TOO MUCH DIAGNOSIS


TOO MUCH DIAGNOSIS. WANDERING through a hospital on a visitors day, you will undoubtedly be vastly impressed with its bright airiness and complete sense of neatness and order. The latest scientific cure that the papers has just been praising comes to mind, and you rejoice that modern medicine has made these strides.


SOME CRITICISMS OF HOSPITALS.

By A HOSPITAL SECRETARY.

WANDERING through a hospital on a visitors day, you will undoubtedly be vastly impressed with its bright airiness and complete sense of neatness and order. The latest scientific cure that the papers has just been praising comes to mind, and you rejoice that modern medicine has made these strides. How great must be the good achieved by these houses of healing, is your reflection, as your contribution falls into a collecting box. To feel that you are helping in this grand work of healing the sick is so good.

But, come again, on an ordinary week-day, when the place will be overflowing with patients. An abundance of patience must be theirs, for a wait of two or three hours is to be expected, half a day is not unusual and even a whole day is not exceptional. The majority of them are poor, miserable-looking folk, but for all that, not lacking in great measures of faith that the doctor will cure their ills. His main concern, you feel sure, will be to make them well again, quite sound and whole, if that be humanely possible.

In all probability he will be surrounded by a crowd of students, and after the symptoms of the patient have been duly noted, it seems the most natural thing that a discussion on the treatment should follow. It is of the greatest importance to the patient, and may mean life or death. Yet, this question is relegated until the last, for it seems that to make a diagnosis is the first business. Here the chief interest centres and the highest interest lies.

Go where you will about a hospital, and at every turn, this disease-labeling system will be met with and continually insisted upon. Be it a special clinic or particular department; fully qualified doctors talking over cases among themselves, or instructing students; a question of a slight ailment, or a serious malady, it is ever the same. With doctors, students and nurses all following this rule, it is not surprising that even the patients themselves acquire the habit. It may even be said, that some are rather proud of a disease which has been given a long and almost unpronounceable name, as being an added distinction to a meager existence.

If the trouble is of particular interest, being rare, which is another way of saying that it is very difficult to label, the patient may be seen several times by the same doctor, or group of doctors. However, it more often happens that he will be treated in more than one department, thus being under the care of several doctors at the same time. Probably they will not be agreed upon a general plan of action, but will be treating various defects entirely separately. In any case, it seldom happens that during a series of visits, the patient is seen by the same doctor.

You may be particularly interested in X-rays, perhaps the most brilliantly helpful of the modern inventions, but here again, you will find doctors gazing at films and writing a diagnosis, with only the scantiest note on the patients condition to guide them. Quite without the possibility of seeing the case, in order to have full information before passing judgment.

The supreme advantage of this diagnosis method is, that it is thus possible to obtain a whole collection of cases of the same so-called name. These serve as useful illustrations to lectures and articles, and gradually the author becomes known as a specialist, charging considerably higher fees for consultation than an ordinary general practitioner.

The patient in the ward may believe that everything done is for the best. Certain it is, that many of them have sleeping draughts at night and strong aperients in the morning, as part of the daily routine. Furthermore, he may think that all the various tests, taking of different specimens or sections, the frequent injections and so on, are entirely necessary and all for his benefit, without realising how sheerly experimentally-minded and unnecessary is so much of it.

He may be ill, to the extent that it is only deemed advisable to move him on his bed, instead of the customary stretcher, yet he will be transferred from one block to another, perhaps crossing an open quadrangle, for the mere purpose of having another photograph taken, although a series already exists. Again, he may be moved in this way, so that another dose of the particular course of ray treatment he has been having, may be given, although it is obvious, even to inexperienced eyes, that nothing more will be of any benefit to him.

Today, we are continually being urged to support our hospitals, and consequently much has been written in their praise, so that it is all the more needful for us to be reminded of the other side of the picture. The list of woes could be further continued, but for those who have been fortunate enough to rejoice in homoeopathic treatment, this indication may serve to show that reformation is a crying need and must not be delayed.

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