From diaphragm to earpiece, a stethoscope dutifully chaperones a patient’s internal orchestra to a clinician’s ears. This facile acoustic communication not only allows a provider to screen for a wide host of cardiovascular, pulmonary and gastrointestinal anomalies, but it also may be a conduit for moral reflection.
Gordian Knot by Elisabeth Preston-Hsu captures the hidden social complexities behind the seemingly simple tool. Preston-Hsu, a Physical Medicine and Rehabilitation physician in clinical practice in Atlanta, reflects on how the entropic twisting of her stethoscope tubing captures the turbulent nature of the American healthcare system. Indeed, the nation’s healthcare system is a multifaceted complex of providers, insurance firms and governmental bodies with patients zigzagging from agent to agent at the center of the web. It is not uncommon for a patient to feel overwhelmed and lost navigating through the complexity. Similarly, many modern reimbursement systems put the best interest of the patient at odds with the financial reimbursement to the provider.
It is clear the healthcare system is cacophonous. The photograph of this seemingly extraneous knot in the tubing of a stethoscope is a call to action for providers to critically evaluate what sounds are important and what sounds are solely noise. The most vital element of the healthcare system is the quality of patient care. In these chaotically unprecedented and convoluted times, healthcare providers must not forget the most important sound is that of a patient’s call for help.
EDITOR’S NOTE: Be sure to read Marc Perlman’s poem, “Cardioneurological Cataclysm,” a slam poetry-style debate between the two organs that is “emblazoned with whimsical insults and self-reverences that are rooted in neurological and cardiological physiology and pathology. Through this medical lens, the greater medical community may better appreciate the advantages and disadvantages of logical versus instinctual action,” Perlman told us.
Marc Perlman is a second-year medical student at Albany Medical College in Albany, New York in the Class of 2023. In 2019, he graduated from Union College as Salutatorian with a Bachelor of Science in economics and biology. He also holds an MBA in Healthcare Management from Clarkson University. Perlman enjoys reading, writing poetry, and exploring local restaurants. In the future, Perlman hopes to intertwine his medical training with his business experiences to improve the management of chronic diseases. His poem “Cardioneurological Cataclysm” appears in the Spring 2021 Intima.