It was clear from the start of Stephen Hoffman’s “Under The Ether Dome” that the writer had a great head on his shoulders – a maturity and ability to see into the heart of matters. This is evident from the start as he says “Our subject after all was people”- which showed a solid understanding of the fact that medicine is about people and their individual all-round situations and not just the science of their disease.
He appreciates the role played by those physicians that went before him and pays due respect – he refers to Newton’s belief that he himself would only find success in life by “standing on the shoulders of the giants that preceded him”.
He appreciates the footsteps he is following in and wonders if he will “prove equal to the task” before him.
He seems a very holistic thinker, both scientifically and non-scientifically, he questions whether medicine’s “reductionist attempts” really uncover the true essence of human physiology and anatomy which seem to “politely rebuff” the efforts of those who try to uncover “her infinite wisdom”.
He sees the diagnosis and treatment of disease as but a sub-section of the subject of medicine, which he views to be more anthropology than mere physiology and pathology; “Our education provided us with a broad mandate to learn what we could about people, and to that end, almost everything qualified as important.”
The enthusiasm and intrigue expressed by the writer in absolutely every little thing he learned in medical school, however, soon became exhausting, not to mention unbelievable. Instances of him and his classmates “edging forwards in their seats” in lecture halls, coupled with constant intrigue in every and any detail passed onto him by his professors were far too frequent and, in the opinion of a current stressed, knowledge saturated medical student, completely unbelievable.
The writer could again be seen letting his imagination run away with himself when he talks of his love of Medical Literature and how he would incorporate the fiction found in his beloved stories into his everyday rotations. His tendancy to look through “the lens of fiction” at real cases in order to gain a fresh, new perspective was, although a nice idea, somewhat OTT. Fiction is generally, by nature, something special and extraordinary and to think that it would be used in such a hands-on way with real patients does not sit well with this future health professional/occasional patient.
Hoffman displays great integrity when he hesitates to go through with his first suturing attempt on an actual patient as he doubts his fledgling skills. He puts the welfare of the patient before his own personal development as a professional and this is an admirable quality. He incites a certain poignancy when he refers to the gift of potential self-sacrifice given by patients in teaching hospitals when interns are let loose on the wards and he prays “One accepts it and hopes that it will have a return for others one day”.
Hoffman’s enthusiasm in this extract certainly rubbed off on me and reminded me of the importance of starting as one means to go on in medical school as we see that the qualities of integrity and respect he encompassed from the start of his studies stayed with him all the way to his clinical beginnings.