Michael Crichton - Five Patients

Здесь есть возможность читать онлайн «Michael Crichton - Five Patients» весь текст электронной книги совершенно бесплатно (целиком полную версию без сокращений). В некоторых случаях можно слушать аудио, скачать через торрент в формате fb2 и присутствует краткое содержание. Жанр: Триллер, на английском языке. Описание произведения, (предисловие) а так же отзывы посетителей доступны на портале библиотеки ЛибКат.

Five Patients: краткое содержание, описание и аннотация

Предлагаем к чтению аннотацию, описание, краткое содержание или предисловие (зависит от того, что написал сам автор книги «Five Patients»). Если вы не нашли необходимую информацию о книге — напишите в комментариях, мы постараемся отыскать её.

Five Patients — читать онлайн бесплатно полную книгу (весь текст) целиком

Ниже представлен текст книги, разбитый по страницам. Система сохранения места последней прочитанной страницы, позволяет с удобством читать онлайн бесплатно книгу «Five Patients», без необходимости каждый раз заново искать на чём Вы остановились. Поставьте закладку, и сможете в любой момент перейти на страницу, на которой закончили чтение.

Тёмная тема
Сбросить

Интервал:

Закладка:

Сделать

The bringing together of patients, personnel, and hardware has certainly been valuable in cardiac intensive-care units; in some units immediate mortality from myocardial infarction has been cut as much as 30 per cent. We are already seeing a pro-

liferation of these specialized units, and we will certainly see more-and from there it is only a small step to complete reordering of the hospital along new lines.

Afterword

although it comes from an ancient tra-dition, the modern hospital, in fully recognizable form, is less than fifty years old.

At most it will last, in fully recognizable form, another decade or so. But by then, almost surely, what is different from the present will overshadow what is similar. And we may expect these changes to represent more than improved technology and differently trained personnel. For there will certainly be a change in the function of hospitals, just as there has been a change in function during the past half century.

During that period, the hospital evolved into a positive, curative agency specializing in highly technical, complex medical procedures. Very likely the hospital will continue to function in this capacity. But it will abandon certain other functions in the process. It will cease to be a convalescent facility, for example, as more specialized convalescent homes appear. It will curtail its in-patient diagnostic work to that which absolutely requires hospitalization. Its custodial function-whether.

Afterword

Represented by a young couple "dumping" grandpa for the weekend, so that they can have a few days to themselves, or by the admission of alcoholics and derelicts who would otherwise have nowhere to go-has already been reduced and will soon be eliminated. One can say this with some confidence because in every case the rationale is economic, not philosophical. Hospitals are becoming so expensive that financial considerations will soon become the paramount determinant of function.

Less certain are those new tasks and responsibilities that the hospital will assume in the future. Here, the pressures are largely social, and their manifestations not easily anticipated. Perhaps the clearest-and most general-trend is the hospital's notion of an extended responsibility, which goes beyond the confines of its walls. A teaching hospital such as the Massachusetts General now sees its job as dealing both with the hospital patients and with the surrounding community. It defines this new role in two ways: discovering those patients who need hospitalization but are not receiving it, and treating other patients so that future hospitali-zations will be prevented.

But the hospital is going further. It is spreading its research and its knowledge beyond the local community to a broader population. In the past, it did this in the form of research papers printed in scientific journals. That form persists, but more directly the hospital now uses television and computer programs to disseminate its knowledge and its resources.

For the patient, something rather paradoxical is happening. Broadly speaking, the whole thrust of enlightened medical thinking is directed toward getting more care to more people. The problem is as enormous and as important as curing any specific disease process. In examining the situation, both doctors and patients express the fear that the individual may cease to be treated as a person, that he may become merged into some faceless, very lonely crowd. Yet at the same time, the hospitals, which have traditionally been the most impersonal elements in any health-care system, are more concerned than ever about tailoring the hospital so it treats every patient individually.

For medical education, the impact of changes in hospital function may be considerable. For the last half century, medical education has been almost exclusively in-patient education-the emphasis has been upon care of the patient who is in the hospital and not outside it. But as the hospital reaches outside its walls, so will medical education.

There is another point about medical education, not often considered in formal discussions. It is a problem, a fact of medical life, which can be dated quite precisely in terms of origin: it began in 1923, with Banting and Best. The discovery of insulin by these workers led directly to the first chronic therapy of complexity and seriousness, where administration lay in the hands of the patient. Prior to that time, there were indeed chronic medications-such as digitalis for heart failure or colchicine for gout-but a patient taking such medications did not need to be terribly careful about it or terribly knowledgeable about his disease process. That is to say, if he took his medicines irregularly, he developed medical difficulties fairly slowly, or else he developed difficulties that were not life-threatening.

Insulin was different. A patient had to be careful or he might die in a matter of hours. And since insulin there has come a whole range of chronic therapies that are equally complex and serious, and that require a knowledgeable, responsible patient.

Partly in response to these demands, partly as a consequence of better education, patients are more knowledgeable about medicine than ever before. Only the most insecure and unintelligent physicians wish to keep patients from becoming even more knowledgeable.

And when one considers a medical institution, such as the hospital, the importance of a knowledgeable public becomes still clearer. Hospitals are now changing. They will change more, and faster, in the future. Much of that change will be a response to social pressure, a demand for services and facilities. It is vital that this demand be intelligent, and informed.

Glossary

Abrasions -Scrapes.

Acidosis - Excessive acidity in the blood.

Acute - In medical reference, meaning of short duration. There is no connotation of severity. The opposite of an acute illness is a chronic illness.

Ampoule - A drug container, usually made of glass. amylase An enzyme produced in the pancreas and found in elevated blood concentration when the pancreas is diseased. amyloidosis A disease characterized by deposits of amyloid in various tissues. Amyloid is a protein substance.

Angiogram - An X-ray study of blood vessels. arrhythmia Irregular heartbeat.

Barium - A metallic element. Barium sulfate, a salt, is opaque to X rays and is not absorbed by the gastrointestinal tract. When a liquid suspension of barium sulfate is swallowed by the patient, the stomach and intestine are outlined in white on X rays and can be better studied.

Bilirubin - A golden pigment formed when the hemoglobin in red blood cells is broken down. Bilirubin is normally excreted by the body; in various disease states it can accumulate, causing jaundice (q.v.).

Biopsy - Removal of a sample of living tissue for examination.

Blood pressure - Expressed in millimeters of mercury, this is generally the pressure within the brachial artery of the arm. Blood pressure is expressed as a fraction, such as 120/80. The first figure is known as systolic blood pressure, and represents the peak pressure inside the artery corresponding to each contraction of the heart. The smaller figure is known as diastolic blood pressure, and represents the pressure inside the artery between contractions.

Blood sugar - Blood normally contains a certain amount of sugar, but the amount can be increased in disease states such as diabetes.

Bone marrow aspiration - Removal of some bone marrow by suction through a needle.

Catheter - A hollow cylinder of metal, rubber, or plastic designed to be passed through any of several body channels, such as the arteries, veins, or the urinary system.

Catheterize - To pass a catheter through a body channel.

Celiac angiogram - An X-ray study of blood vessels which supply abdominal organs, that is, of the so-called celiac arteries.

Читать дальше
Тёмная тема
Сбросить

Интервал:

Закладка:

Сделать

Похожие книги на «Five Patients»

Представляем Вашему вниманию похожие книги на «Five Patients» списком для выбора. Мы отобрали схожую по названию и смыслу литературу в надежде предоставить читателям больше вариантов отыскать новые, интересные, ещё непрочитанные произведения.


Michael Crichton - Drug of Choice
Michael Crichton
Michael Crichton - Gold - Pirate Latitudes
Michael Crichton
Michael Crichton - Esfera
Michael Crichton
Michael Crichton - Latitudes Piratas
Michael Crichton
Michael Crichton - Beute (Prey)
Michael Crichton
Michael Crichton - The Terminal Man
Michael Crichton
libcat.ru: книга без обложки
Michael Crichton
libcat.ru: книга без обложки
Michael Crichton
libcat.ru: книга без обложки
Michael Crichton
libcat.ru: книга без обложки
Michael Crichton
Michael Crichton - The Andromeda Evolution
Michael Crichton
Отзывы о книге «Five Patients»

Обсуждение, отзывы о книге «Five Patients» и просто собственные мнения читателей. Оставьте ваши комментарии, напишите, что Вы думаете о произведении, его смысле или главных героях. Укажите что конкретно понравилось, а что нет, и почему Вы так считаете.

x