David Healy: The Shipwreck of the Singular

Samuel Gershon’s reply to Hector Warnes’ comment on his comment on David Healy’s essay

 

            I thank Hector Warnes for his supportive remarks on my comments. Yet, I would like to add that the current bulldozer of programmed scheduled patient visits does not permit the call for adequate history taking.

            I recently was drawn into a hot diagnostic debate about a patient passing out pretty often. He was about 65 and since he was exercising energetically, he was advised to drink more fluid, which he did. However, since the  juice product he drank was loaded with sugar the drinking of more fluid made him more hypovolemic. So, instead of helping him, it made him pass out more often.

 

April 11, 2019