Open Heart (60 page)

Penicillium notatum
,
270
–
71

penile induration.
See
Peyronie's disease

peptic ulcer,
260
,
268

periodontal disease,
260

persistence,
39
,
45

PET-scans,
231

Peyronie's disease of the author,
135
–
42
,
143

spontaneous remission,
146

variation in recommended treatments,
143

P53 system,
272
–
75

pharmaceuticals.
See
drug industry; medications

physical examination

of the author, prior to surgery,
55
–
56

percentage of total information needed for diagnosis,
38

physicians

dehumanization of,
35
,
87
–
88
,
164
–
65

economic conflicts of interest,
37
,
261
–
62
,
290

important qualities: active listening,
21
,
88
,
93
; compassion,
20
,
212
,
265
–
66
; saying “I don't know,”
16
,
244
; sympathy,
212
; training in new technologies,
37
–
38
,
133

judgment skills, 88.
See also
listening to the patient; content and context for,
265
–
66
; for diagnosis of depression,
204
; as a gift,
34
; impact of technology on,
35
–
36
,
133
–
34
; impaired by managed care,
34
–
35
,
159
–
61
,
232
–
33
; importance in choice of treatment,
31
,
34
; role of instinct in diagnosis,
101
,
105
,
247

recent graduates, gaps in training,
35
–
36
,
37
–
38
,
163
,
173

relationship with the patient,
17
, 26: and clinical science,
168
–
69
,
175
–
76
; cultural aspects,
45
; importance of,
38
,
158
–
59
,
265
; lack in managed care system,
34
–
35
,
159
–
61
,
163
,
175
,
232
–
33
,
293
; lack of time,
88
,
169
–
70
,
175
; listening.
See
listening to the patient; the power of authority,
124
,
134
–
35
,
145
–
46
,
164
; restoration,
294
; as the “science” in medicine,
32
; trust,
41
,
146
,
151
–
54
,
175
,
180
–
81
,
202
–
3
,
265

placebo effect,
153
–
57
,
264

plaque

in the author's arteries,
4

components,
29

limitations on knowledge about,
255

role in a heart attack,
29
,
105
,
257
–
58

Pneumocystis carinii pneumonia (PCP),
193

pneumoencephalography,
230

pneumonia,
91
,
109
,
110
,
193
,
271

policy-making,
287
–
91

poliomyelitis,
88
–
89
,
109
,
110

political aspects of AIDS treatment and research,
282

Porphyromonas gingivalis
,
259
,
260

positron emission tomography (PET),
231

post-traumatic stress disorder,
211
,
219
,
298

potassium para-aminobenzoate (PABA),
138
,
140
,
143
,
145

poverty

access to AIDS treatment,
41
,
282
,
286

access to vaccinations,
285
–
86

in American culture,
184
–
85

childhood mortality from preventable diseases,
286

Pravachol,
29
,
96
,
260

prostate cancer,
33
,
300

prostate-specific antigen test (PSA),
118
,
138
,
145

Prozac,
97
,
99
,
154

psychological aspects

appreciation of life. See life: as a gift

compassion,
20
,
212
,
265
–
66

concept of choice,
287
–
88
,
290

distancing from reality,
68

effects of author's experience on friends,
25

effects of positive attitude,
40
,
47
,
83
,
131

empathy,
42

fatalism,
25

fear.
See
fear

feeling of no use,
297

importance of friends.
See
friends persistence,
39
,
45

safety as an illusion,
210

self-revelation and self-reflection,
202

shock and denial,
3
–
4
,
47

sympathy,
212

unreliability of memory,
50
,
61
,
69

of writing,
18
–
19

psychotherapist, of the author,
51
,
63
–
64

public health

historical background,
91
,
111

importance of clean water,
102
–
3
,
108

medical school curriculum,
164
,
165

in policy-making,
289

pulse,
5
,
127

“pump-time,”
13

racial aspects

baseball,
236
,
237

discrimination,
236
–
37
,
281

quality of medical care and mortality statistics,
39
–
40

radiation therapy for Hodgkin's disease,
76

recovery

of the author: after two years,
122
–
23
; first few hours after surgery,
299
–
300
; first few weeks,
17
,
18
,
120
–
21

effects of a caring relationship,
149
–
50

effects of positive attitude,
40
,
131

family support as predictor for,
41

Reeve, Christopher,
268
–
69

retinal damage,
9

rheumatic fever,
111

rheumatic valve disease,
249

rheumatoid arthritis,
268
,
272

The Rise and Fall of Modern Medicine
(LeFanu),
262

risk factors

cancer,
111
,
113
,
116
,
117

heart disease,
5
,
30
,
106
,
252

type 2 diabetes,
106
–
7
,
249

Robinson, Jackie,
235
–
37

Rofman, Sam and Elaine,
80

Rogaine,
97

Rudy, Arthur

background,
11
,
12

education,
200
,
201
,
206
,
209

friendship with the author,
11
–
12
,
122
,
124
–
28
,
152
,
199
,
207

motivation to be a psychologist,
200
,
205
–
8
,
211
–
12
,
267

personality,
199

responsibilities as a psychologist,
11
,
200
,
297
–
98

support for the author prior to surgery,
79
,
81

in Vietnam,
209
–
11
,
213
–
14
,
219

views: on his future,
298
; on the role of psychotherapy,
103
–
5

Rudy, Marcia,
213
,
219

Rudy, Paulette,
200
,
219
,
297

Sachs, Fred,
300

Saving the Heart: The Battle to Conquer Coronary Disease
(Klaidman),
33
–
34

scarlet fever,
94
,
109

scars,
123
,
140
–
41

Schaufenster schauen
strategy,
65
,
66

schistosomiasis,
182
–
84

self-revelation and self-reflection,
202

September 11 attacks,
151
,
152
,
285
,
298

serendipity, role in medical discovery,
114
,
268
,
270
–
71

Seth

at the hospital during author's surgery,
12
,
14
,
84

trip to London,
52
,
53
–
54

visit with author after surgery,
17

wedding, to Miriam Neugeboren,
12
,
57
,
130

Sharon,
73
–
74
,
75
–
76
,
78
–
79

sickle cell anemia,
250
,
253

Siegel, Asher,
192

smallpox,
90
,
109
,
110
,
111

smoking

as risk factor for cancer,
111
,
113
,
116
,
117

as risk factor for heart disease,
5
,
24
,
106

tobacco marketing,
291

social aspects

effects of a caring relationship on recovery,
149
–
51

importance of family and friends.

See
family; friends

isolation,
82
,
148
,
150
,
297

loneliness,
50
,
55
,
56
,
58
,
64
,
129

societal aspects

access to health care,
41
,
175
,
282
,
285
–
87

discrimination,
236
–
37
,
281

medical training and service,
166

responsibility to other human beings,
166
,
287
–
88

responsibility to provide doctors and universal health care,
166
,
175
,
289

Some Choice
(Annas),
287
–
88

South Africa,
281
–
82
,
284
,
285

specialists

financial incentives,
295

“gatekeeping” in managed care,
35
,
292

missed diagnosis from,
232
–
33

neonatal,
294
,
295

vs. general practitioners,
246

spiritual aspects, balance with modern medicine,
184

staphylococcus,
26
,
270
–
71

statins, 259.
See also
Baycol; Lescol; Lipitor; Mevacor; Pravachol; Zocor

stent.
See
angioplasty, stent

steroids,
268

stethoscope, use in heart disease diagnosis,
35
–
36

streptococcus,
249
,
255

streptomycin,
268
,
270

stress

of the author prior to surgery,
47
,
50
–
52
,
61

as risk factor,
24

stress test

of the author,
56
,
64
,
66
–
68

as predictor for heart disease,
30

procedure,
68

stroke

with coronary bypass,
9

MRI for diagnosis,
231

with open-heart surgery,
44

with type 2 diabetes,
107

surgery.
See
coronary bypass; heart transplant; open-heart surgery

survival,
126
–
27

symptoms

asymptomatic heart attack,
25
,
28
–
29

of the author prior to surgery,
5
,
8
,
47
,
49
–
62

of heart disease,
5
,
16

vs. causes of disease,
87

teaching positions, of the author,
13
,
57
,
82

technology

economic and policy issues,
290

“halfway technologies,”
44
–
45
,
87