The Island

Peter A. Selwyn

doi:10.1370/afm.763

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In Appreciation of "The Island"
Tony Stern

Published on: 30 September 2008
Comment on "The Island"
William B. Shore

Published on: 18 February 2008
Musing on The Island
Carolyn C. Lopez

Published on: 15 January 2008

Published on: (30 September 2008)
Page navigation anchor for In Appreciation of "The Island"
In Appreciation of "The Island"
Tony Stern, Hastings-on Hudson, NY, USA
In only two pages, this author goes to the heart of what the medical profession needs to retrieve for the sake of our patients. He shows us where we need to keep looking for our own sake as well. In the process, he reveals his own humanity. This palpable sense of his own humanity is wonderfully deepened by the slight tinge of a mystical sensibility ("sometimes everything aligns").
How easy it is to use diagn...
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In only two pages, this author goes to the heart of what the medical profession needs to retrieve for the sake of our patients. He shows us where we need to keep looking for our own sake as well. In the process, he reveals his own humanity. This palpable sense of his own humanity is wonderfully deepened by the slight tinge of a mystical sensibility ("sometimes everything aligns").
How easy it is to use diagnostic thinking to distance ourselves. How easy it is to get lost in the prison of our own judgments. How easy it is to disconnect from the caring curiosity that not only helps to make us human, but also builds rapport with our patients and provides the impetus for a real exploration of the history of present illness, the core of our patient assessments. How hard it is to keep this caring curiosity truly alive in today's clinical environment.
In his own simple way, Dr. Selwyn has reminded us to open ourselves to the rich meaning of our patients' stories, even briefly.
Competing interests: None declared
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Competing Interests: None declared.
Published on: (18 February 2008)
Page navigation anchor for Comment on "The Island"
Comment on "The Island"
William B. Shore, San Francisco, CA
The author describes a situation that we have all encountered and been guilty of: We observe an interaction and quickly jump to conclusions and judgments about the people and situation involved. These events are really only small snapshots in time and, as in this instance, we often do not have the whole story or context about the lives of the people in the interactions. Similarly, this quick leap to judgment happens fre...
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The author describes a situation that we have all encountered and been guilty of: We observe an interaction and quickly jump to conclusions and judgments about the people and situation involved. These events are really only small snapshots in time and, as in this instance, we often do not have the whole story or context about the lives of the people in the interactions. Similarly, this quick leap to judgment happens frequently in our clinical interactions with patients. When we are able to take time to gather more information from patients, we often discover a different picture of the patient and their situation. In our current context of very busy clinics, often with patients from diverse backgrounds, it is particularly important, and can be very challenging, to find a way to get the patient’s story. We must continue to remind ourselves to be open to surprises and to let go of our “first pass” conclusions and judgments that come so easily.
Thank you for sharing this reflection. I will share it with our medical students.
Competing interests: None declared
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Competing Interests: None declared.
Published on: (15 January 2008)
Page navigation anchor for Musing on The Island
Musing on The Island
Carolyn C. Lopez, Chicago, IL, USA
This article prompted so many thoughts for me. First is recognizing that we have, as physicians, a unique and intimate entry into the lives of our patients. Second, though, is how seldom we take the time to reflect on this privilege. I think we sometimes miss the open doors, the opportunities, because we’re hurrying from one patient to the next and then we’re hurrying home to our own families and lives and the drama th...
Show More

This article prompted so many thoughts for me. First is recognizing that we have, as physicians, a unique and intimate entry into the lives of our patients. Second, though, is how seldom we take the time to reflect on this privilege. I think we sometimes miss the open doors, the opportunities, because we’re hurrying from one patient to the next and then we’re hurrying home to our own families and lives and the drama that resides there. Such missed opportunities deprive our patients of our potential insights. We also deprive ourselves, however, of the opportunity to learn more, not just about our patients but about ourselves and life. If we just took 5 minutes in the middle of the day to reflect on our experiences we’d be better and happier doctors. That, however, is more easily said than done, at least it seems so in the current environment. I certainly appreciate the opportunity prompted by the article and thank Dr. Selwyn for sharing his own reflections on this.
Competing interests: None declared
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Competing Interests: None declared.