On the second day of cardiology, we followed Dr. Chen (陳桂峰醫師) in the ultrasound room. Dr. Chen is very knowledgeable in his specialty and taught Nicole and I many diagnostic techniques on the ultrasound as well as clinical features of cardiology. One interesting observation we noticed was that in many valvular diseases, although surgery was indicated and highly recommended by the doctor, the patients still remain highly reluctant to operation. Dr. Chen explained that it is a common dilemma faced by cardiologists in Taiwan. In traditional Taiwanese view, surgery is already a very invasive procedure, regardless the real clinical invasiveness of the procedure, let alone cardiac surgery, where the surgery prognosis was often poor in past decades. Although the technology has gotten a lot better at cardiac surgery and the success rate has been very high, for many Taiwanese people, the stigma still present and the parents often remain reluctant to surgery unless patient life is in immediate danger. This is in contract to the amount of compliance Dr. Chen gets in his outpatient clinic. When we observed him in the outpatient clinic on Wednesday, I noticed that his patients seem to have great compliance to both his drug regiment, life style change, and even keeping a detailed blood pressure log. When I asked him about that, he answered that although many Taiwanese people are reluctant when it come to surgery, they are very welling to comply when it comes to drug, especially many cardiac drugs have immediate effects that makes convincing the patients a lot easier than other specialties. In addition, the fact that Dr. Chen has a good reputation and many year of experience in the field makes the patients respect him and will heed his advise a lot better than other doctors.
In the afternoon, we ran into a pacemaker placement in the catheter room. It was very interesting for me because unlike the other GHP members, it was the first operation that I was able to see during this trip. During the procedure, we talked with Dr. Chen again about cardiology and many aspects of being a physician. He said something that meant a lot to me: being a physician means constant learning and self-education; one must always consider the interaction between drugs and maintain the delicate balance between therapeutic effects of the drug and its adverse effect to the patient. Furthermore, adverse effects from drugs or treatment methods are responsibility of the doctor, not the patient. If a patient show signs of adverse effect from the drug, the doctor must be able to catch it whether the patient realized it or not and change the treatment plan accordingly. He also said that if any of his patient in good compliance with his treatment plan ever developed a MI, than he must have done something wrong and have failed his job as a cardiologist. It touched me to see that even after so many years in the field, Dr. Chen still shows such passion and dedication to his work and to his patients. Dr. Chen is truly a great role model for all the physicians to come.
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