Yesterday, we went to Freud's old home. It was cool to visit and to hear about his life, but one of the real problems with the musuem is that it is almost completely empty. You see, the Freud's were fortunate enough to plan their emigration to London in 1938 before it was no longer possible to flee from the Holocaust. They took most of their things with them, and their apartment became a Jewish ghetto. What was there was very impressive, especially since the "talking cure" is making a little comeback, from what we were told.
My favorite idea that Freud had was the supreme influence parents have on their children based on what they tell them, and not so much based on their actions. I feel that my personal experience confirms that. For some reason it seems that what parents say has a much greater impact on me than what parents do. It makes me want to be very aware of what I say around my children years from now.
Today was a trip to the medical history museum that is attached to the medical university in Vienna. There were a lot of very impressive wax figures that are extremely well preserved considering their age (many around 250 years old, still with real hair!). There was also a large painting of a surgery with early anesthetics signed by none other than John Quincy Adams. No idea on its authenticity. Some of Vienna's medical history highlights the tension between physicians and surgeons. One of the university's primary goals was to give surgeons a formal education and move away from an apprentice based system.
There's a very good chance that this will be my last time online in Europe. I've had a lot of fun on this trip and I wish I could stay here and see more things like this for a very long time, but I've got some work to do back in the States so I guess this is farewell. I recommend this program to anyone who can get in, no matter what your interests may be. Much of what we've learned on this trip are things every person ought to know. I wish everyone safe travels on their way back to school, and a very good semester in College Station.
Showing posts with label lecture. Show all posts
Showing posts with label lecture. Show all posts
Thursday, January 15, 2009
Wednesday, January 07, 2009
Lectures in Berlin at the Charite and in Hannover
The public hospital in Berlin is the Charite. They have an exhibit on the history of modern medicine. The exhibit had a lot of interesting specimens from individuals who suffered various diseases. One of the great contributors to the development of anatomy, Virchow, was a professor at the Charite. He performed about 800 dissections a year and was among the earliest physicians to champion the dissection of victims of disease as a key to finding the cure.
While we were at the Charite we also heard from the current head of Complimentary Medicine, Dr. Witt. I was mostly interested in her explanation of how insurance companies determine if certain forms of complimentary medicine should be covered. The data that they examine to make this decision is not necessarily designed to remove the placebo effect. They focus on the difference in recovery between patients who receive, for example, acupuncture and patients who don't. If the improved level of recovery justifies the cost of the procedure, the insurance companies are often inclined to support it.
The following day in Hannover was spent talking to Dr. Kriestein, a nephrologist. It was especially interesting hearing him talk about the health care system in Germany. Though many Americans assume that all our problems will disappear as soon as we have universal health insurance, there are still in truth many challenges a health system has to face, some of which are indirectly caused by state sponsored health care. In Germany, for example, doctors had no concerns about the cost of a procedure and would blow away large amounts of money on patients with very trivial problems. German health care has recently gone through some reforms, as this has threatened to slowly consume the entire country's wealth. While patients still rarely see bills in Germany, doctors making a better effort now at being economical in their practice. One reform I found interesting is the addition of a small copayment for drugs in Germany. Dr. Kriestein was a proponent of this, because he found that a very large difference between Americans and Germans was that Americans actually knew about the drugs they were taking, what they did, and would generally take them as instructed. Germans, however, seemed to devalue their medicine, having little knowledge of them, how they worked, and were irregular in taking them. In his opinion, the copayment has alleviated this problem as well as some of the issues health care has had in balancing its check book.
The next day was also in Hannover, and we spent the morning in lecture with Dr. Wasser talking about the Doctor Trials at Nuremburg. He explained that after the chief war criminals were tried, there were 12 additional trials held only by Americans in order to try various other Nazis for war crimes. The doctor trials prosecuted 22 men and one woman, mostly doctors, for crimes against humanity, using as evidence records of their experiments and testimonies from survivors of the experiments. The defense claimed that, yes, you can prove that we did these things, but you can not demonstrate that these are crimes against humanity. Scientists have experimented on animals to the benefit of humanity, and we were doing just the same.
The prosecution then set out to prove that among physicians and scientists there was an understood standard for how humans could and could not be treated in experiments. Interestingly, some of the prosecution's expert witnesses were outspoken proponents of animal experimentation. The case laid down in common law what is now sometimes known as the Nuremburg Code, a guideline for the humane treatment of subjects in an experiment. The most well known of these points is the necessity of informed consent.
While we were at the Charite we also heard from the current head of Complimentary Medicine, Dr. Witt. I was mostly interested in her explanation of how insurance companies determine if certain forms of complimentary medicine should be covered. The data that they examine to make this decision is not necessarily designed to remove the placebo effect. They focus on the difference in recovery between patients who receive, for example, acupuncture and patients who don't. If the improved level of recovery justifies the cost of the procedure, the insurance companies are often inclined to support it.
The following day in Hannover was spent talking to Dr. Kriestein, a nephrologist. It was especially interesting hearing him talk about the health care system in Germany. Though many Americans assume that all our problems will disappear as soon as we have universal health insurance, there are still in truth many challenges a health system has to face, some of which are indirectly caused by state sponsored health care. In Germany, for example, doctors had no concerns about the cost of a procedure and would blow away large amounts of money on patients with very trivial problems. German health care has recently gone through some reforms, as this has threatened to slowly consume the entire country's wealth. While patients still rarely see bills in Germany, doctors making a better effort now at being economical in their practice. One reform I found interesting is the addition of a small copayment for drugs in Germany. Dr. Kriestein was a proponent of this, because he found that a very large difference between Americans and Germans was that Americans actually knew about the drugs they were taking, what they did, and would generally take them as instructed. Germans, however, seemed to devalue their medicine, having little knowledge of them, how they worked, and were irregular in taking them. In his opinion, the copayment has alleviated this problem as well as some of the issues health care has had in balancing its check book.
The next day was also in Hannover, and we spent the morning in lecture with Dr. Wasser talking about the Doctor Trials at Nuremburg. He explained that after the chief war criminals were tried, there were 12 additional trials held only by Americans in order to try various other Nazis for war crimes. The doctor trials prosecuted 22 men and one woman, mostly doctors, for crimes against humanity, using as evidence records of their experiments and testimonies from survivors of the experiments. The defense claimed that, yes, you can prove that we did these things, but you can not demonstrate that these are crimes against humanity. Scientists have experimented on animals to the benefit of humanity, and we were doing just the same.
The prosecution then set out to prove that among physicians and scientists there was an understood standard for how humans could and could not be treated in experiments. Interestingly, some of the prosecution's expert witnesses were outspoken proponents of animal experimentation. The case laid down in common law what is now sometimes known as the Nuremburg Code, a guideline for the humane treatment of subjects in an experiment. The most well known of these points is the necessity of informed consent.
Friday, January 02, 2009
The First Set of Lectures
Our first lecture was in Bonn at the AIB offices. It was given to us by Jürgen Weiland, a homeopathologist who works in Bonn. His focus was on the history of homeopathy, but he also gave us a brief explanation of what homeopathy was.
The whole practice hinges on two ideas. The first is that a substance that produces a set of symptoms in a well person will cure the disease of an ill person that shows the same set of symptoms. The second is that the theraputic effect of a substance can be separated from the toxic effect through a special series of dilutions.
As far as the history goes, a German by the name of Samuel Hahnmann was the founder of homeopathy. He began as a physician, but was shocked by the harm that medicine would often cause his patients. He set out to find a form of medicine that would meet his ideal: one that would cure the patient at minimal discomfort. While I believe that what he settled on was a fantastic demonstration of the placebo effect, I still found this lecture to be very helpful in the sense that it forced me to think about what dreams and ideals ought to be chased after in medicine today.
The second lecture so far was given by Dr. Wasser, and was about the 'racial hygiene' practiced by the Nazis just before and during World War II. The official name of the program was Aktion T4 and was a systematic murdering (under the name of euthanasia) of any kind of invalid, but especially the mentally and physically retarded. Under this program, doctors were no longer expected to consider the health of the individual so much as they were to consider the health of the race. The unworthy had to be cut from the gene pool like a tumor from the body.
It was interesting to learn that many of the individuals involved in this program used their acquired experience for death camps a few years later. Some have even described Aktion T4 as a 'test run' for the Holocaust. Dr. Wasser also spent the first part of the lecture describing some of the intellectuals and their writings that led up to Aktion T4 in Nazi Germany. I was amazed to hear that some of these men were great intellectuals of their day who had very scientific and rational explanations for their views. One of the few hospital directors that refused to permit euthanisation remarked, as best as I can remember, that God would not permit him to do so.
The whole practice hinges on two ideas. The first is that a substance that produces a set of symptoms in a well person will cure the disease of an ill person that shows the same set of symptoms. The second is that the theraputic effect of a substance can be separated from the toxic effect through a special series of dilutions.
As far as the history goes, a German by the name of Samuel Hahnmann was the founder of homeopathy. He began as a physician, but was shocked by the harm that medicine would often cause his patients. He set out to find a form of medicine that would meet his ideal: one that would cure the patient at minimal discomfort. While I believe that what he settled on was a fantastic demonstration of the placebo effect, I still found this lecture to be very helpful in the sense that it forced me to think about what dreams and ideals ought to be chased after in medicine today.
The second lecture so far was given by Dr. Wasser, and was about the 'racial hygiene' practiced by the Nazis just before and during World War II. The official name of the program was Aktion T4 and was a systematic murdering (under the name of euthanasia) of any kind of invalid, but especially the mentally and physically retarded. Under this program, doctors were no longer expected to consider the health of the individual so much as they were to consider the health of the race. The unworthy had to be cut from the gene pool like a tumor from the body.
It was interesting to learn that many of the individuals involved in this program used their acquired experience for death camps a few years later. Some have even described Aktion T4 as a 'test run' for the Holocaust. Dr. Wasser also spent the first part of the lecture describing some of the intellectuals and their writings that led up to Aktion T4 in Nazi Germany. I was amazed to hear that some of these men were great intellectuals of their day who had very scientific and rational explanations for their views. One of the few hospital directors that refused to permit euthanisation remarked, as best as I can remember, that God would not permit him to do so.
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