Mit - Index

Mit - SINFO 2008 04 - 8 - Index

would be very wrong if we gave him sedatives because it turned out
that the patient was agitated due to pain and/or a full bladder.
How ImPortaNt arE your
SPEcIalIZatIoNS IN NEuroloGy aND
INtErNal mEDIcINE to you aND to your
EvEryDay worK wItH PatIENtS? Do tHE
tyPES of KNowlEDGE comPlEmENt,
buIlD uPoN EacH otHEr?
In terms of a stroke, the diagnosis is provided from the field of
neurology, while treatment is provided from the field of internal
medicine. Therefore, both areas of knowledge complement each
other well. A stroke is just one of the clinical forms of atheroscleroses,
which today belong in the domain of internal medicine − but it
touches all of us, whether it be our patients, or all of us (smiles).
“The patient is, of course, the most important; we all say
this, but at the same time, we are asked if we work according
to guidelines and whether everything is financially all
right. There is a lot of money, and at the same, there is
very little money, because things are extremely expensive
and therefore not accessible to everyone. We feel this
most in the area of neurology, which has changed from an
inexpensive science, to a, therapeutically, very expensive
branch of medicine. An old anecdote: ‘Only lawyers with
their lawsuits and the insurance company with its money
change a doctor’s mind!’ Education and everything else
has a smaller effect.”
“I try to be a good doctor, but I know that I have made
many mistakes and I think that I still will. But these were
unconscious. It is very easy to write of all that a doctor’s
mistake could be, but in practice, things are not black and
white.”
aftEr a buSy carEEr, (cIIm, maStEr’S
DEGrEE, DoctoratE, aND wHIlE
coNtINuING your StuDIES IN tHE
uNItED StatES aND comPlEtING your
GraDuatE StuDIES IN PNEumoloGy),
you worK at tHE clINIc of NEuroloGy.
wHat IS your fIElD of worK?
Neurological patients, but this area is so horribly divided: there are
older patients, who I see in the hospital every day, and who are with us
because of strokes, and there are patients who are immobile because
of Parkinson’s disease or multiple sclerosis; there are many patients
with dementia; and there are patients I meet in the clinic every day
because of dizziness, because of a previous loss of consciousness −
these are young patients, and of course, also older patients, who come
because of memory disturbances. I work with different populations of
people.
IN our Day aND aGE, wHEN waItING
tImES arE HorrIblE, arE PatIENtS wEll
carED for? wHat arE tHE coNDItIoNS
IN HEaltH carE IN your fIElD of worK?
31
P E o P L E
We are at a crossroads: on the one hand, there are possibilities that
we are able to provide and a huge leap forward has been made in
the field of neurology. Fifteen years ago, we cured diseases with
vitamins and offered diagnoses with the help of a hammer, and
rarely with the assistance of computer tomography, whereas today,
the possibilities are enormous. New biological medicine in the area
of multiple sclerosis and other nervous system disorders has proven
very successful, and in the area of strokes, internal-vascular splints
have also undoubtedly brought us an incredible step forward.
But this treatment is frighteningly expensive, and for this reason,
we have fewer possibilities and we are very limited in the area of
financial resources, and even more so in terms of personnel politics,
which is catastrophic in the medical profession. Perhaps this is true
in neurology even more so than in other areas, as in Slovenia, there
are many white and grey areas: there are few neurologists to cover
these − or there aren’t even any at all.
IS tHIS Not a lIttlE StraNGE, GIvEN
tHat wE KNow tHat tHE SlovENIaN
PoPulatIoN IS GEttING olDEr aND tHat
ItS NEEDS wIll alwayS bE GrEatEr?
Yes, yes, (temperamentally), these are sins from the past that all of
us will be paying for − as patients. In ten, fifteen years, there will
be a large increase in the elderly and in age-related degenerative
diseases − dementia, Parkinson’s disease. Actually, the number of
strokes, due to preventative measures, is somehow staying in the
same range; it is not growing. Due to their course of development,
the worsening from year to year, degenerative diseases are more
difficult than strokes. But this is my personal perspective. I am glad
that some are already aware of threatened groups, even though
our eyes are all too often still closed. It will be necessary to take
steps in this direction, but these should have already been taken
yesterday − not today or even tomorrow.
IS It bEcauSE of tHIS − aS I uNDErStaND
− tHat you arE coNSIDErING actIvE
PartIcIPatIoN IN PolItIcS?
That’s correct. Because those who decide, and those are politicians,
do not well understand the problems of patients, the elderly - that
are a large proportion of a marginalized population that is always
increasing: if we also add to these the relatives who are forced to
care for elderly patients, for whom there is not enough room in
nursing homes, the number becomes huge.
but DoES It maKE SENSE to traDE IN
So maNy yEarS of StuDy, a PErmaNENt
collEctIoN of KNowlEDGE, worK
wItH PatIENtS, for PolItIcal worK?
woulD you bE ablE to Do wItHout
tHE PErSoNal Doctor-PatIENt
rElatIoNSHIP tHat you HavE So
DEvotEDly coNNEctED wItH?
That is a very good and a very personal question. I feel a need for this
and I feel obligated to speak of the elderly. Of course, idealistically, I
imagine that I would still be able to continue working with patients,
at least in a clinic for people without health insurance. In our field, you
must love people!
april 08 sinfo