House of God question (Not really medical)

gonzo914 · Post by **gonzo914** » Sun Sep 03, 2006 10:42 pm

A question for you doctor and nurse types (others may disregard)-- In the book House of God, which I read twenty-plus years ago, there are five non-patient-contact specialties described. I can only think of four -- RAYS, PATH, PSYCH, and DERM. What is the fifth one?

This isn't a contest. I just want to know. I've been trying to remember it for a week now. I'm losing sleep over it. What is the fifth one? Help me. For god's sake, please help me.

Thanks.

gonzo "Get out of my emergency room" 914

Lambchop · Post by **Lambchop** » Mon Sep 04, 2006 12:19 am

There are six no-patient-contact (NPC) specialties: Rays, Gas, Path, Derm, Ophthalmology, and Psychiatry (1).

1. Shem, Samuel. House of God: The Classic Novel of Life and Death in an American Hospital, p. 378-380 or thereabouts, courtesy of one of the finest emergency reference sources in existence . . . Amazon.com.

Cynth · Post by **Cynth** » Mon Sep 04, 2006 8:54 am

Lambchop wrote: There are six no-patient-contact (NPC) specialties: Rays, Gas, Path, Derm, Ophthalmology, and Psychiatry (1).

1. Shem, Samuel. House of God: The Classic Novel of Life and Death in an American Hospital, p. 378-380 or thereabouts, courtesy of one of the finest emergency reference sources in existence . . . Amazon.com.

What does no-patient-contact mean? Mightn't a dermatologist touch a patient as much as a heart specialist? What is Gas? Oh, gastrointestinal? I am so mystified. Is this a good book for a general reader?

gonzo914 · Post by **gonzo914** » Mon Sep 04, 2006 10:29 am

Yaaay!! I knew you could do it. This has been making me crazy since the book came up in conversation at work, because I could only think of four. Wikipedia didn't list them, and google was making me crazy because there are a gazillion churches called House of God. And I had been to the amazon entry because I wanted to see it it was still in print (yaay -- it is), but I didn't find the no patient contact specialties there. Special thanks to Lambc. for enabling me to sleep the sleep of the just again.

Lambchop · Post by **Lambchop** » Mon Sep 04, 2006 11:31 am

Cynth wrote:
Lambchop wrote: There are six no-patient-contact (NPC) specialties: Rays, Gas, Path, Derm, Ophthalmology, and Psychiatry (1).

1. Shem, Samuel. House of God: The Classic Novel of Life and Death in an American Hospital, p. 378-380 or thereabouts, courtesy of one of the finest emergency reference sources in existence . . . Amazon.com.
What does no-patient-contact mean? Mightn't a dermatologist touch a patient as much as a heart specialist? What is Gas? Oh, gastrointestinal? I am so mystified. Is this a good book for a general reader?

Rays = Radiology
Gas = Anesthesia
Path = Pathology

Strictly speaking, these are all specialties in which you don't have to interact with the patient himself significantly. In radiology, you might interact with some patients, in anesthesia you make sure you don't have to interact very much, in pathology they're all dead, and in ophthalmology and dermatology there is fairly little contact.

Gonzo may have had his trouble because ophthalmology and dermatology do require some patient contact. Although, in the book the definition related more to the hideousness of the residency program leading up to it--long hours, miserable years of it, stress--than to the actual patient contact later.

Lambchop · Post by **Lambchop** » Mon Sep 04, 2006 11:32 am

gonzo914 wrote:And I had been to the amazon entry because I wanted to see it it was still in print (yaay -- it is), but I didn't find the no patient contact specialties there.

Well, you had to use the search thing.

djm · Post by **djm** » Mon Sep 04, 2006 9:43 pm

Sorry, LC, but all the ophthalmologists I have dealt with (I have astigmatisms) are eye surgeons, which strikes me as a fairly hands-on occupation (but I could be mistaken).

djm

Cynth · Post by **Cynth** » Mon Sep 04, 2006 10:15 pm

I guess this is strictly physical interaction? It seems like a psychiatrist would have to interact with the patient a lot.

Lambchop · Post by **Lambchop** » Mon Sep 04, 2006 10:19 pm

djm wrote:Sorry, LC, but all the ophthalmologists I have dealt with (I have astigmatisms) are eye surgeons, which strikes me as a fairly hands-on occupation (but I could be mistaken).

djm

Well, yes, they are eye surgeons. That's what's wrong with that specialty being included in the non-patient-care group. That's why Gonzo so abjectly failed to recall it.

However, in the great spectrum, there isn't much laying on of hands in ophthalmology. If you'll notice, they don't touch you very much, and when they do, there is often an instrument between you and them. They don't listen to your chest or poke around where nobody should.

Now that we've cleared that up . . . .

Moderatorer! Oh, Moderatorer! He talked about a medical condition!!!!!

Lambchop · Post by **Lambchop** » Mon Sep 04, 2006 10:20 pm

Cynth wrote:I guess this is strictly physical interaction? It seems like a psychiatrist would have to interact with the patient a lot.

Exactly. Psychiatrists, according to Samuel Shem, never touch their patients. It inflames the transference.

gonzo914 · Post by **gonzo914** » Mon Sep 04, 2006 10:31 pm

And I think there was also an element of how disgusting the patient contact is. Yes, derm docs have to deal with the occasional suppurating fistula, but that's nothing compared to the daily regimen of tube insertions the GI docs have to deal with. Minimal contact, and what contact there is, is clean.

I gotta go order that book. And I just noticed on Amazon there's a sequel.

Flyingcursor · Post by **Flyingcursor** » Tue Sep 05, 2006 8:53 am

As an ex ophthalmology technician I can proclaim that patient contact is minimal even in eye surgery. In the clinic about the only thing you touch with your hands is a person's forehead and eyelids. And occasionally smack the back of their heads to get them to sit up in the slit-lamp.

I also can attest that eyeballs don't bleed very much even if sliced nearly in half.

djm · Post by **djm** » Tue Sep 05, 2006 8:55 am

FlyingC wrote:I also can attest that eyeballs don't bleed very much even if sliced nearly in half.

Cool!

djm