Hearing from two Dr. Epstein's

Dr. Frank Epstein (seen above in 1979), a former Chief of Medicine here, was beloved and respected. When he died, the Department of Medicine created a lecture series in his honor. The first Grand Rounds speaker yesterday was Jonathan Epstein, Frank's son (seen here with his dad!) Jonathan is Chairman of the Department of Cell and Developmental Biology at the University of Pennsylvania, where he is also Scientific Director of the Penn Cardiovascular Institute.

Dr. Epstein's lecture will appear in article form in the near future, so I don't want to steal his thunder. The main topic was congestive heart failure and the potential for new work in genetics that might be used to treat it. Today, treatment is generally based on interventions that improve the hemodynamics of the body, not treatment that helps the heart itself.

But the heart and soul of Jonathan's talk was about the relationship his father had with his patients and how that pattern of care could set an example for doctors in general. Dr. Epstein was known for taking the time necessary to get to know his patients, their family background, and other personal information that could assist in diagnosis and treatment. He realized that the most sophisticated tests and therapies were but tools in the total treatment of the patient, and that the doctor-patient relationship was all important. When a patient arrived late for an appointment and apologized, Frank said, "Don't worry, I have all the time in the world."

Jonathan's description reminded me of the speech given by Dr. Amy Ship a few months ago, which I again recommend. But then he elaborated on it by quoting a portion of his father's last grand rounds. Here's a similar quote from an article, "The Role of the Physician in the Preservation of Life." Q J Med 2007; 100:585–589.

We physicians belong to an ancient profession, standing apart from all others in its primary concern and respect for human life and its enmity to death. And in the long run, that attitude of the profession may be as important to society as any miracle that modern technical medicine can perform.

The fact is that for all our talk and our science, we do only a little. Life cannot be prolonged indefinitely, and death comes at last. But the little we can do has an importance that transcends the patient, for it carries a message to all our patients and to the world: Human beings are important.