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Healing the Wounds is the most revealing book eve written by a doctor about his own profession. In it David Hilfiker breaks the silence surrounding the everyday practice of medicine and gives us a dramatically personal account of how the family doctor gets by in a world of spiraling information and high anxiety. Drawing on his years of rural and urban experience, Dr. Hilfiker lets us all know what it really feels like to be a doctor. What do you do when you make a serious medical mistake? Is it enjoyable to play God? What do you say to a patient who wants reassurance when the essence of diagnosis is uncertainty? What about money? What happens when you patient is taking forever, your waiting rooms full, and you want to get home? Dr. David Hilfiker graduated from Yale College and the University of Minnesota Medical School. He practiced medicine as a Board Certified Family Practitioner in a small town in rural Minnesota from 1975 to 1982, and now works in Washington, D.C., where he is medical director of Community of Hope Health Services and St. Josephs House, a shelter for homeless men with AIDS.
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Healing the Wounds : A Physician Looks At His Work
author
:
Hilfiker, David.
publisher
:
Fordham University Press
isbn10 | asin
:
1881871231
print isbn13
:
9781881871231
ebook isbn13
:
9780585171166
language
:
English
subject
Family medicine, Medicine, Rural, Physicians--Psychology, Physician and patient, Hilfiker, David.
publication date
:
1997
lcc
:
R729.5.G4H55 1997eb
ddc
:
610.69/52
subject
:
Family medicine, Medicine, Rural, Physicians--Psychology, Physician and patient, Hilfiker, David.
Page iii
Healing the Wounds
A Physician Looks at His Work
David Hilfiker, MD
CREIGHTON UNIVERSITY PRESS Omaha, Nebraska Association of Jesuit University Presses
Page iv
1998 by Creighton University Press All rights reserved
No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the Publisher, except in the case of brief quotations embodied in critical articles and reviews.
Grateful acknowledgment is made to the New England Journal of Medicine for permission to reprint parts of this book which were originally published, in slightly different form, in that journal. Chapter 6 appeared in the January 12, 1984 issue as "Facing Our Mistakes" (vol. 310, pp. 118-22). Chapter 8 appeared in the issue of March 24, 1983, as "Allowing the Debilitated to Die" (vol. 308, pp. 716-19).
Library of Congress Cataloging in Publication Data
Hilfiker, David. Healing the wounds: a physician looks at his work / David Hilfiker. p. cm. Originally published: New York: Pantheon Books, c1985. ISBN 1-881871-23-1 (pbk.) 1. Family medicine. 2. Medicine, Rural. 3. Physicians Psychology. 4. Physician and patient. 5. Hilfiker, David. I. Title. R729.5.G4H55 1998 610.69'52dc2196-47942 CIP
EDITORIAL
MARKETING & DISTRIBUTION
Creighton University Press
Fordham University Press
2500 California Plaza
University Box L
Omaha, Nebraska 68178
Bronx, New York 10458
Printed in the United States of America
Page v
For Roger A. MacDonald, MD
Page vii
Table of Contents
Acknowledgments
ix
Preface
xi
Chapter 1 Cardiac Arrest
1
Chapter 2 The Pressure Cooker
14
Chapter 3 The Limits of Help
23
Chapter 4 The Boundaries of Knowledge
33
Chapter 5 Uncertainty
44
Chapter 6 Mistakes
55
Chapter 7 Taking Sides
67
Chapter 8 Playing God
77
Chapter 9 Clinical Detachment
92
Page viii
Chapter 10 Efficiency
102
Chapter 11 Authority
112
Chapter 12 Hierarchy
119
Chapter 13 Money
130
Chapter 14 Moving on
140
Chapter 15 The Wounded Healer
144
Postscript
158
References
162
Page ix
Acknowledgments
Any physician who presumes to write about his work owes a debt of gratitude to the patients who consent to having their "stories" made public. That debt is even deeper when the doctor is from a small town and his patients run the risk thatdespite all attempts at camouflagetheir own personal pain will become general knowledge. In writing such a personal book as this one, I expose not only myself but my patients, my clinic, and my community. I am most grateful for the encouragement and support they have offered me.
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