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Humanism: Ed Viner
31 Plays3 years ago
Dr. Edward Viner is a Professor of Medicine at Cooper Medical School of Rowan University (CMSRU) in Camden, NJ. He is also the founding director of CMSRU's Center for Humanism. Listen to Ed discuss the commercialization of medicine, the electronic medical record and CMSRU's role in the Camden community.
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Transcript
Introduction and Hosts
00:00:09
Speaker
You're listening to The Wound Dresser, a podcast that uncovers the human side of healthcare. I'm your host, Jon Neri. Today, my guest is Dr. Edward Beiner.
Introducing Dr. Edward Beiner
00:00:25
Speaker
Dr. Beiner is an internal medicine physician and professor of medicine at Cooper Medical School of Rowan University. He also serves as the founding director of Cooper Medical School's Center for Humanism.
00:00:36
Speaker
From 1987 until 2006, Dr. Viner was the chief of medicine at Cooper and was instrumental in the creation of its medical school. Prior to joining Cooper, Dr. Viner was an attending physician at Pennsylvania Hospital for 22 years. Ed, welcome to the show. Thank you.
Dr. Beiner's Influences and Career Path
00:00:56
Speaker
So first, as I mentioned in your intro there, you definitely have an interest in humanistic medicine. So can you tell our listeners about your background and how you got interested in humanism?
00:01:08
Speaker
Well, my background, as far as the humanism is concerned, I'd like to think I was always a humanistic person. My mom and dad taught me those values and I was used to being taken on
00:01:26
Speaker
trips around the area where we lived when I was a youngster and delivering baskets of food to anybody that got sick or birthday cake on somebody's special birthday, that kind of thing. So there was a sense, I was brought up to respect people and to learn how to interact with them relatively young.
00:01:51
Speaker
But the real issue of my interest in humanism as a subject came when I was a patient. I was 34 when I went to the doctor and a big liver was found and it led to surgery for what was thought to be a epitoma, a malignant tumor of the liver.
00:02:17
Speaker
And I had crisis after crisis post-operatively and ended up being re-operated to drain an infection. I had sepsis, bloodstream infection, and that was a
00:02:32
Speaker
five weeks on the respirator because of the pulmonary complications that sepsis can produce. It's called ARDS, Acute Respiratory Distress Syndrome. So I was very, very sick and likely to die and knew that.
00:02:53
Speaker
I was in the hospital in the end four months and I learned a lot of things. I decided I could tell whether
00:03:05
Speaker
a care provider at whatever level was really cared about me or not in about 60 seconds. They might as well have worn a sign on their chest that says, come on to me. I want to take care of you.
Commercialization and Its Impact on Healthcare
00:03:18
Speaker
And the other group says, I don't want to get too close. I don't want to get my hands dirty on here because I have to have a job and make a living. And
00:03:29
Speaker
I think I was probably nearly always right in my immediate judgment. So what was that? What makes one person, I think I'm talking about the humanism of a person. What makes one person able to demonstrate humanism and another not? So I've been very interested in this for a long time.
00:03:56
Speaker
And then more recently, of course, we are deluged with journal articles and TV shows and whatever, dealing with the fact that doctors are unhappy, doctors are depressed, doctors are burning out. They don't have resilience. They don't get joy from the workplace. And woe is me.
00:04:25
Speaker
And well, at any rate, what's happened to medicine? And what's happened to medicine, I think is summed up in one word, it's become commercialized. And Dwight Eisenhower worried about the industrial medical military complex after he was
00:04:46
Speaker
When he was president, now we're worrying about the industrial medical complex. And we have medicines being run by big businesses. It's delivered by big business in the hospital. Hospital's a big business, and most medical care is
00:05:11
Speaker
being in cities at least is being delivered that way. And we have huge pharmaceutical companies and insurance companies that are dictating policy one way or another. They're setting the tone and they're requiring huge amounts of documentation before they'll pay the doctors or the hospital. And this means the electronic record
00:05:40
Speaker
all the woe that that has brought to physicians. So, docs are unhappy, not getting joy from the workplace, and we're trying to mitigate this tsunami in our little center for humanism at Cobra.
00:06:00
Speaker
So I can tell you more about the specifics of that as we go.
Compassion in Healthcare
00:06:05
Speaker
Yeah, that was great. You gave me a lot to obviously unpack there, kind of talking a lot about your work.
00:06:12
Speaker
really just to make health care more human. And I guess I want to for a second focus maybe on the compassion piece. Recently I had the pleasure of reading Compassionomics by your colleague Stephen Trasiak and Dr. Anthony Mazzarelli. And in this book the authors discuss the lack of compassion present in health care and
00:06:34
Speaker
present scientific evidence for why compassion matters. So can you describe to our listeners the ongoing compassion crisis in medicine? Well, doctors, it starts very early. Medical students come to their first day of medical school with compassion in their hearts and with the desire to take good care of
00:07:00
Speaker
needy human beings and be sensitive to their needs and their personalities and whatever. And then that gets dissipated. And this has been studied and the devils in the third year when the students get to the hospital and start interacting on the floors with the chains and with the patients
00:07:28
Speaker
they get less rather than more empathetic. You'd think when they saw sick people or actually working with them that this empathy would magnify, not shrivel, but it shrivels. And why is that? And we think it's the hidden curriculum that does this. The hidden curriculum is all the stuff that students learn by osmosis, by watching, by listening,
00:07:57
Speaker
not part of a dictated and fixed curriculum, but it's how the person above them, be it the staff physician or the resident, how does that person demonstrate humanism in his approach to care? A frown at the wrong place,
00:08:21
Speaker
It's not common. An insulting common, the patient's a big fat slob. That may be true, but we have to respect people's dignity. That gets in the heat of the excitement in the middle of the night when the patients are crashing and the docs are really trying to
00:08:49
Speaker
keep afloat, emotion comes out, the students hear this, see it and whatever, and it influences them a great deal. So that's one of the major problems with compassion. Another problem is that we just have lost the art of communication.
00:09:13
Speaker
You know, what I was saying before about being able to tell in 60 seconds whether a person was going to be a good caregiver, it's connecting. We have to teach our students and young physicians how to connect with patients when they first meet them. And it's no different than you meet a new kid next door that moves in and you connect.
00:09:43
Speaker
That is both a natural skill and it's also teachable. So we are trying to teach doctors how to communicate better and to express their humanistic feelings better so that it shows.
00:10:03
Speaker
Yeah, it sounds like a lot of sort of like you said, the hidden curriculum and some other trends in healthcare pushed you to ultimately create or to help found Cooper Medical School as well as the Center for Humanism. So can you talk more kind of like what you're trying to do in both medical school and that specific program to kind of make healthcare more humanistic? Yeah, well, basically our mission is to foster humanistic care.
00:10:32
Speaker
And to do that, we have to teach communication skills. We have to help the physician feel that he or she is part of the team, that they're not isolated. The electronic health record
00:10:57
Speaker
EHR is isolating. Doctors don't talk to each other anymore. They communicate through the computer and this makes one feel isolated and that they're in this alone and there's no camaraderie.
Challenges with Electronic Health Records
00:11:16
Speaker
We're trying to work on that. We're developing a program called the Commensality Program. Commensality
00:11:25
Speaker
Refer is a term that describes a meeting of people to over a meal to discuss issues of the day. And we're starting gonna kick this off very shortly. Mayo Clinic originated this idea. It wasn't our own, but we think it's good and we're gonna try it and we're gonna start everything we do in our center with an objectives to be studied. We have two PhDs that we've hired
00:11:55
Speaker
And we're trying to scientifically determine whether or not we're doing any good and also determine what action on our part might help solve a problem. So that's an example of the kind of thing we're doing.
00:12:17
Speaker
Yeah, you're talking about the electronic medical record certainly resonates in my own work in healthcare where you feel like, you know, there's so much documentation, there's so much related to billing that's done on the computer that you kind of scratch your head and wonder, you know, what's the point of all this, right? It's ultimately to provide quality care to a patient. You know, let me interject because you raised some important oratories.
00:12:42
Speaker
You talked about the billing and the medical record. The reason the docs resent the medical record in large part is because it's been designed to help expedite collection of billing at the maximum level and collecting at the maximum level. It's documentation, documentation, documentation.
00:13:04
Speaker
So they're up at midnight still working on the day's charting, so to speak, because so the hospital can collect more money. Since it's not their own practice, they have no personal
00:13:21
Speaker
you know, they don't have skin in the game of collecting more money. And it would ultimately, obviously if the hospital went broke, they wouldn't be able to get paid. But on a day-to-day basis, this doesn't mean much to the docs. And they're tired in the evening when a lot of this work gets done and they're angry about this. So we're trying to figure out how to
00:13:50
Speaker
improve that, that's a tough one though. But we have to compensate for it. Doctors have to have interaction, they have to talk to each other, they have to talk to the nurses. It's got to be human, just in the daily interaction with each other. We're trying to help that we have programs and all of these issues ongoing.
00:14:19
Speaker
That certainly resonates with some other points I've heard. It just seems like in general, right, that billing at one point was used to kind of provide better care, but now the care is sort of being changed to accommodate the billing, right? Excuse me to interrupt, but the medical record ought to be a wonderful thing. The medical record, first of all, is typed. There's no issue of the doctor's lousy handwriting.
00:14:44
Speaker
and not being able to read it. I mean, it's a record, it's permanent, it can be sent
Medical Residency Policies
00:14:50
Speaker
all over the world at a moment's need. And so there's a lot of good about it, but it interferes with the human interaction. And when the dog's looking at his typewriter or the keyboard,
00:15:08
Speaker
somehow that's much more interfering than it used to be. We used to write by hand, but you were look, you were writing and looking at the patient. It wasn't, he wasn't separated. He said they were working together on this patient and doctor to get this history down and so on. And, and just in so many ways, it's, it's interfered with, with, uh,
00:15:35
Speaker
the good side of what we ought to be doing. I talked to your colleague, Dr. Elizabeth Churchill a little bit about this, but I think with the billing too, there's no longer this sense of as much a sense of ambiguity in medicine. A diagnosis needs to fit into a billable code, and you can't have leeway in terms of thinking a little more
00:16:00
Speaker
maybe artistically or humanistically about a diagnosis? You can't order a lab test without providing a code number that justifies doing that test. So you can't order something because you suspect something. You can't use it until you've proven it. It's a vicious circle just to order the documentation for a laboratory test. Right, right, right.
00:16:30
Speaker
Yeah, this conversation also calls to mind a discussion I had with a physician maybe a year or two ago. She said the worst two things to happen in healthcare in recent years was one being the electronic health record. We've kind of touched on some of those issues, but the other being sort of limitations that have been put on residency hours. And I've heard you talk briefly about this, but can you kind of paint a picture for our listeners? What are some of the limitations on residency hours and kind of had those come to be and perhaps how they're working out in healthcare?
00:17:00
Speaker
Well, all this began with a young woman named Libby Zion. And Libby Zion came into the hospital quite acutely ill and died. And died because the resident didn't get
00:17:18
Speaker
certain details of her situation and medications that she was on and so forth. And the patient died. Libby's father was a writer, I think, for the New York Times. And he sued the hospital and he pressed that this happened because the house staff was too tired.
00:17:46
Speaker
and the tired doctor makes mistakes and we're working 80 or more hours a week and how can you be alert, whatever. So he didn't blame the individual, he blamed the system and the concept. And this led to huge changes in the way we train residents. Residents can only be in the hospital
00:18:13
Speaker
sleeping even if the the hours he sleeps when he's on call in the hospital count he can't be he or she can't be in the hospital more than 80 hours a week and at that point they got to leave so they're told six o'clock you have to leave
00:18:31
Speaker
in the middle of your very sick patients, crucial moment perhaps. And somebody else comes in and you pass, you do a handoff, pass the baton and lots lost in that. So, and that inhibits doctor's sense of the, you know, we want to be there, we need to be there, the patient needs this. But that all is over,
00:18:56
Speaker
overcome by this rule that they can't be in the hospital more than so many hours. And that has also cost hospitals huge amounts of money because faculty have to be hired to work all the hours that our staff used to be relied on to cover. And so it's probably a major thing. Now, obviously, when I was, every doctor at my age has a war story. You know, we worked every other night.
00:19:27
Speaker
And you literally came to work at six or seven in the morning on Monday morning and you didn't go home until seven or eight Tuesday night. And then you were up Wednesday morning at six o'clock again and every other weekend and every other holiday.
00:19:49
Speaker
And it was, did that for a year, then we moved to the residence we were on every third night. Now people are on for the most part every fourth night and it's much more civilized, but there's a lot of lost opportunity. You learn so much in a hospital at night when you're alone to handle the acute problems and you,
00:20:15
Speaker
you get challenged and it's good for resilience building and it's good for confidence and that you can handle that. And that's gone.
Burnout and Career Advice
00:20:29
Speaker
Yeah, I want to connect this discussion to burnout. My initial rebuttal to kind of why these residency rules might be important was that, oh, it would reduce burnout. But the more I've kind of learned about it, I've talked to some other physicians, and one person expressed that they felt that residents were less burnout when they were working more hours. So how do you kind of, in your own head, work out that connection between burnout and residency hours?
00:20:58
Speaker
Burnout is, you know, if you're exhausted at night after night after night, you're gonna burn out on that basis, but burnout can also occur on an emotional basis. And I don't know that there's, I mean, the hours worked are important, but I don't know that they're so specifically important to burn out a lot of other things that are causing burnouts.
00:21:29
Speaker
I must tell you that I was burned out. I'd left Pennsylvania Hospital to go to Cooper because I realized I was working 50 hours a week as a general internist and 50 hours a week as a hematologist oncologist. I was tired and I started to be short with patients and I was
00:21:55
Speaker
horrified with some of the things that came out of my mouth during that period. I mean, I'm usually, I think, a sensitive, supportive, kind person. And I was not that for about six months. And to the point that my wonderful nurse practitioner quit, and I know that it was
00:22:20
Speaker
She never told me until years later, but I knew then that it was because she wasn't working for the same Ed Viner. She had been for the past five years. So I recognize, but this is a very important piece of what I want to say today. Students.
00:22:37
Speaker
In medicine, house officers, young faculty, young staff, doctors, they have a role in this. We can't just say that this is the hospital and the medical school's responsibility to fix all this.
00:22:51
Speaker
The individual has to help fix it. I was smart enough that I followed the advice of intelligent senior doctors that were important in my life. And they always said, you gotta prepare yourself for your next step. What are you gonna do if you get burned out or you just plain up don't wanna do what you're doing here for after 20, 25 years? What's the next chapter?
00:23:20
Speaker
And so I think young physicians need to invest in their futures. They need to learn something, have a special project, have
00:23:35
Speaker
something that's going to help them with the next step. When I got burned out, and the real burnout comes when you feel trapped. If you have something else in your pocket that you know you can do, you don't feel trapped.
00:23:51
Speaker
So my wife used to ask me, we're sitting on the beach and instead of enjoying myself or reading a mystery book, I'm writing a paper. Oh, why are you doing that? I said, because I want to keep my options open.
00:24:07
Speaker
And so I wrote enough papers and I did a little research and I always have had a project now. My project is the Humanism Center, but it was the hospice. After I got out of the hospital, I started the first hospice in this part of the country, a hospice program at Pennsylvania Hospital.
00:24:32
Speaker
So I knew I would want to be a chief of medicine at some hospital someday. That was my long-term concept. And so I made myself able to get such a job. I made myself qualified to get such a job. And when I
00:24:51
Speaker
I got three calls in a week at one point when I look at a job in the hospital. It's JF medicine, COBRA being one of them. I say, you know, this is a sign. I was 50 years old and I was tired out. Now is the time. And I was, I looked at six jobs. I got offered four of them. I was very surprised because I was in the classic academician at that point. But so,
00:25:17
Speaker
Today, a student, a resident needs, and a young faculty person, that's where they really, as a young faculty person, you gotta start having, and the institution has to give you a little time to do some project on your own that you're interested in that can lead to, whether it's a leadership position or a teaching position or whatever, get yourself prepared for the next step.
End-of-Life Care Discussions
00:25:47
Speaker
And I've been able to do that all of my life. And following Max Scarf and Sid Zubrau's advice to me when I was a young first or second year in practice, doctor and these wise older people kept telling me this.
00:26:06
Speaker
Yeah, I wanna take this, now talk about some broader trends in healthcare and some things that are going on. You mentioned the hospice program you started. So can you kind of just discuss the goals of hospice care and what good end of life care looks like? Well, end of life care is an important topic because of, and it's important for we physicians because think about it, we are gonna ultimately take care of
00:26:36
Speaker
Every patient that we have until we die is gonna, every patient that dies before us is gonna be our responsibility to help them to do it. And so you really, well, whatever you practice, you don't have to be an oncologist to be, your patient's gonna get sick and have instaged the illness of some kind and die. And that's the process that doctors need to
00:27:05
Speaker
learn how to handle, they need to learn how to talk to people, be supportive, to be honest with them, answer their questions honestly, help them heal old wounds if they'd been a spouse, estranged from a brother or a parent for years and they're dying, that's a time for you to help them make nice again.
00:27:33
Speaker
Lots of things that enter into end of life care, maintaining the patient's physical comfort, emotional support, teaching family how to handle it and helping the family with their emotional issues and challenges. And so that's a very, very important part of being a humanistic physician is knowing how to do that. Now, you know, there's no perfect way, but if you, if you're comfortable to be
00:28:02
Speaker
interacting with the folks on an honest basis, as I said, you're gonna handle as well. We never used to tell people they had cancer.
00:28:13
Speaker
And it was bizarre how people found out. They found out because they saw it on their charter. They found out because somebody slept up and said something that either told them right out or gave them reason to be concerned it was cancer. So again, honesty is a very important thing. And once you get over the hard,
00:28:43
Speaker
initial knock that comes when you learn about your diagnosis. If you know it and your doctor's honest with you and whatever, you can have a relationship that works for the rest of the patient's time. Do you feel like our healthcare system as it currently exists kind of just often pushes too aggressively for a lot of treatments and kind of just almost as a little too driven by the fear of death in that we need to kind of reassess our approach in that sense?
00:29:13
Speaker
Yes. Well, that's, that's right. That's part of why honesty is so important in standing instead of, well, we had a situation in my Pennsylvania hospital in our oncology department. We, we had a training program, a residence, a fellowship in pathology oncology. And one of our doctors, patients always wanted another consultation. They always want,
00:29:39
Speaker
And my patients never wanted another consultation. Well, I said to him one day, well, why do you think this is? What's the difference? And the difference was that he never was honest with his patients about that this was end-stage disease and we needed to work on accepting that. So they were always clutching at straws and he was always sending them to Sloan Kettering or MD Anderson for consultation.
00:30:09
Speaker
Poor souls were traipsing around the country sick as hell and looking for some magic that wasn't existent.
Balancing Commerce and Care
00:30:19
Speaker
And so being honest and supportive and dealing with the emotion is very important.
00:30:31
Speaker
So we can bring this full circle back to one of our earlier discussions. You mentioned the commercialization of healthcare. You said the medical industrial complex, right? So can you kind of describe what that is more to our listeners and kind of potentially changes that can be made to help improve that, the way healthcare is now? Well, that's a real tough challenge to undo that.
00:31:01
Speaker
Um, I mean, I think hospitals and doctors have to try to resist some of the, some of the control that, that these big industries, for a pharmacist, pharmaceutical, the pharmaceutical industry and the insurance industry are set in policies in our hospitals. And they're, that's not good. And, uh,
00:31:30
Speaker
Again, undoing it is going to be, I think, not possible, but we can compensate for it and fight back a little and we'll see what the next few years brings on that. Yeah, I think I've sort of had these discussions with, you know,
00:31:50
Speaker
people who are more on the administrative side and it sort of just always come down to, well, the institution needs to stay economically viable. Somebody's got to pay and that's how you kind of push to the side a lot of these other things. So can you talk about maybe your relationships with some of the administrative financial people and how you can kind of meet some middle ground to keep the financial stability? We're very fortunate at Cooper because we have a very enlightened leadership
00:32:21
Speaker
We have two co-presidents, one of whom is a physician, who was my student at one point, Dr. Mazzarelli. Dr. Mazzarelli is very, very supportive of our efforts to try to make this better. And I think physician executives really know better than lay executives what
00:32:50
Speaker
where the rubber hits the road here in this arena and we're fortunate to have him. He's also, he's an emergency room physician. He has his law degree and he has a master's degree in medical ethics. So he's a man for all seasons in medicine and we're lucky to have him.
00:33:19
Speaker
So we're working well with our administration, towards the goals that our Humanism Center is trying to achieve.
Community Engagement and Impact
00:33:28
Speaker
If we think now like more outward, right, we've talked a lot about kind of what's going on within the hospital. But as I understand, Cooper Medical School, it's located in Camden, traditionally, you know, community with a lot of poverty and crime. How can a health care system kind of, you know, go outside of the hospital doors and really make an impact in the community? Well, I'm so pleased that you brought that up, because we're very proud of
00:33:52
Speaker
something. I'm going to backtrack to the beginning. As you know, I was quite involved with the creation of the school. And I sat with our chiefs. We had a committee of chiefs of departments that were preparing the groundwork for getting permission to try for a school.
00:34:16
Speaker
and then work together to create nuts and bolts, the curriculum and all the things. Whoops, you have to jump through. And the first meeting of this committee of chiefs of which I was chair, I said, we have to figure out early on what we want to become known for. 10 years from now, 20 years from now, what do we want people image to be of our medical school?
00:34:45
Speaker
And I got the usual responses. Well, it'd be a great research center and this and that. And I said, well, you know, that costs a fortune and it takes years and years to gain credibility in that arena. Let's try to create a school with a soul. And what did I mean by that? Well, again, it was the, we would have a,
00:35:12
Speaker
a safe and comfortable educational year for our students, that we would emphasize collaboration and not competition, and that they would have, we tried to teach them how to be humanistic physicians, and we would have a relationship with our community. Camden is a poor community. There are many poor people that live there.
00:35:40
Speaker
current proper term is underserved, not poor. But at any rate, I think you know what I'm talking about here. And these people need help. And so we developed, I didn't do this part, but a wonderful woman named Jocelyn Mitchell-Williams created a community outreach program that two years ago in our eighth year only,
00:36:10
Speaker
of existence, we won a national prize from the academic medical leadership, the AAMC and LCMA for the best community engagement program, the best community outreach program in all of the country. All the medical schools and all the big teaching hospitals are eligible for this. So we have,
00:36:40
Speaker
Our students give a huge number of hours over their four years of non-medical time to the people in the community. And they have all kinds of things. They have ranges from street medicine group to
00:36:59
Speaker
teaching kids in grade school after school to teach them in the library, how to helping seniors in their last year of high school to write their college application essays that we all had to write. And so all kinds of services that makes the students really
00:37:27
Speaker
feel like they know these folks and that they're doing something good, gives them pride and gives them joy in the workplace. And the end goal in all of this is to have joy in the workplace. And so I'm glad you asked that.
00:37:49
Speaker
Yeah, I think it's, from what I've gathered, it seems like the medical school's doing amazing things in the community. So looking forward to hearing more about the great things that are going on. We also have a student-run clinic. And if you're very poor, if you can't get Medicaid, if you're an undocumented but sick person, who's going to take care of you?
00:38:17
Speaker
We created this clinic right from the beginning. Students start seeing patients after about a month of their first year, they start going to their own clinic and they're very well supervised, obviously, but they have a sense that they're
Personal Insights from Dr. Beiner
00:38:36
Speaker
feel like they're doctors and that's good. And it's a very nice program. The hospital has been very supportive so that they pay for tests and other things that the people need. And we have some private philanthropic money to buy vaccines for all these folks. And so it's a very, very nice thing for the community and for our students.
00:39:05
Speaker
We've certainly hit a lot of things in this discussion. So I want to wrap it up by just considering, if you were to change one thing, right? If there was one thing that you could do to make healthcare more human, what would it be? Everyone learns how to talk to a patient, how to connect and talk with a patient and develop as quickly as possible close and caring relationship.
00:39:35
Speaker
With that, it's time for a lightning round, a series of fast-paced questions that tell us more about you. So I know you're a Philly guy. I'm curious to know if you have a favorite spot for a cheesesteak in Philly. Not really. I've always had a weight problem. I say, stay away from that kind of food. OK. I know in the pats and genos debate, I'm a genos faithful. I like genos better. So I'll throw that in there for genos.
00:40:05
Speaker
Um, I know, uh, part of, you know, the curriculum at Cooper is, you know, incorporating some humanities education. So I'm curious to hear what's your, what's your favorite book? My favorite book. Uh, I can't say Harris is medicine. Uh, look, uh, I read, uh, I love mysteries. I, uh, I, I like history.
00:40:34
Speaker
I read, I've read about many of the presidents of the last hundred years, their biographies and autobiographies and whatever. But I don't have much time to read for my own interest and pleasure, unfortunately. I also have 10 grandchildren. So what time I don't.
00:41:01
Speaker
I have for myself, I try to give to them because that's the most special thing of all. Yeah. That leads me into my next question. I know your, your father and grandfather. So do you have an activity you really enjoyed to do with your family? Well, yeah, we have, uh, getting everybody together for big holiday celebration or we take a week, the last two to three years we've gone.
00:41:28
Speaker
for a week, all of us together, go on somewhere for a summer week. And those are real highlights. We also like to travel. And when I was doctor to the Philadelphia Orchestra, we were in May 23, I think, trips around the world with the orchestra as their doctor, and we were able to take children on those trips. And that was very special, of course.
00:41:55
Speaker
And I always try to get to my kids' sports games, whatever they were. And so that's another important thing. So now we start with the grandchildren in that same relationship. What's the best piece of advice you've received? That I received? Yeah. Plan ahead, as we discussed.
00:42:20
Speaker
And then last thing, we talked about a good number of problems in healthcare, but what's one thing that's working in healthcare right now? Well, the technology, the ability to study a patient, imaging, catheterizations, all of this is a marvelous thing. And the development of the new drugs
00:42:49
Speaker
that we have when I started in medicine, we only had three or four antibiotics, sulfate drugs, we had penicillin, they both got developed during the Second World War and they came into
Conclusion and Sign-Off
00:43:04
Speaker
daily care community in the early 50s. I was in medical school from 56 to 60. So we've had an explosion. I mean, the pharmaceutical companies, I sort of spoke negatively as a group, but in fairness, they have done a fantastic job in creating new drugs.
00:43:27
Speaker
And so between new drugs and new ways to study genetics, for example, genetics used to be, we studied fruit flies. Well, that was a medical student, 1960, 56 to 60. Now we're, you know, we have the genetic basis. We understand it for so many diseases and we can prevent its passage on and we can some cases alternate chains. There's all kinds of,
00:43:57
Speaker
I can't give you one thing that's impressive. All of these things are impressive. Dr. Edward Viner, thanks so much for joining the show. I've enjoyed it too. Thank you, John.
00:44:21
Speaker
Thanks for listening to The Wound Dresser. Until next time, I'm your host John Neery. Be well.