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Five clinical situations, each illustrating a different aspect of contemporary health care, serve as the vehicle for Crichton, then a fourthyear medical student, to analyze the structure and function of the monolithic Massachusetts General Hospital. He includes a cardiac arrest, requiring the resources, speed, skill, and impersonality of the modern emergency room; a fever of unknown origin with its seemingly limitless battery of tests, consultations, and expense; a virtually severed arm meticulously repaired with ultrasophisticated surgical techniques; a space-age history and physical examination performed via closed-circuit TV on a traveler at Logan Airport; and, finally, a "diagnostic problem" (lupoid hepatitis) emphasizing the complex interpersonal relationships between patients and doctors at a teaching hospital. Together they create a vivid and representative image of the ultimate potential of modern medicine.
The author achieves historical perspective by tracing the origin, growth, and development of the MGH as a university teaching hospital and community
Kugelman TP. Five Patients: The Hospital Explained. JAMA. 1970;213(5):878–879. doi:10.1001/jama.1970.03170310156075
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