Sunday, March 21, 2010

After Reading Chapters 1 and 2:


Respond via the BLOG (for periods 3,5,6) to:

1.) Would you have chosen a hospital similar to Bellevue or a “white-tower” hospital in the suburbs?

2.) Do you think Dr. Nolen should have asked the Attending Physician for more help during his first appendectomy operation? Why? Why not?

33 comments:

  1. 1. I would have chosen a hospital like Bellevue. I think at Bellevue a medical student would acquire the necessary skill much quicker. William Nolen even discusses at great length the lack of practical, yet basic, skills that medical grads have. I think Bellevue is good because it is the fastest and best way, in that it is a very hands-on environment, for these grad students to learn the practical skills. For example, William Nolen remembers how at Bellevue he immeadiately had to learn tasks as simple as how to draw blood: a task that is simple but that most medical students don't have any idea about how to do. Nolen also had to learn skills such as how to stash pipettes and fight for one's own survival in a hospital with few resources. I think Bellevue is a good experience because it represents the reality doctors face when they go into their own practice. Most hospitals are not the "white-castle" kind and therefore it is better to learn how to work in the "Bellevue kind" under the instruction and guidance of a resident rather than work in the "white-castle kind" all of one's training and then suddenly get a first job at a hospital with minimal funds and staffing.

    2. I do think William Nolen should have asked for help in the appendectomy. I think it is important for doctors to learn by experience and this may mean going-it-alone at times. I think that doctors should never go-it-alone when someone's health is seriously at risk. Nolen should have been guided through the surgery by an experienced doctor. His hand should have been guided the whole time just as it was at the very end of the surgery. In such situations the patients should have the right to know that they are going under the knife of an inexperienced surgeon and therefore the surgery should be free at least, or something along those lines. The patient was totally oblivious and very trusting. He ended up having to stay in the hospital weeks after because Nolen messed up the surgery.

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  2. 1.) I think I would have chosen a hospital similar to Bellevue rather than a "white tower" hospital in the suburbs because it "(offers) the ultimate in challenge to anyone in the medical profession" (8). It is the Everest of the medical profession. If you can survive your five years of training there, you can make it anywhere. Also, it seems as though if you are an able surgeon, your skills would be more useful at a hectic hospital like Bellevue (with a greater patient load and need for good doctors) than at a "leisurely" white tower hospital.

    2.) I don't think Dr. Nolen should have asked the Attending Physician for more help during the appendectomy operation because there eventually has to be a moment when a doctor finally takes the reins and performs his first surgery. Dr. Nolen has already watched the senior resident do the surgery countless times, but as he experienced, there is a big difference between watching someone "feel the cecum... and bring it to the wound" and actually doing the same. I think it is good that George shows an incredible amount of self control and patience in letting Dr. Nolen continue with the appendectomy, albeit with a lot of hand holding.

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  3. 1) I would not have chosen a hospital like Bellevue. First of all, I don't like blood or surgery, so I wouldn't be a surgeon. If I had to be, I would choose a clean, high tech hospital to intern at. Aesthetically it would be more fulfilling.

    2) For the sake of the patient, I think Dr. Nolen should have asked for more assistance. Because the surgery was sloppy, the patient suffered from indigestion and other bowel problems for weeks when recovering. If I were the patient, I would want Dr. Nolen to ask for more help.

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  4. 1.) Would you have chosen a hospital similar to Bellevue or a “white-tower” hospital in the suburbs?

    1. I like to think that I would have chosen a hospital like Bellevue for the reasons that Nolen mentioned himself--it presented a challenge to any doctor, especially young, eager doctors like him. It is highly likely that the conditions at Bellevue would have encouraged(forced) an intern to become creative and make do with the immediate supplies. It also forces doctors to really learn how to work efficiently and manage their time wisely. Because Bellevue was a city hospital, Nolen probably had to treat a larger number of patients every day than he would have at a "white castle" hospital. He probably developed more efficient bedside manners, making a balance between being polite and straight to the point. Working at a hospital like Bellevue would give you all these advantages that would serve you in the long-run and better prepare you for all kinds of situations, but I'm honestly not sure that, given the chance, I would sacrifice better environment and prestige over more responsibility and mediocre resources.


    2.) Do you think Dr. Nolen should have asked the Attending Physician for more help during his first appendectomy operation? Why? Why not?

    Yes, Dr. Nolen should have asked the attending physician for more help. Although Nolen felt that he had prepared adequately by going through all the routine textbooks and research, written procedure does not make up for the experience and know-how of a physician that had already performed the surgery before. Although appendectomies are generally considered to be a relatively minor and easy procedure, pride is not worth putting over the patient's well being, especially in this case, where the patient ended up suffering from Nolen's pride.

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  5. 1. Well, I don't think I would have chosen any hospital because I don't want to be a surgeon. But if I was in that situation, I would have chosen a hospital similar to Bellevue. Although working at Bellevue is harder, both physically and emotionally, than working at a nice, wealthy hospital, the knowledge and experience you would gain from working there are invaluable. The entirety of Bellevue - the grimy and inadequate facilities, the impoverished patients and the over-worked doctors - presents a challenge that induced Dr. Nolen to work there and would attract me too. Dr. Nolen learned far more at Bellevue than he could have at any "white-tower" hospital. For example, because of the lack of staff and assistance, he had to quickly learn how to do everything by himself with the upmost efficiency and thoroughness, skills he might not have needed to use in a nicer hospital. Dr. Nolen also learned the valuable skills of communicating with his patients, not an easy task especially with the drug addicts and self-diagnosed homeless men. These "people skills" are important for any surgeon, and Dr. Nolen would have never learned to work patiently with his clients if his patients were all rich and white.

    2. I think Dr. Nolen should have definitely asked for more help during his first surgery. Although sometimes the best way to learn is to just delve in and experience sometime by yourself, with no outside help, in situations with real people whose health and sometimes even lives are at stake, it is foolish to assume that you can do everything by yourself and have too much pride to ask for help. Fortunately Mr. Polansky only suffered indigestion and minor bowel problems due to Dr. Nolen's ineptness, but if the attending physician had to offered last minute help, Mr. Polansky might have been much worse off. Because the whole point of a surgical internship is to put in practice all the theories taught in med school and finally learn how to actually be a doctor, I think it is probably easy to forget that your experiments and practice is happening to real people, and I'm sure Dr. Nolen was eager to prove himself, but because the surgeries can have very serious outcomes it is important to always be careful and make sure an experienced doctor is helping you.

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  6. 1.) Would you have chosen a hospital similar to Bellevue or a “white-tower” hospital in the suburbs?
    I think I would have chosen a hospital similar to Bellevue because I feel that I would learn more than I would at a "white-tower" hospital. I think a hospital like Bellevue is much more intimate and Dr. Nolen would learn more because he is one of the only interns at the hospital so the residents and doctors are much more attentive to them, compared to a "white-tower" hospital. I think this would also help Dr. Nolen with patient care because he would need to visit a lot of patients which would be good because he would need these skills later in his doctoring career.
    2.) Do you think Dr. Nolen should have asked the Attending Physician for more help during his first appendectomy operation? Why? Why not?
    Yes, I think Dr. Nolen should have asked for help, however I can understand why he didn't ask for help. I think he should have asked for help because he put his patient in danger because of his ineptness and lack of surgical experience but I feel that he felt the need to prove himself in that he could accomplish the task presented to him. He also should have asked for help because it shows that he *can* ask for help and he isn't afraid to ask for help when he needs it.

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  7. 1. I think I would have chosen a hospital similar to Bellevue because it would be more challenging and i would learn more, and more quickly. I would be attracted to the challenging atmosphere and competition at Bellevue rather than settling for a less challenging hospital where I probably wouldnt learn as much. I think after the initial brutal years at a hospital like Bellevue, the work would pay off and you would be a much better and more experienced surgeon able to confront a variety of different problems.

    2. I think Dr. Nolen should have asked for more help during his first surgery. He took far too great a risk, and as he said, if Polansky had died he might have quit surgery forever. He didnt have much of an idea of what he was doing and simply got lucky in that everything worked out relatively okay. The experience taught him a lesson and offered a great and terrifying experience for him but the risk in it far outweighed these benefits. He was too eager and unprepared for a surgery by himself and I think he should have slowly brought himself into the whole process of more slowly, starting out with a lot of help and gradually working towards completing it himself.

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  8. 1. I personally would not choose Bellevue. I don’t think I would be able to deal with the dirtiness and messiness and the overall lack of proper procedure. I understand Dr. Nolan’s point that this will make him a better surgeon, and I admire this too; but I think Bellevue would just drive me crazy and I would enjoy a “white tower” hospital in the suburbs more.

    2. I don’t think Dr. Nolan should have asked for more help. Learning happens only when you do things yourself and learn from your mistakes. Of course, if Dr. Nolan was so bad that he would kill the guy otherwise, he should ask for help; but it didn’t seem like too much of a risk, especially with the experienced Attending Physician right at his side. In this case, I think it was good for Dr. Nolan to do most of the procedure by himself.

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  9. 1. I think that it would be good to choose a hospital like Belleview in order to plunge right into the field of surgury, acquire more medical skills, and quickly learn how to perform operations. I think that in the end, however, I would end up choosing a hospital like the "white tower" buildings in the suburbs because they are much cleaner and I don't think I would have the guts to work in a place like Belleview. I think I would end up choosing the "white tower" hospitals because I think I would be guided more, rather than left to figure things out on my own.

    2. I believe that Dr. Nolen should have asked for more help during his first apendectomy operation because he was not sure of what he was doing and he was making a lot of mistakes that could have put the patient's life in danger. Even though he might have ultimately gotten more experience from doing the surgury on his own, for safety reasons I believe that he should have asked for more help.

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  10. 1. I personally would've chosen Bellevue because it would provide plenty of practical experience and would require me to really become flexible with my work environment (because of the minimal supplies). The cases that one would deal with at a hospital such as Bellevue would also be more 'interactive' and gritty than those at another hospital. Basically, the type of experience that would be attained there would be incredible.

    2. For the first appendectomy, I believe that Dr. Nolen, by not requesting more assistance, gained a greater knowledge of the requirements and skills needed for the surgery, and was therefore better able to adjust to the learning situation/surgical methods at Bellevue.

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  11. 1. If I were looking for intern work, I honestly would probably want to work at a "white-tower" hospital first, then as I gained more experience, go to work at a Bellevue-like hospital. I would want to work at a nicer, more well-equipped hospital first so I could work without the stress of insufficient needles as Dr. Nolen had to deal with and other problems because I know that I do not learn as well with that uncessary stress. I would want to learn the basics and become very comfortable with all the procedures before I move to the high-stress, but rewarding, "Everest" environment. I would want to be guided by expert doctors, instead of jumping into the hospital routine without much oversight or help.


    2. If Dr. Nolen had been practicing the appendectomy on a cadaver, then I would agree with a more laid-back mentoring style that would let him explore and learn from his mistakes. However, he was operating on a live human being and his mistakes were costly and could potentially have been life-threatening. It was somewhat horrifying to read about all the mistakes he made, such as cutting through the fascia, not being able to find the appendix, and not properly tying the base. The fact that his inexperience led to complications post-op in the patient is proof that the attending doctor should have stepped in. If I were the patient, I would not have wanted to be the guinea pig for an intern's surgical procedures. I think that George should have taken the lead in this surgery while Nolen helped from the side, but Nolen could independently practice his surgeries in a scenario where his mistakes would not be so destructive.

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  12. 1) I would like to think that I would choose a hospital similar to Bellevue like Dr. Nolen did, but I honestly do not think I would. Although interning at a place like Bellevue would be more beneficial for me, because I would have more hands-on tasks and because there are fewer interns, I do not think that I could handle the run-down environment. Bellevue has awful resources and living conditions, and if I was offered a chance to work at a cleaner more prestigious "white-tower" hospital, I do not think that I could resist.

    2) I think that Dr. Nolen should have asked for a little bit more help during his first appendectomy operation because the patients life was in jeopardy. Yet, I believe that Dr. Nolen should only have asked for very little help only towards the end. I believe that learning through experience is extremely effective. After a little failure in his surgery, Dr. Nolan learned that surgery is not as simple as it looks. So although he had trouble, the learning experience he gained was extremely effective.

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  13. 1. I would probably not have chosen a hospital like Bellevue. Though the idea of working in tough conditions to heal those who have nowhere else to go has a strong moral and idealistic appeal, I think I would find the lack of supplies and bad conditions too frustrating and depressing. At the risk of sounding superficial, I would be much happier in a "white tower" hospital. However, if I was passionate about surgery then a hospital similar to Bellevue might be the better idea. I think those conditions probably produce a mentally tougher and more resourceful doctor, and thus would be particularly useful to an intern. So my ideal plan would be to intern at a place like Bellevue, but do my residency at a nicer hospital.

    2. Yes, Dr. Nolen should have asked for more help with his first appendectomy operation. I think there are many situations in the medical profession where learning from one's mistakes is not an acceptable first strategy since said mistakes could have a terrible effect on the patient. When mistakes are avoidable, someone as inexperienced as Dr. Nolen was at the time should definitely ask for help. Rather than plunging in, he should have asked for confirmation or more detailed directions. Or even better, I think he should have been the assistant to the resident to gain a more detailed observation experience so he would be better prepared for the next situation. As it was, Dr. Nolen put the patient in a much more dangerous situation than was necessary.

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  14. This is Connor Townsend

    1) Honestly, I probably wouldn't go to a place like Bellevue. I get frustrated easily, so the lack of supplies and staff would put me off pretty quickly. That, and I like sleep. I don't think I'd survive with just four to five hours of sleep a night.

    2) I think he should have asked for more help. If he were repairing a car engine, fine, let him practice a bit. If he breaks something important, the engine can be worked on later. But he was "repairing" a human being. If he had screwed up worse, he could've killed that guy.

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  15. 1.)I would have chosen a hospital similar to the Bellevue hospital. After seeing how badly the Bellevue hospital needed help, I would have definitely chosen to work there. It is important to me to have a job where I can make a big difference and this would be the perfect opportunity. It seems like many doctors would prefer to work at a hospital where they would get paid well, which would probably not be at Bellevue since it is so under-resourced. That must mean that the hospital needs more good doctors.

    2.) I think Dr. Nolen should have asked the Attending Physician for more help during his appendectomy operation. It seems like in the hospital environment, there is a lot of pressure to present yourself as a confident doctor. I’m sure that there are lots of doctors who are too intimidated to ask others for help. Dr. Nolen did ask the Attending Physician for help, but he could have asked for more. Although he asked for some assistance, he still felt guilty for not doing his best to care for his patient.

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  16. ① I understand that Dr. Nolen is a very driven person with a strong will to become a very good surgeon, so it makes sense that he would challenge himself by choosing Bellevue over a nicer hospital for his internship, but I personally would not be able to stand this kind of experience. It is really despicable that Nolen and the other doctors and surgeons at Bellevue, who have to deal with life or death situations on a daily basis, have to put up with such a grueling work environment. The fewer hours that these people are able to sleep, the greater the possibly of error. Unlike most professions, a surgical mistake could mean death for the patient. I do not think that I could put such a burden on myself. I am almost positive that I would forgo the opportunity for the challenge that Bellevue offered in exchange for some sanity!

    ② I think that Nolen should definitely have asked the attending physician for more help. He simply was not ready to perform this complicated task, and he did not have the right to put a life at risk, just for some training. Of course, it is a good idea to get lots of practice, but until he becomes very proficient, Nolen should ask for help. Perhaps he could be eased into the art, taking a little bit more responsibility each time until, after a few months he would be able to successfully perform the procedure by himself. This seems to be a major problem that seems to result from training surgeons at a very understaffed and underfunded hospital. It is not really possible for the personnel to get there work done quickly and safely.

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  17. 1)Although Bellevue is a challenge, I would pick a white tower hospital. I think that Nolen is a much more ambitious person than I am, especially to do a great job in those mediocre conditions. And while Bellevue is a very needy hospital and it would have been important to me to lend a hand, I do not think I would make the best surgeon in those conditions.

    2) No I do not think Nolen should have asked for more help. People benefit from learning from their mistakes, which is exactly what Nolen did. When he performs more appendectomies later he'll do a better job. He did a pretty good job...I mean he didn't kill the guy and he finished the procedure. He should ask for help if he is putting the patient's life at serious risk.

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  18. 1) Although it may seem like Bellevue may seem like a better place in some respects, I personally would go somewhere similar to "white-tower" hospital. I feel that I would be able to get a greater overall experience at a hospital with better conditions and all of the correct materials to operate with. I also would not be held responsible for the shortcomings of the hospital itself. Nolen feels that the terrible conditions of Bellevue hospital help him learn more effectively, but he would be doing all of the same things at a nice hospital with better conditions.

    2) Nolen should have asked for help during this operation. As a doctor, he should always put the patient before his own experience, and it is selfish to do otherwise. Even if he needs to present himself as a strong doctor, he has to realize that this is a very serious issue, and he has to care for the patient above his own standing.

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  19. 1) I'd choose to work in a hospital like Bellevue for my first job after medical school. As Nolen explains, there are many unique benefits to working in this type of environment as a new doctor. Bellevue teaches Nolen to make due with fewer resources and to be as efficient and effective as possible. Also, the constant influx of patients with vast range of problems helps Nolen gain experience in many areas rapidly. Working in a well-funded and more organized hospital would be a better fit for a doctor who has been in practice longer.

    2) Nolen definitely should have asked for help during the appendectomy. The highest priority of any doctor should be the health of the patient, and Nolen's choice not to ask for help put the patient's health in jeopardy. The potential learning benefits Nolen could garner from botching this surgery are not only uncertain but also relatively minor. There is no reason Nolen wouldn't learn how to do the surgery just as well by working with another doctor and watching it done properly.

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  20. 1. If I were in Dr. Nolen’s position I would definitely avoid Bellevue in favor of a less… crappy hospital. It is perfectly possible to get excellent surgical training at a so-called “white tower” hospital—perhaps even superior training, since I can focus on learning surgery rather than on logistics and playing hide-and-scan. “Challenging” myself with an ill-equipped, rundown hospital won’t make me a better surgeon—it will make me a better nurse, or maybe a personal assistant. Furthermore, the added risks increase my chances of killing someone, which would probably not look good on my surgical record. Bye-bye medical license.
    2. Dr. Nolen should have asked for help—or Relaxy McDoctorface should have intervened more quickly. Learning his profession of surgery is very important—but Bellevue is not his personal training ground. It is a hospital, and the function of a hospital is to heal the sick, not nearly kill them during low-stress routine surgery. The patient didn’t die, luckily, but was probably not told exactly why he needed so much extra recovery time. His life was on the line; Dr. Nolen’s “winging it” isn’t good enough. As I said in #1, it’s better to take your time, learn your job, and NOT KILL ANYONE.

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  21. (per6)
    1. I would have chosen a white tower hospital. As a new medical student, it could be extremely frustrating, and even quite dangerous to work with inadequate supplies and in an unclean environment when I am not as experienced. Suburban hospitals have superior supplies and technology and apt professionals, all of which are important in learning the fundamentals of becoming a surgeon. It's not as if a white tower hospital would offer less of an education in becoming a surgeon, in fact, it may end up being beneficial because one can see how a clean and efficient hospital is run. If, later in my career, I were to work at a place like Bellevue, I would not only have many more surgical techniques as second nature, but likely be able to help the hospital improve, knowing much more about organization from previous experience in a nicer place. A new student would have to deal with unnecessary dilemmas at Bellevue and might not receive as focused training experience.

    2. He certainly should have asked for assistance. Though it is certainly good for one to learn on one's own, this situation does not apply. Someone's life is at stake, or at the very least their health. Nolen, as a surgeon, should know that the patient's health and safety come before anything else. It would have been far more respectful and professional of him to have asked for help and ensured the surgery was a success. By not asking for help, Nolen seems self-centered and perhaps too prideful in a career that should be selfless and pragmatic. In any work situation, the client (or patient) deserves confidence from professionals, and that is not achieved unless Nolen takes proper measures to ensure the patient's safety.

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  22. 1)I would prefer to work at a place similar to "white tower". this is primarily because the atmosphere at Bellevue comes off as grimy and intimidating. i feel that working in a hospital in the suburbs, like "white tower" would allow me to slowly grow accustomed to the ways of surgery instead of being afraid of working with insufficient needles. I also believe the method of teaching at Bellevue is rather harsh, making for a poor learning environment.
    2)I believe Nolen should have asked for more help during his first operation. This is mainly because he put the patient at risk by attempting to complete the procedure on his own. He most definitely should have requested someone to instruct in him when he realized he had messed up. Also, it is important to have a superior present and helping when the operation is at risk. The other surgeons would not be serving no purpose if they are not instructing the new surgeon how to complete the procedure correctly.

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  23. 1. I think that, as Dr. Nolen said, Bellevue would offer a more unique training experience, but a white tower hospital might make for a better training experience. The conditions at Bellevue were not at all what a surgical intern should be learning in; I think that learning to be a good surgeon starts in a good environment -- namely, one not lacking supplies or staff. It's true that one may get more hours and get to do more procedures at a hospital like Bellevue, but the extra work and the far harsher conditions overshadow those benefits. I think I'd prefer an internship at a white tower hospital.

    2. I think that Dr. Nolen definitely should have asked for help during his first appy. He unnecessarily put the patient's life in danger. The Attending is there specifically to prevent foolish mistakes like that. Besides, an intern is there TO LEARN. Not to try to play the hero and attempt to complete a procedure by himself. That doesn't make for a good doctor. His first concern should have been the condition of the patient, not trying to do the operation by himself. There wouldn't have been any shame in asking for help.

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  24. 1. I think I would have chosen to work at "white-tower" hospital rather than one like Bellevue. While I understand that a place like Bellevue can teach you very important skills such as how to manage your time and how to be efficient, I just don't think that would be a good learning environment for me. Between the lack of supplies and lack of guidance I just wouldn't be comfortable being at Bellevue because I would probably feel like I was putting a patient's safety in jeopardy because of my inexperience. I think a "white tower" hospital would be a better place to build up one's confidence so that one could work at a place like Bellevue without having to worry as much about hurting a patient due to lack of experience.

    2.I absolutely think that Dr. Nolen should have asked for help during the surgery. While it is important to have hands-on experience in order to learn, learning should not come at the expense of a patient's safety. The patient's safety and health should have been Dr. Nolen's primary concern so he certainly should have asked for help if he felt like he would not be able to safely perform the procedure himself.

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  25. 1. I would have chosen to work at Bellevue. If I were to become a doctor, I would do so in order to help out people who are in need. Though a "white-tower" hospital may seem more appealing, I don't think that it would give the self-satisfaction of working with those truly in need. Further, I think Bellevue would give a better training experience. As a doctor, people often have to be on their toes and work efficiently. The constant influx of new patients and small amounts of utensils would allow me to learn about a larger variety of situations and how to make due with what I have.
    2. I think that Dr. Nolen should have asked for more help during the surgery. As a doctor, his priority should always be the well-being of the patient. Though the surgery may have been a valuable lesson for him, it should not come at the cost of his risking a patient's health. Further, asking for help could have taught him a valuable lesson.

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  26. This is Thera from 6th period!

    1. I can understand why Dr. Nolen wished to challenge himself by signing up for the "Mount Everest" of hospitals, I also feel that this choice--as he himself admits--was a bit naive. As a novice doctor, I would prefer to immerse myself in a clean, sanitary, and healthy environment in which I could hone my skills and become more confident with execution of techniques before taking on such a challenging post. The conditions at Bellevue do not seem at all conducive to a healthy lifestyle: the doctors barely sleep and eat, but how can they perform well while running on zero?
    2. Dr. Nolen should not have risked the livelihood of his patient for his own development as a surgeon. The patient's safety should ALWAYS come first for a doctor. It was very irresponsible of him to take such chances with such a precious thing. As Dr. Nolen mentions, the patient had a complicated and painful recovery, which could have been avoided had Dr. Nolen asked for additional help during the surgery.

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  27. Jazmyne- Per.6

    1)I would definitely choose to work at a nicer and cleaner hospital. A place such as Bellevue would immediately scare me away if I were a new physician. I would like to be in a hospital where I could learn in a more peaceful enviroment. I would want to ease my way into working at a place like Bellevue.

    2) I feel that Dr. Nolen should have asked the assisting doctor for more help. I understand that he needs to learn how to perform operations on his own, but Nolen reached a point where he should have received more guidance. It's great to face a challenge and learn from one's mistakes, but in this case the patient's life was in jeopardy.

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  28. 1) If I were deciding where to first work as an intern, I would choose to work at a "white-tower" hospital located more in the suburbs. Working at a hospital like Bellevue would be very challenging, due to the dearth of reliable resources, and though I understand the benefits of learning to work under these kinds of circumstances, I think I would start off slow by learning the fundamentals techniques of medical practice in a cleaner and friendlier environment. (very long sentence, sorry!) However, I think that after getting used to the rhythm of hands-on experience, I would be prepared to undertake the bigger challenge of working at a hospital like Bellevue.

    2. I think that Dr. Nolen should have asked the Attending Physician for more help during his first appendectomy operation. Although learning from mistakes and from first-hand experience is important in training to be any kind of profession, doctors must constantly keep in mind the safety of their patients. By not asking for more help, Dr. Nolen put the patient in an incredible amount of risk. In this case, Dr. Nolen was lucky enough that his sloppy work did not fatally impact the patient.

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  29. 1. I like to think that I would take the plunge and work at Bellevue. I think I'd get a greater satisfaction helping a system that cared for poor people, and I don't care much about prestige. But then again, I'm not sure if I'd be able to take the stress it brings, so on a practical level I can't see myself doing such a crazy job. And since I have no real interest in medicine, I don't think I'd ever be passionate enough for it to be worth doing.

    2. Well saying "should've" feels a bit moot, I think that once his confidence started to go away asking Walters for help would have pulled him through more easily. At several points he acted a bit too impulsively, such as when he pulled the knot so tightly that it broke open. And since he started so nervously, a walk-through might've been best for pulling him through the operation.

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  30. 1. First i think bellevue is the better option in terms of providing the greatest impact. In addition i also believe it would be the best opportunity to get experience. After a few years at bellevue however ithink i would move more into the position of a private practice or more like the "white tower" of the suburbs where i would spend a large sum of years. After i have ended my private practice i think it would be a great idea to end where i began and spend my last few years working in a place providing the greatest impact.

    2.I think that under the conditions of having someones life at stake it is key to swallow pride and ask for aid. Experience can be gained by watching an experienced craftsman. No need to risk someone's health.

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  31. 1. Although it would be tempting to work at a hospital like the "white tower", I think it would be more beneficial and a better learning experience to work at a hospital like the Bellevue. I think I'd feel more satisfaction, and it would definitely be more challenging, so I'd feel more accomplished. Bellevue can train doctors well by showing them the really difficult and challenging aspects of the job, and I think that's really important. Perhaps once I'd get older, I would want to work in a cleaner, less intense place such as the "white tower".

    2. I definitely think Nolen should have asked the assistant for more help. I understand the pride aspect in wanting to do something this big by himself, but when there is a fatality risk, and there's a person's life on the line, one needs to put pride aside, because the patient could've died, and the patient deserved a better surgery. The health and life of a patient is more important than one's pride.

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  32. 1.) Would you have chosen a hospital similar to Bellevue or a “white-tower” hospital in the suburbs?

    The best option would be to choose a hospital similar to Bellevue over a “white tower” hospital because although the environment would be less than ideal for a budding surgeon, the skills that I would learn from my experience there would help me not only in a hospital like Bellevue, but also in a “white-tower hospital.” Working at Bellevue forces a surgeon to work efficiently at jobs and tasks, and makes people use critical thinking and problem solving to work around a problem. I feel like a “white-tower” hospital will make a surgeon learn less as the road is paved for them becuase one never has to worry about the shortage of supplies and lack of resources. In short, I believe that Bellevue incorporates the experience that a “white tower” hospital would have plus an additional experience that requires thinking outside the box. In reality, however, I would pick the “white-tower” hospital because I don't think I’m strong enough to work at Bellevue. I feel like I would break down from all of the problems that I had to solve, and being an intern at a hospital is stressful enough.

    2.) Do you think Dr. Nolen should have asked the Attending Physician for more help during his first appendectomy operation? Why? Why not?

    I believe that Dr. Nolen should have asked for more help during his first appendectomy operation. As a surgeon, Nolen needs to realize that the patient’s life is the upmost priority, not his ego. I feel like Nolen let his ego and his high confidence take the highest priority, which is why he didn't ask for more help. While I know that Dr. Nolen’s behavior is understandable, it isn’t the best behavior when the life of a patient is on the line. Nolen could have avoided the near disaster at the end of the surgery if he asked for help.

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  33. 1. I would have chosen a hospital similar to Bellevue. Though grimy and falling apart, Bellevue provides an opportunity to learn – the bare-bones, no frills way – how to work as a surgeon. I believe in this environment where professionals work as just that – professionals – I would learn how to really do my job well. The challenge that Bellevue offers would be hard to find in a “white-tower” hospital, as they have excesses of staff and equipment. Bellevue’s lack of these essentials forces the staff they have to be diligent and dedicated to working all they can, doing the best work, for anything less and Bellevue wouldn’t be able to survive.
    2. I certainly understand why Dr. Walters let Dr. Nolen continue the operation. In order to learn, one must be able to fix his/her own mistakes. If Dr. Walters had taken over for Dr. Nolen, Dr. Nolen would have lost his confidence completely. Even though the operation did not go smoothly, Dr. Nolen was able to finish it (basically) by himself. However, the patient’s health always comes first. If Dr. Nolen’s operation was really becoming dangerous to the patient, he should have asked for help.

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