicine had 0 answers.
The problem was basically an imbalance of the sort that isn't even in the Western lexicon. TCM views the body in a totally different way. But for me this made "how doctors think" the subject, not the book seem frustratingly constrained, with very limited training in or willingness to explore truly holistic health. Jul 17, Emma rated it it was amazing. Can Jerome Groopman be my doctor? He is so thoughtful and humble and insightful! I am glad that as I go into medical school, I have read this book, and I think I may need to read it again to refresh my memory.
Anyone can learn something from this book about how doctors think and how you as a patient can help them. We have all had our frustrating moments with the medical system. And I think all doctors and aspiring doctors should read this book. Oct 17, Christine rated it really liked it Shelves: Groopman is a doctor who realizes he needs a doctor as the result of an experience in which he found himself plagued by a wrist injury that resulted in multiple diagnoses and treatments from four different doctors with no clear and rationale diagnosis.
As a result, he decides to embark on a journey to understand How Doctors Think. His results are simultaneously illuminating and confirmatory of our own questions, doubts and frustrations when talking with doctors or confronted with difficult diagnoses. Through multiple interviews with doctors and patients in Boston and San Francisco hospitals, Groopman discusses why and how doctors make errors of misdiagnosis and along the way he provides some very useful tips for how to: He also confirms and explains the necessity of seeking second opinions or for very difficult diagnoses, two, three or four doctors!
The multiple patient stories that he recounts in this book keeps the pace of the book moving and also provides readers with real life stories of people who have confronted challenging medical problems and how they ultimately were able to obtain the needed medical assistance. Lastly, Groopman also touches upon how the current health care system can in some cases create and foster doctor misdiagnoses. A good recommendation for anybody who interacts with doctors, or who may be faced with a difficult medical diagnosis. Mar 19, Assia Mohdeb rated it it was amazing.
Do different doctors think differently? Are different forms of thinking more or less prevalent among the different specialties?
In other words, do surgeons think differently from internists, who think differently from pediatricians?
Is there one "best" way to think, or are there multiple, alternative styles that can reach a correct diagnosis and choose the most effective treatment? How does a doctor think when he is forced to improvise, when confronted with a problem for which there is little or no precedent? How does a doctor's thinking differ during routine visits versus times of clinical crisis?
Do a doctor's emotions—his like or dislike of a particular patient, his attitudes about the social and psychological makeup of his patient's life—color his thinking? Why do even the most accomplished physicians miss a key clue about a person's true diagnosis, or detour far afield from the right remedy?
In sum, when and why does thinking go right or go wrong in medicine? May 29, P Chulhi rated it it was ok Shelves: Groopman's free-flowing anecdotal style is his strength, and his unique perspective and journalistic skill are highlighted in the chapter entitled, "Marketing, Money, and Medical Decisions. Medical decisions are indeed influenced by money, Groopman argues, but not in the way most of us might think with the bad guys dressed in black on one side and the good guys adorned in white on the other.
Instead, medical decisions a Groopman's free-flowing anecdotal style is his strength, and his unique perspective and journalistic skill are highlighted in the chapter entitled, "Marketing, Money, and Medical Decisions. He guides the reader to this conclusion by recounting his interviews with many different specialists and even a pharmaceutical company executive. The solution is "informed choice," a comprehensive understanding of the risks and benefits of all available treatments, which also encompasses an understanding of how different doctors think and how factors like money, personal bias, and tradition influence that thinking.
This chapter is worth a read, and it's unfortunate that it appears near the end of the book. The rest of the book, however, feels incomplete.
Groopman often fails to consider the epidemiological "big picture" in certain key moments. For example, he criticizes the use of patient templates versus traditional open-ended questioning in reaching a diagnosis because the former tends to restrict a doctor's ability to reason Ch.
He implicates the financial pressures that lead insurance companies to increase the number of patients a primary care physician sees on a given day and therefore necessitate the development of templates. This sounds reasonable on its surface but the question at the crux of the matter goes unasked; namely, does open-ended questioning lead to different outcomes versus patient templates at the population level?
After all, checklists developed at Cook County hospital improved the overall accuracy of diagnosis of chest pain there. Groopman also introduces many unresolved contradictions throughout the book.Eye To Eye: Dr. Jerome Groopman
While his description of his own personal journey with his mysterious wrist pain and its elusive diagnosis is interesting at an anecdotal level, the lessons drawn from that journey are puzzling at best. Groopman praises the young doctor for ignoring data from the all-mighty MRI scan and paying heed to pertinent data in reaching the correct diagnosis Ch.
This contradicts one of the major running themes in this book: Doctors are often lead astray by confirmation bias, i. What I'm left to wonder is what distinguishes this young doctor's "insight" from the myriad of doctors who employ seemingly similar thought processes but arrive at wrong diagnoses. In other words, Groopman seems to praise and reject the exact same thought process based on the success or failure of the outcome. As a future doctor myself, this doesn't really help me understand how to avoid cognitive errors.
This book is not without its occasional gems - I like the idea that "the perfect is the enemy of the good" in reference to managing patient outcomes pre- and post-surgery Ch. That said, however, Groopman leaves too many unresolved questions for me to consider this a persuasive work as a whole. Dec 30, Jack rated it it was ok Shelves: First of all, I should say that I'm a doc. This book was strongly recommended to me by several colleagues who I deeply respect. It makes for a reasonable read, and I see why they enjoy it. It's pretty typical doctor-authored literature.
It takes a half decent idea from the social sciences in this case, that heuristic reasoning is essential for managing very complex environment, but that heuristics have predictable failings. It then illustrates this with a bunch of stories of touching stories of First of all, I should say that I'm a doc.
It then illustrates this with a bunch of stories of touching stories of human tragedy and triumph. It has some reasonable suggestions for being aware of one's limitations and trying to compensate for predictable lapses. The heuristics stuff is not terribly novel -- it seems to derive from a very minimal reading of Kahneman and Tversky. If you want to read the underlying social science, and can stomach more academese, you can get a lot deeper than this in Judgment under Uncertainty.
I found most frustrating the medical stories. Frankly, they seemed a little trite. Regrettably, Groopman's good, but the bar has gotten set pretty damn high in the last few years.
Atul Gawande Finally, Dr. Groopman is a professor of experimental medicine. He wants to argue that doing lots of extra tests, moving beyond accepted knowledge is essential.
But his discussion of trying fourth or fifth line chemo agents on the off-chance one unexpectedly works seems to me to be underestimate the real human suffering eternally searching for miracles induces.
I would have like a book about the limits of doctor's thinking to be more thoughtful about that blindspot. Apr 26, charlie rated it really liked it Shelves: I really should not have read this book!
It confirmed all of my worst assumptions about doctors - how little they know, how so many factors can influence their diagnoses and approaches, how visiting 5 different doctors may yield 5 different perspectives. All that being said, I am glad I read this book since the author, to some extent, gives you strategies on how to manage or select doctors to improve care. In the end, I am not sure I am that much wiser, but I appreciated that one doctor the aut I really should not have read this book!
In the end, I am not sure I am that much wiser, but I appreciated that one doctor the author is being honest about what to expect from this very inexact science.
Jan 01, Greg rated it it was amazing Shelves: This book helped me make decisions that gave me the patience to weather many tests and consultations that led to the discover of my coronary artery disease before I got a heart attack.
Doctors are people too. They are trying to make a living and doing the best they can. Don't hate them because the prescribe expensive drugs or inconclusive tests. You need to work with them and force them to communicate their thinking.
Always ask why a test is being administered. When a diagnosis is made, always a This book helped me make decisions that gave me the patience to weather many tests and consultations that led to the discover of my coronary artery disease before I got a heart attack. When a diagnosis is made, always ask: What other body parts are near the region where I am experiencing symptoms? The patient starts prodding the doctor to think a little bit more. The reality is the doctor has three of his or her minutes left with this particular patient and that's all the time they've got. Well, I think both doctors and patients need to basically resist together.
It's not easy, but one thing can be done, which is to schedule a follow-up appointment. But to cut off someone who's still suffering and doesn't have an answer is not the solution. What if you're sitting there with a doctor and you think the doctor doesn't like you? This is a setup for bad care. I actually write about one woman who irritated me and I shut my mind off to her. Her voice sounded to me like nails scratching on a blackboard.
It was when I was a resident. She kept complaining and I just became deaf. And it turned out she had a tear in her aorta. And it was fatal. She may have died anyway, but it's a terrible thing. I think if you feel that a doctor doesn't like you, then you can first say with all candor, 'I feel like we're not connecting well. Each doctor said to me, 'I'd find another doctor. If everybody followed your advice, listened more carefully, spent a little more time with patients, thought a little bit more, would our health care cost more? I think it would cost less because when you make a misdiagnosis that means that the patient gets sicker and sometimes dies.
So that the intensity of treatment that's required by not detecting something early is much more costly than coming to the right diagnosis. Anne Dodge had lost count of all the doctors she had seen over the past fifteen years. She guessed it was close to thirty. Now, two days after Christmason a surprisingly mild morning, she was driving again into Boston to see yet another physician.
Her primary care doctor had opposed the trip, arguing that Anne's problems were so long-standing and so well defined that this consultation would be useless.
But her boyfriend had stubbornly insisted. Anne told herself the visit would mollify her boyfriend and she would be back home by midday. Anne is in her thirties, with sandy brown hair and soft blue eyes. She grew up in a small town in Massachusetts, one of four sisters. No one had had an illness like hers.
Around age twenty, she found that food did not agree with her. After a meal, she would feel as if a hand were gripping her stomach and twisting it.
The nausea and pain were so intense that occasionally she vomited. Her family doctor examined her and found nothing wrong. He gave her antacids. But the symptoms continued.
Anne lost her appetite and had to force herself to eat; then she'd feel sick and quietly retreat to the bathroom to regurgitate. Her general practitioner suspected what was wrong, but to be sure he referred her to a psychiatrist, and the diagnosis was made: If the condition was not corrected, she could starve to death. Over the years, Anne had seen many internists for her primary care before settling on her current one, a woman whose practice was devoted to patients with eating disorders.
Anne was also evaluated by numerous specialists: She had been treated with four different antidepressants and had undergone weekly talk therapy. Nutritionists closely monitored her daily caloric intake. But Anne's health continued to deteriorate, and the past twelve months had been the most miserable of her life.
Her red blood cell count and platelets had dropped to perilous levels. A bone marrow biopsy showed very few developing cells. The two hematologists Anne had consulted attributed the low blood counts to her nutritional deficiency. Anne also had severe osteoporosis. One endocrinologist said her bones were like those of a woman in her eighties, from a lack of vitamin D and calcium. An orthopedist diagnosed a hairline fracture of the metatarsal bone of her foot.
There were also signs that her immune system was failing; she suffered a series of infections, including meningitis.Groopman: The Doctor's In, But Is He Listening?
She was hospitalized four times in in a mental health facility so she could try to gain weight under supervision. To restore her system, her internist had told Anne to consume three thousand calories a day, mostly in easily digested carbohydrates like cereals and pasta.
But the more Anne ate, the worse she felt. Not only was she seized by intense nausea and the urge to vomit, but recently she had severe intestinal cramps and diarrhea.
Her doctor said she had developed irritable bowel syndrome, a disorder associated with psychological stress. By December, Anne's weight dropped to eighty-two pounds.
Although she said she was forcing down close to three thousand calories, her internist and her psychiatrist took the steady loss of weight as a sure sign that Anne was not telling the truth. That day Anne was seeing Dr. Myron Falchuk, a gastroenterologist. Falchuk had already gotten her medical records, and her internist had told him that Anne's irritable bowel syndrome was yet another manifestation of her deteriorating mental health.
Falchuk heard in the doctor's recitation of the case the implicit message that his role was to examine Anne's abdomen, which had been poked and prodded many times by many physicians, and to reassure her that irritable bowel syndrome, while uncomfortable and annoying, should be treated as the internist had recommended, with an appropriate diet and tranquilizers.
But that is exactly what Falchuk did not do. Instead, he began to question, and listen, and observe, and then to think differently about Anne's case. And by doing so, he saved her life, because for fifteen years a key aspect of her illness had been missed.
This book is about what goes on in a doctor's mind as he or she treats a patient. The idea for it came to me unexpectedly, on a September morning three years ago while I was on rounds with a group of interns, residents, and medical students. I was the attending physician on "general medicine," meaning that it was my responsibility to guide this team of trainees in its care of patients with a wide variety of clinical problems, not just those in my own specialties of blood diseases, cancer, and AIDS.
There were patients on our ward with pneumonia, diabetes, and other common ailments, but there were also some with symptoms that did not readily suggest a diagnosis, or with maladies for which there was a range of possible treatments, where no one therapy was clearly superior to the others.
I like to conduct rounds in a traditional way. One member of the team first presents the salient aspects of the case and then we move as a group to the bedside, where we talk to the patient and examine him. The team then returns to the conference room to discuss the problem. I follow a Socratic method in the discussion, encouraging the students and residents to challenge each other, and challenge me, with their ideas. But at the end of rounds on that September morning I found myself feeling disturbed. I was concerned about the lack of give-and-take among the trainees, but even more I was disappointed with myself as their teacher.
I concluded that these very bright and very affable medical students, interns, and residents all too often failed to question cogently or listen carefully or observe keenly. They were not thinking deeply about their patients' problems. Something was profoundly wrong with the way they were learning to solve clinical puzzles and care for people. You hear this kind of criticism — that each new generation of young doctors is not as insightful or competent as its forebears — regularly among older physicians, often couched like this: I suspect each older generation carries with it the notion that its time and place, seen through the distorting lens of nostalgia, were superior to those of today.
Dr. Jerome Groopman, 'Anatomy of Hope'
Until recently, I confess, I shared that nostalgic sensibility. But on reflection I saw that there also were major flaws in my own medical training.
What distinguished my learning from the learning of my young trainees was the nature of the deficiency, the type of flaw. My generation was never explicitly taught how to think as clinicians. We learned medicine catch-as-catch-can.
Trainees observed senior physicians the way apprentices observed master craftsmen in a medieval guild, and somehow the novices were supposed to assimilate their elders' approach to diagnosis and treatment.
Rarely did an attending physician actually explain the mental steps that led him to his decisions. Over the past few years, there has been a sharp reaction against this catch-as-catch-can approach. To establish a more organized structure, medical students and residents are being taught to follow preset algorithms and practice guidelines in the form of decision trees.
Sacks had hoped for a life with a young, energetic man named Mel, whom he met while training in neurology at UCLA. At first, they became roommates, enjoying motorcycle excursions and exercise at the beach.
There was close physical contact with wrestling, but not sex. Then, while giving a naked Mel a massage, Sacks had an orgasm. I felt desperately lonely and rejected when Mel moved out, and it was at this juncture that I turned to drugs, as some sort of compensation. I rented the little house in Topanga Canyon—it was rather isolated, being at the top of an unpaved trail, and I resolved never to live with anyone again. I took a puff, nervously, then another, and then, voraciously driven, smoked the rest, voraciously because it was producing what cannabis alone had never produced—a voluptuous, almost orgasmic feeling of great intensity.
When I asked what the joint had contained, I was told that it had been doped with amphetamine…. I was hooked after that night with an amphetamine-soaked joint and was to remain hooked for the next four years. In the irresistible thrall of amphetamines, sleep was impossible, food was neglected, and everything was subordinated to the stimulation of the pleasure centers in my brain. Sacks easily could have suffered a heart attack or stroke.
His addiction continued after he moved to New York, where he entered psychoanalysis with Dr. I was still half-psychotic at times from the amphetamines I had not yet kicked. Thinking of my schizophrenic brother, Michael, I asked Shengold if I too was schizophrenic. I would continue to seek satisfaction in drugs, I felt, unless I had satisfying—and, hopefully, creative—work. It was crucial for me to find something with meaning, and this, for me, was seeing patients. As soon as I started clinical work in October ofI felt better.
I found my patients fascinating, and I cared for them. I started to taste my own clinical and therapeutic powers and, above all, the sense of autonomy and responsibility which I had been denied when I was still a resident in training.
I had less recourse to drugs and could be more open to the analytic process.
I had one more drug high or mania in February ofand this—paradoxically and unlikely all my previous highs—took a creative turn and showed me what I should and could do: It was not just a vague feeling of potential but a very clear, focused vision of future neurological work and writing which came to me when I was high but then stayed with me. Instead of mere repetition, each adjective enhances the breadth of the described subject. Where did this nuanced sensibility originate? My mother was a natural storyteller. She would tell medical stories to her colleagues, her students, her patients, her friends.
And she had told us—my three brothers and me—medical stories from our earliest days, stories sometimes grim and terrifying but always evocative of the personal qualities, the special value and valor, of the patient. My own impulse to write—not to write fiction or poems, but to chronicle and describe—seems to have come directly from them. In Uncle TungstenSacks describes a home filled with Jewish celebrations. As the youngest child, he asked the Four Questions at the seder, and searched for the hidden half-middle matzah, the afikomen.