Vital Times 2019 - 82

Dr. Verghese quoted a verse from the Gospel of St.
Matthew 25:36, "I was ill and you cared for me," to
underscore the importance of what he termed "the
Samaritan function of being a physician."

disrobes and allows touch. It is a profound moment.
It is part of our responsibility to the patient. In the
context of reading the body as a text, we have that
privilege."

The peril of "loss of ritual"

"They know when you're doing it well, and they know
when you're doing it poorly," Dr. Verghese continued.
"You can't learn these skills online; you can only learn
them one on one. Part of our obligation is to pass
down this craft of ours, this calling, one on one."

Today, clinical rounds are conducted too often
around a table or a mobile computer workstation
instead of at the bedside, Dr. Verghese noted.
Since the advent of the electronic health record,
"more and more people are only trusting their
numbers," Dr. Verghese said. In times past, "the entire
data set was in the intern's head and on the patients
body," whereas today "if you came to the hospital
missing a leg, no one would believe it until you got an
orthopedic consult and an MRI."
Dr. Verghese and his colleagues collected hundreds of
vignettes about instances where the inadequacy of the
physical examination was the cause of medical errors
and adverse events. Examples included vomiting
due to a testicular torsion that was misdiagnosed
as gastroenteritis, and a patient with severe chest
pain from shingles who was sent for cardiac
catheterization.
"This is a moral erosion that undercuts everything we
try to teach students," Dr. Verghese said.
Rituals of all kinds - opening ceremonies, weddings,
funerals - are about connecting in the process of
transformation, he explained. Examining the patient
is a ritual too. "The patient tells you things that they
would never tell anyone else. And then, the individual

82 | CSA Vital Times

In closing, Dr. Verghese quoted Sir William Osler,
"Patients will form an estimate of you by the way
in which you conduct yourself at the bedside. Skill,
whether in the simple act of feeling the pulse, will
establish more confidence in you than any diploma."
And to my delight as an English major, he also quoted
from E.M. Forster's famous novel, Howards End:
"Only connect."



Vital Times 2019

Table of Contents for the Digital Edition of Vital Times 2019

No label
Vital Times 2019 - No label
Vital Times 2019 - Cover2
Vital Times 2019 - 1
Vital Times 2019 - 2
Vital Times 2019 - 3
Vital Times 2019 - 4
Vital Times 2019 - 5
Vital Times 2019 - 6
Vital Times 2019 - 7
Vital Times 2019 - 8
Vital Times 2019 - 9
Vital Times 2019 - 10
Vital Times 2019 - 11
Vital Times 2019 - 12
Vital Times 2019 - 13
Vital Times 2019 - 14
Vital Times 2019 - 15
Vital Times 2019 - 16
Vital Times 2019 - 17
Vital Times 2019 - 18
Vital Times 2019 - 19
Vital Times 2019 - 20
Vital Times 2019 - 21
Vital Times 2019 - 22
Vital Times 2019 - 23
Vital Times 2019 - 24
Vital Times 2019 - 25
Vital Times 2019 - 26
Vital Times 2019 - 27
Vital Times 2019 - 28
Vital Times 2019 - 29
Vital Times 2019 - 30
Vital Times 2019 - 31
Vital Times 2019 - 32
Vital Times 2019 - 33
Vital Times 2019 - 34
Vital Times 2019 - 35
Vital Times 2019 - 36
Vital Times 2019 - 37
Vital Times 2019 - 38
Vital Times 2019 - 39
Vital Times 2019 - 40
Vital Times 2019 - 41
Vital Times 2019 - 42
Vital Times 2019 - 43
Vital Times 2019 - 44
Vital Times 2019 - 45
Vital Times 2019 - 46
Vital Times 2019 - 47
Vital Times 2019 - 48
Vital Times 2019 - 49
Vital Times 2019 - 50
Vital Times 2019 - 51
Vital Times 2019 - 52
Vital Times 2019 - 53
Vital Times 2019 - 54
Vital Times 2019 - 55
Vital Times 2019 - 56
Vital Times 2019 - 57
Vital Times 2019 - 58
Vital Times 2019 - 59
Vital Times 2019 - 60
Vital Times 2019 - 61
Vital Times 2019 - 62
Vital Times 2019 - 63
Vital Times 2019 - 64
Vital Times 2019 - 65
Vital Times 2019 - 66
Vital Times 2019 - 67
Vital Times 2019 - 68
Vital Times 2019 - 69
Vital Times 2019 - 70
Vital Times 2019 - 71
Vital Times 2019 - 72
Vital Times 2019 - 73
Vital Times 2019 - 74
Vital Times 2019 - 75
Vital Times 2019 - 76
Vital Times 2019 - 77
Vital Times 2019 - 78
Vital Times 2019 - 79
Vital Times 2019 - 80
Vital Times 2019 - 81
Vital Times 2019 - 82
Vital Times 2019 - 83
Vital Times 2019 - 84
Vital Times 2019 - 85
Vital Times 2019 - 86
Vital Times 2019 - 87
Vital Times 2019 - 88
Vital Times 2019 - 89
Vital Times 2019 - 90
Vital Times 2019 - 91
Vital Times 2019 - 92
Vital Times 2019 - 93
Vital Times 2019 - 94
Vital Times 2019 - 95
Vital Times 2019 - 96
Vital Times 2019 - 97
Vital Times 2019 - 98
Vital Times 2019 - 99
Vital Times 2019 - 100
Vital Times 2019 - 101
Vital Times 2019 - 102
Vital Times 2019 - 103
Vital Times 2019 - 104
Vital Times 2019 - 105
Vital Times 2019 - 106
Vital Times 2019 - 107
Vital Times 2019 - 108
Vital Times 2019 - 109
Vital Times 2019 - 110
Vital Times 2019 - 111
Vital Times 2019 - 112
Vital Times 2019 - Cover3
Vital Times 2019 - Cover4
https://www.nxtbook.com/allen/csvt/vital-times-2022
https://www.nxtbook.com/allen/csvt/vital-times-2021
https://www.nxtbook.com/allen/csvt/2020
https://www.nxtbook.com/allen/csvt/2019
https://www.nxtbook.com/allen/csvt/2018
https://www.nxtbook.com/allen/csvt/2017
https://www.nxtbook.com/allen/csvt/2016
https://www.nxtbook.com/allen/csvt/2015
https://www.nxtbook.com/allen/csvt/2014
https://www.nxtbookmedia.com