Medical Marijuana Cooking 101
1950 edition
Be like newly is 23 edition. The edition that I read in those days already was written down not clear.
If writing in front:
The medical that I had read is classical not much, " internal medicine of rare family name learns " it is only a few one of. To me the impact is the biggest is not professional content, it is introductive: " medicine is profession of path of pundit of a need. Internal medicine learns and current internist " , its what kind of to serving as a doctor to should be had professional quality, humanitarian quality, and the patient‘s need is how what, right patient expression consideration has classic description etc. This book was read when strong 1991 finish school, affected the professional career with my whole to this day. There is not OFFICE software at that time, it is the DOS edition that uses UCDOS(WPS) preface one word is knocked one sentence into computer, these characters turn later for WORD documentation, as me hold industry spot is transitional, following from beginning to end I.
Today, I stick my at the back, to those first the doctor that is an employee and nurse turn to share by medic first, the hope can have to the professional career of everybody sexual influence.
" family name internal medicine learns on the west " : Medical is profession of path of pundit of a need
Internal medicine learns and current internist J.ClaudeBennett
Patient
In short, the patient needs to give the person of the help namely, this kind of subjective view can bring uneasiness to the patient, although be not behaved certainly,come out. Even if most the patient of broad-minded, also can put in this kind of worry. This physician absolutely cannot be ignored, anxious uneasiness of the patient may be specific, be like scared cancer, include the average person understanding to cancer: Aching, exasperate, be destined to die etc. But commonner is the sort of notting have but the worry of renown shape: Be afraid of lose independent viability and unemployment; Be afraid of cannot responsible to the family or the consideration that loses the person that dote on; Be afraid of the dignity that loses the life and meaning to wait. Internist often shows medical history because of be eager to deciding action in chief is mixed and fail to give enough attention to this.
The sickbed that the patient is the office that decorating meticulously, clinic or hospital is classy and complete in new environment, see a doctor. This kind has the form of Medical Protection to the individual, differ with the public health protection to collective. People is commonly used a not apt term says confront a system for the individual. Regretful is, this kind of lot often makes a patient embarrassed. Actually, the patient is it is painful to will remove, do not seek experience. The life is numerous and complicated is complex, in genetic, one‘s early years experience, culture and mental environment, education, successful, failure, illusion, feeling is placed, motive and the adjustment to ill incomplete and manhood and remedy waiting for a respect is differ in thousands ways. And the life of each one is very special, because this life just is final individual,confront a system. The patient is to taking rich and varied life to arrive via all through the ages before the doctor, the requirement solves a problem. When the doctor asks about action in chief, the patient‘s line of defence breaks down already, spreading outpouring sentiment may be depressed, the response that they make is possible also very very finite, brief. Because of this doctor often misinterpret the response that misreads a patient even.
What is what when the patient sees a doctor, ask? The patient has hope and expect jointly, they ask the doctor listens to their allegation carefully, it is difficult that requirement doctor discharges care to solve for them, their hope doctor with sympathizing with is not the manner that censure, regard them as an Everyman will treat. They hope the doctor has best medical treatment technology, still hope the disease to oneself and pathogeny and prognosis have a logical explanation. They hope won‘t by close the door on. Of course, to each patients, these hopes and expectant photograph are very old to importance difference.
Internist
Internist is devoted into at this one onerous and for the public the profession of urgent need, him since the choice also is the result that is chosen. The doctor is a kind of profession that having long history, archaic doctor, since is abbe, it is alchemist, reflecting the belief of that times and expectation, can satisfy the need of broad masses. Medical history is a bequest that every internist should accede, it is mirrorring social culture to develop a process from flank.
What the physician is engaged in is the traditional profession that there is certain value on morality of Men Zailun manage and responsibility. But with the patient, internist also is distinctive. Internist is not the tool that exceeds reality, not be to be able to pass a profession inactive bring up. Internist is an Everyman, have oneself good qualities and weak point, must know this adequately, ability satisfies patient and occupational need. All sorts of normative much of humanness also are a doctor standard of this one occupational. Good physician should have what kind of quality and style, it is easy to say, accomplish truly be not easy thing, these character and morals include to sympathize with, nature of mankind of straight-out, understanding, quick-witted, ad cool-headed, curious, assiduous study and the moral level that have height, (precise scientific manner, objective academic spirit) wait, still perhaps should add abundant energy, the life because of the physician and slack and faineant it is antipathetic. Anybody won‘t have these fine quality and style completely, the doctor should have one accurate knowledge to oneself above all, must be clear that how ability is in his professional career, utmost ground approachs these ideal levels.
Of the patient (problem) requirement
How can I just find a good doctor?
How can I just find me you can pay have the good doctor of charge?
How can I just find, the good doctor that I am treated when a person?
How can I just find a patience listen to action in chief and the good doctor that can you understand a patient?
In world each district, all people that need Medical Protection are in everyday the question that raises such. They raise such question is the sex of science of medical treatment system that faces because of them very strong, in textural excess load runs, in general, system of this kind of medical treatment did not regard the patient as a person will consider. In fact, when person firm sicken, without giving thought to symptom how, what need most is someone can say so to him: I am a good doctor, collect fees reasonable, to resemble you such patient serves; I can listen to your illness to narrate patiently.
A of center of a large medicine outstanding teacher (internist) ever admonished his student: Want to listen to the patient‘s narration, he can tell you where is uncomfortable. Still can tell you what he needs. When the patient finds the physician that can satisfy its adequately to ask, some people in them will be very gratified. But most person is to appreciate completely ineffable. After understanding above concerns this kind, the patient can realise, a conspicuous technician and a distinction between true internist are, internist knowledge is broad and profound, have deep scientific knowledge, rich clinical practice and scientific research experience. Unfortunate is, in the career that devotes oneself to oneself actively in that prominent physician when, had serious rheumatoid arthritis. Without doubt, because oneself also contract a disease personally, he looks for him to see a doctor to the patient, the sort of expectation when undertaking constitution and spirit are checked, need, fear and appreciative complex mood know sth like the palm of one‘s hand. The patient often looks for this doctor to see a doctor in crows, because he can have accurate diagnosis, proper treatment,this is not only, and his enthusiasm to the patient, the height that more important is the ability and wisdom that shows when contacting everybody because of him and opposite work is hopeful spirit. He is good at holding the person‘s feature like Shakespeare, having the extraordinary ability that expression loves and can respect to others. He is having the ideal that all internist should go after, a lot of readers meet the physician that has these characteristics; All internist should be known hard and foster oneself professional ethics. Such ability are in have masterly technology while the moral character that does not lose a person.
The requirement of science and technology that a good doctor should have
Since 1910 Flexner
Since publishing his famous report, american medicine teachs a bound to devote oneself to to build a solid scientific base namely. The precondition on this kind of intelligence has become medical preparatory, undergraduate course, graduate student education and continue the important one part that medicine teachs. Biology medicine science is understanding disease, make examine break, innovatory therapeutics and the base that make an assessment to the complexity of new technology and effectiveness. Internist cannot be satisfied at which understanding to plant to treat means to be in only the time of 90 ％ of 80 ％ ～ is effective, use no matter why to plant means, they still must master those who regard this kind of method as the foundation is physiological with pharmacological. They still must have the intelligence that tracks contemporary research report on medical periodical. Such no matter they are engaged in how the domain is complex, can master newest method ceaselessly. Accordingly, schoolbook of this kind of medicine emphasizes pair of treatise that nod each below particularly, namely the pathological change that pathology process place causes and pathological changes mechanism, and the treats methodological place generation influence that in order to corrects pathological changes. We try to arouse a kind of more deep to science comprehension in our reader memory, can make sure its are in the forward position of scientific knowledge continuously, actually, the expert place in any scientific domains should have this.
We are entering a new period, medicaments preparation is the child of organic chemistry only no longer, and often more it is to pass DNA
Recombine a technology to obtain. The technology can be opposite the new preparation that is about to appear to caustic is short of inside body or complement. If the doctor does not have sufficient understanding to the action of these new-style preparation, utility and potential side effect, chan Ping its rational honesty, cannot apply them. Below clinical condition, appearance of rehabilitate of opposite content consistence, nuclear magnetic resonance, high frequency laser and such are studying medium method, diagnosing learn and therapeutic the function that attend and latent capacity, the person ability that trains through background science only makes an assessment.
Medical Protection worker
How can I just find you can regard me as does a person come the good doctor of cure?
Speak of Medical Protection, people must figure out first the meaning of Medical Protection. When the doctor is being diagnosed and opening medicine to treat, if the technology is sterling, accord with science, but feeling is chill, the illness perhaps can improve -- even heal. But from on the other hand for, the patient puts forward: Whether does the doctor have true medical treatment? When such problem, the patient‘s means: Whether does the doctor care my sufferings? Besides medical treatment technology, is the doctor mixed to the sensitivity of other sufferings sympathize with a heart? We talk about the character of sanitarian worker on this meaning just about.
Saying medical treatment is a kind of skill appears very absurd, nevertheless medical treatment presses his is a kind of technology really for real significance, the student that getting education is sensible. They should know the way that a few kinds of expression sympathize with at least. Accepting groomed doctor to must understand these skill in practise medicine, try to use in the correlation that handling doctor and patient and its family member. Include to learn how to be conveyed among them sympathize with. Kahlil Gibran
Ever taught us: When the belongings that what pay when you is you, what what you give is one bit only, in you only systemic heart gives when, you just were made truly pay. Easy, natural, significant complete body and mind is paid, for most to us person, it is a kind of need learns ability getatable skill. The heart that still needs a kind of profundity sometimes again arousal, can make young when what have not behaves a priori that pass is sensitive and sympathize with new show to come out. Learned Medical Protection, the action that still needs complete him change sometimes and mood will be close to a patient, undertake be such more when cure in different to culture setting and us patient. The compassion that a lot of people think the responsibility that current medical science teachs is education medic heart.
When the patient is accepting medical treatment, must the body oneself even doctor of life resign to, so the doctor must obtain the patient‘s complete reliance, ability has treatment with honest manner. It is negligible that sheet is treated by the technology, should letting a patient believe is in what differ by each one the circumstance has treatment. This kind shows loving care for the exchange with reliance, although be different from friendship and love, can have same effect however. Produced a kind of interdependent sex between doctors and patients so, this does not have harm not only, enhanced curative effect instead, be helpful for the heal of the disease. 20 centuries later period, our enthusiasm, humour and kindheartedness often flood the guiding principle that gives priority to at forging affectation and craft in, this makes we are in isolated condition in the society namely. Regard a profession as the doctor, what even if be opposite,the patient breaks is humane, sacredder than acting machinery also part is close friends more.
The social sense of responsibility of good doctor and human character
The patient can say you fulfil his duty only responsible, improve my patient‘s condition, make me comfortable, can sympathize with my sufferings, listen to my narration, I just can trust you. Dag Hammarskjold
Admonish we: Others is the reliance to you civilly to you. This kind of differentiate card that give and accepts credit concerns, what serve with respect to patient of requirement doctor promising is compulsory. Of course, if possible sentence, the patient also should bear a bit responsibility in treating a process, nevertheless, the doctor must be happy to satisfy the patient‘s requirement, no matter how these requirements are changeful, no matter how these requirements are unreasonable, no matter how be misunderstood to demand, the doctor should give solve. Average physician is assuming job of long-term to the patient iatrical, they must remind themselves every day, this kind of task asks they are in make accurate examine break or finish inside after lens is checked, stay beside the patient even, they should know to just accepting heart conduit art or seam last needle, the patient is pushed when ward, still need cure to protect. In whole rehabilitation process, internist should use all sorts of technologies, undertake nurse and maintaining to the patient with close human relationship.
Through the family member the relation helps a patient
Have the woman of fatigue, listless, insomnia and irritable medical history, the inchoate symptom of the disease may be narrated before the doctor, she is shown possibly still cannot as poisonous as the husband of excessive drinking, be addicted to son, and the sign that the old mother with ministrant need gets along well and feels spirit is depressed, well-advised doctor is considering implement qualitative sex pathological change while, still can discover apparent symptom just is the one part element that perplexes a patient truly actually. This is had with respect to requirement doctor unusual sensitive, can adopt subtle and considerate, understanding manner to listen to the patient‘s narration. Satisfy the patient‘s requirement, this is a kind can and the quality that must have foster and be carryinged out. The doctor‘s action is to help a patient know healthy state undesirable, the mood is bad with the relation between all sorts of symptoms. Sometimes, the doctor should help a patient understand this kind of concern only, let them understand the doctor understands them, can sympathize with ground listen respectfully their narration, comfort them, such, although the doctor did not have direct proposal, but already expressed to show loving care for however. Some earlier moment, most Medical Protection comes to serve. Although the doctor does not understand domestic situation of the patient, also can make clear very quickly its living conditions and domestic concern. And now, the patient is to come round alone commonly of go to a doctor, do not have socioeconomy connection again with the doctor, the doctor makes clear harder the thing that produce, when asking medical history, medical or briefer outpatient service, the doctor must use more excellent skill to understand the correlation inside patient family.
Help patient reduces ailment
In process of development of most chronic illness, go up in the body, the anguish that there can be fixed rate with affection respect on spirit, but some patients good as a result of psychological quality, tough-minded or have very strong self-confident heart, with respect to easy conquer disease, and some patients are very pessimistic when contracting severe chronic disease, arrived even sometimes the brim that spirit breaks down. Internist must master the skill that handles human relation, this asks they are familiar with each respects of the life, be familiar with ailment especially. They want be considerate ground to know the patient‘s sufferings, still answer to contact the life experience with ailment and wide range. Such their ability treat the patient of all sorts of types. Medic fails to get the case of elaborate cure to inpatient, sometimes likelihood catch a glimpse of, but more be this kind of phenomenon sees when the chronic illness that does not heal for a long time in outpatient service cure. Besides the express one‘s thanks to of affable, kind manner and understanding, the physician lacks specific remedial method commonly at this moment. As medical treatment practice and year all is added, be used to of can ceaseless in getting along with the patient geoscience raises medic. Best internist always learns ceaselessly, because every patient can let them,acquire some kind of method that reduces specific ailment.
Come 20 years recently, all sorts of medical treatment organizations already got countless more, the number of the person that demand medical service is ceaseless also grow in quantity, have such medical treatment organization and couple of a lot of center of large medical treatment, the effect that they have is very main, they allow a patient expatiatory its concern and fear, let a patient listen to other the feeling of the patient that has same patient‘s condition to it, can partake the patient‘s anguish. They are medium to comprehensive treatment of the patient hold the balance. Internist still must make clear the particular case of every patient patient‘s condition and serious degree. Everybody has his special demand, know the patient‘s anguish merely, do not mean it is painful to remove, same, know a certain patient has a responsibility only, also differ to be planted at reducing this burden. The doctor should contact a patient not only, still must give a patient in order to encourage. The possibility that although know perfectly well,improves healthy condition is very finite, the doctor also cannot abandon hard absolutely.
Help dying patient
Neither one person is willing to go dead truly. But arrived really blamed when, the patient always hopes to die creditably. After all we are most what person place hopes is living not merely, more important is to should live satisfactorily, live significantly. Sometimes, we chose to escape the life of unlike to die, this perhaps is reasonable. About the problem of dying patient, still have true meaning of death even, it is the topic that current doctor often comes up against.
It is normal that existing technology and equipment can make each system props the body function, this is the successful place of modern medicine, although not without veiled word, but still often be praised by people. Ignore what kind of to patient generation consequence, still continue to maintain their function, can safeguard to those dying life nurse in room and serious illness ward the patient‘s person brings issue of ethics of quite a few.
Accepting the youth that medicine trains, to dead incident and dead process, should as far as possible remain unruffled. When to withdraw life to manage facility, when to stop to anabiosis the problem that waits for such, right even to medic for a lot of seasoned physicians, may pose passion conflict. Although talk the content of a Confucian school of idealist philosophy of the Song and Ming Dynasties to involve each aspects of health and medical practice, but the special case that a few problems of dying patient just result from legal element and course ballyhoo however, this makes the doctor is in awkward condition. Just arrived recently, after the investigation that passes case of death of counterpoise disease ward, just had objective verdict. Pass those who weigh disease ward to nurse, quality of the life after leaving hospital very tall patient, there is no lack of really its person, but current surviving rate still is like person meaning very much. This often asks doctor and patient and its family member make the decision of life and death of difficult of dimension of advance and retreat, this asks to make the policy that decides about those life and death again, and of this kind of policy make must mix with careful clinical research again live to be not being had really the analysis that the patient of the hope keeps life place to require cost is a foundation. But had not made such policy up to now. In this on one hand, good doctor is having special effect in letting a patient get used to the process of life evening circumstance, what he can understand a disease in the patient is inevitable with final result when, become their good teacher and helpful friend. Internist returns what should help a patient to kiss friend to love, prepare somewhat in mentally to the patient‘s death.
To each patients, should particular case is particular treat, the property that wants the desire that has said the patient before, terminal disease, heal from time to tome the possibility that high quality lives, and the desire of family and mutual influence are written down in the heart, although return very difficult balance,these elements are opposite the action of dying patient, but objective evaluation and the arrowy annals consideration to the patient can make the doctor makes optimal choice.
Brief summary
Internist can be regarded to be course medicine theory and the person that carry out training, but more comprehensive to its description thinks: Internist not only should have arrive from molecular level integral organ system is physiological the knowledge of biology science of the category, the demand of the life that still answers a person and patient has special knowledge, to modern society, life, and the understanding with the social structure due also and overall effect to the person. Although Ben Zhangjiang moved the correlation of patient and doctor, but we must realise biology medicine science provided infrastructure for medicine. So, if want to become good doctor, want to master medical science above all, master the optimal means that when treating a disease, can provide, additional, the society that still wants a doctor and ethical responsibility and union of condition of current medical treatment rise consideration. If the doctor has the technology with broad and profound masterly knowledge only, and make patient support absolutely won‘t become good doctor like crutch only. Good doctor -- the doctor that also is patient place need -- must mix masterly medical skill sympathize with sense of responsibility of heart, society be in harmony has the job for an organic whole.
Bibliographical reference:
Merkel WT, margolis RB, smith RC:TEaching Humanistic Andpsychosocial Aspects Of Care:CUrrent Practices And Attitudes. J GenIntern Med 5:34, 1990.
Scherrl, farber SJ, hildreth EA, et Al. American Collegeof Physicians Ethics Manual. Part I: History The Patient Otherphysicians. Ann Intern Med 111:145, 1989.
ZSmedira NG, evans, BH, grais LS: Withholding Andwithdrawal Of Life Support The Critically Ill. N Engl J Med322:309, 1990.
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