Pauline W. Chen: A Surgeon's Reflections

The Surgeon and the Torture Memos

Earlier this week, a friend asked me how aspiring surgeons learn to cut. She couldn’t imagine ever putting a knife to someone else’s flesh.

“Habituation,” I told her. “You get used to it.”

I’ve spent a lot of time since that discussion thinking about my response. Like others in this country, I read about the recently declassified contents of four memos that describe brutal interrogation techniques condoned by the Bush Administration and carried out by the Central Intelligence Agency. But as horrified as I was by the content in these 100-plus pages, what continues to haunt me are the descriptions of the individuals responsible.

Many of them seem like ordinary professionals. Some appear to be not all that different from, well, me.

Can anyone become habituated to the horrific?

I explore this question in this week's "Doctor and Patient" column, and I’d  love to read your comments, either below or on Tara Parker-Pope’s “Well” blog.

From Medical School to Middle Age

Tonight and next Tuesday, PBS (Nova) airs the fifth and final installment of "Doctors' Diaries," the 22-year chronicle of the lives of seven Harvard Medical School students. It's a moving documentary, tinged with the nostalgia and sadness that comes with nearly perfect 20/20 hindsight.

But it is also hopeful. Each of the seven, while transcending a range of personal challenges, ultimately becomes the kind of physician any one of us would like to have. And, even more poignantly, they become the kind of caring doctors they had always hoped to be.

You can find my review of "Doctors' Diaries" at http://www.nytimes.com/2000/04/07/health/07chen.html

Do You Know What Your Doctor Is Talking About?

Lately I have noticed that at the end of every patient visit, the same question runs through my mind. Have I used words, analogies and explanations that are meaningful for this particular person? I ask myself because it’s hard to be certain that what I am saying is helping, rather than preventing, a patient from understanding his or her illness or my therapeutic plan.

Inevitably, though, I also find myself thinking of similar patients. Their memories – mental movies, really – run through my mind. I see them nodding, seemingly comprehending, then recall how weeks, months or even years later it becomes startlingly clear that they never did.

In this week's "Doctor and Patient" column, I write about one such past patient and discuss what researchers now call "health literacy" -- the ability to obtain, understand and act upon health care information. Almost half of all Americans, regardless of educational or socioeconomic background, have limited health literacy; and the cost can be tremendous, both economically and personally.

Has health care literacy affected your health or the health of those you love? I would love to read your comments below or on Tara Parker-Pope's "Well" blog.