Today is March 14th, Medical Day. The day of our physicians who reach out to people in earthquakes, wars and epidemics. The events of recent years and the recent earthquake have shown that this profession is very valuable. Let’s appreciate it… Dr. M. Genco Erdem is one of those physicians. He is an Internal Medicine specialist at ISU Medicalpark Gaziosmanpaşa Hospital. At the same time, he is a Lecturer at Beykent University Faculty of Medicine. Member, Head of the Department of Internal Medicine. We wanted to discuss this March 14th from the perspective of an internal medicine physician and an academic, and we directed our questions accordingly. We hope it will guide many young people who want to study medicine. Happy reading…
If you were to define medicine, how would you define it for yourself? What does it mean to you?
A physician is a person who not only diagnoses and treats diseases, but also maintains health, and whose job is people at every moment of the day. Considering the desire and ability to heal people and the effort spent for this cause; they are priceless concepts. However, sometimes the smile and sometimes the blessing of a patient you heal makes you feel that all the effort is worth it.
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No other creature in the world opens its belly in front of its own kind except human beings.
Have you ever seen another lion lying down with its belly open in front of a lion? Exposing the belly is the moment when a creature feels the weakest. Only human beings open their stomachs in front of a physician. This gesture alone shows the great responsibility that our profession places on us.
The physician deals with human life. ATATÜRK, the great leader, has engraved this issue in history with the words “These doctors give life to human beings. ” with his words engraved in history.
For me, being a physician is an indispensable passion. So much so that if I came to the world a hundred times, a thousand times, I would want to be a physician in all of them. My late teacher Dr. Ratip Kazancıgil used to say, “Medicine is the apprenticeship of God. ” he used to say. Perhaps this is the most beautiful definition of our profession that fascinates me…
Was it a conscious choice for you to study medicine or did you decide during the university preference process?
I have wanted to be a physician for as long as I can remember. As a child, I was often sick. Every time I went to hospitals, I would look enviously at the physicians walking fast in the corridors. Years passed and I stepped into the profession with great excitement.
Which areas are you mostly interested in as an internal medicine physician?
Our branch is a science that examines the systems in the adult human body and their diseases. Circulatory, excretory, digestive and immune system diseases, diseases caused by metabolic events managed by hormones, blood diseases and rheumatic diseases are the main topics we focus on. In addition, diseases of the heart and lungs and diseases of the nervous system are other topics of interest because of their common, if not primary, involvement in metabolism.
What is the place of internal medicine in medical science? What is its importance?
Internal medicine is the foundation of medicine. Apart from dealing with all the problems of adult patients, I am a member of a department that acts as an orchestra conductor in the management of the care of patients with multiple chronic diseases. As my esteemed teacher Prof. Dr. Tufan Tükek often says, “Internal medicine is everything. ”
Why should physicians who want to become specialists choose the field of internal medicine?
My colleagues who want to deal with the patient as a whole rather than focusing on a single organ system, who like problem solving, who want to use most of the information they learned in medical school throughout their professional life can choose internal medicine with peace of mind. An internist can find a cure for 95% of patients who present to the hospital with an internal complaint. Moreover, specialists who want to further specialize in a certain subject can satisfy their hunger for learning by switching to sub-branches such as gastroenterology, nephrology, hematology, rheumatology, intensive care, geriatrics, oncology, endocrinology.
At work, you’ve probably encountered emergencies, a moment of crisis or a critical decision-making process many times. How do you react in such situations? What advice would you give to your young colleagues in this regard?
The ability to deal with emergencies depends on multiple factors. Knowledge is the most important one. A physician who knows can remain calmer than one who does not. Another factor is experience. Experienced physicians who have practiced the art of medicine for a long time may act more calmly because they have encountered emergencies more often. Finally, some people are cooler than those around them in all circumstances, which I think is an innate talent. So my advice to my young colleagues is: Hard work and lots of practice. If you are a medical student, hold on to your textbooks, especially the basic sciences. Go to emergencies and observe physicians, nurses, auxiliary staff and patients. If you are a resident physician, read almost everything about the diseases of the patients you follow. Knowledge and experience, when combined, open every door…
You, young physician candidates, know that you will be practicing the most sacred profession in the world. While practicing this profession, there will be moments when you will have difficulties and think that there is no way out. But never lose hope…
Based on your professional life so far, when you think about your patients, how is the bond between you? Are there parts of the patients that challenge you? Besides, what are the aspects that make you work comfortably?
I am a physician who embraces my patients very much. This can sometimes cause us to have sweet and harsh dialogues. I do not hesitate to warn my patients who blatantly disregard their health, disrupt their diet, and neglect their medications with appropriate language because they do not give the necessary importance to themselves. I am as happy as they are with the health goals they achieve. For example, when a diabetic patient of mine confesses that he eats sweets almost every day from three months to three months, that he does not take his medication and that he applies treatments “for which there is no scientific evidence” on the recommendation of friends and relatives, fire starts to come out of my ears. I do not give in to the tension between me and patients who do not care about their own self and body. I support anyone who wants to restart treatment. We have a cotton-like relationship with my patients who understand that a healthy lifestyle is not a goal but a required behavior, who do not want to use unnecessary medication, and who follow the treatment plan in a disciplined manner when necessary…
You work as a physician and lecturer at the same time. How do you manage to manage these two challenging fields and how do they feed each other?
I have been teaching undergraduate students in the field of health for about 7 years. For the last 4 years, I have been teaching internal medicine to medical students. Being a lecturer, or academician to put it more broadly, keeps a physician’s knowledge fresh and his mind fresh. The experience of being a physician, on the other hand, enriches the lesson you teach with the examples you have experienced. This, in turn, supports the young physician candidates to focus on the lesson, enjoy the lesson and increases the memorability of the lesson.
Although the two jobs are very different from each other, they are not without similarities. For example, both require dedication and proper preparation. It is not easy to lecture to today’s Generation Z and to appear in the position of a teacher to this community that easily navigates the sea of information with the internet at their fingertips. I overcome this with a good preparation and (I think) a nature that loves to explain. Above all, I am honest with my students (as I am with my patients). If I get a question about something I don’t know, I state that I don’t know. A person cannot know everything, but if they know how to access the right information, they will eventually learn what they are curious about. Our responsibility as teachers and physicians is to give the right information to the other person. Those who play the role of a know-it-all with unnecessary ego are doomed to lose their dignity.
By working in the field and taking part in medical education, you can see the field as a whole. When you look at it like this, what are the things that are done well and what are the things that are not working properly?
Although the minimum educational requirements of medical education in Turkey and the world are clear, there are still significant debates on the best model. In my humble opinion, it is important that on the basis of a good basic education, students should be introduced to patients in clinics starting from the third year. In this way, new graduates will not falter as they step into the profession. However, in our country, there are still physicians in almost every branch of medicine who graduate from medical school without seeing the minimum number of patients or, even more painfully, without seeing enough patients. This situation causes physicians to start taking care of patients with inadequate clinical practice. Therefore, it creates a self-confidence problem for a newly graduated physician. It does not seem rational to say “Let him/her start working, he/she will learn in the field anyway. ” does not seem rational to me. The way to correct this mistake is to supervise medical faculties more strictly and rationally; to support students who are found to be deprived of sufficient basic or clinical knowledge for whatever reason; and to help fill these gaps by using the facilities of training and research hospitals if necessary. It should not be forgotten that all students, regardless of state or foundation universities, are in the same boat. Ultimately, the students of all these schools will receive a physician’s diploma and every new graduate physician will be dealing with human beings. This should be our most important priority in medical education.
In which fields do you give lectures as a faculty member? How is your relationship with students?
For a long time, I taught “pathophysiology of diseases” to my students at the faculty of health sciences. As of this year, I handed over that baton to younger academics. At the moment, I only teach internal medicine courses at the faculty of medicine, which is my own branch. My relationship with students is excellent from my point of view.
I learn something new from them every day. We have a good time together. I enjoy both telling and listening. I feel like a mother and father smiling and feeling proud when they see every new movement of their baby, when I see the reactions of my students, especially when they start clinical sciences….
Do you think our young people can evaluate medical education correctly when choosing it? How can they understand that it is a suitable profession for them?
I don’t know the answer to this question because even I, at the age of 44, have difficulties in making decisions on issues that I do not know, and I am not sure whether young people aged 16-18 will be able to make an accurate choice of profession that will affect their whole lives. I see that it is the sincere wish of many parents around me that their children become physicians, but unfortunately, parents who question whether their children want this or whether they are capable of doing this profession are still in the minority.
Medicine is a profession that can be practiced by young people who love helping people, reading, researching and developing; who do not mind entering people’s private spaces; who can continue to work with above-average motivation even if they do not receive material and especially moral rewards for their work; who have the patience to fight for the improvement of basic human rights and who have been abused by the administrators by saying “let them go if they go” and who have the patience to continue their profession despite this; who are able to think analytically….
Not having enough time for your own family or hobbies is one of the issues that physicians suffer from. Are you able to overcome such problems in this busy schedule?
As a physician who has been lecturing at two different universities for a long time, heading the department of internal medicine at a medical faculty, and simultaneously seeing patients six days a week, I don’t think I can devote as much time to my family as I would like. From time to time, I try to be with my family more by reducing the time I need to rest for the maintenance of my health. Although they have justified complaints from time to time, they are aware that this is how the process is progressing for now due to the nature of this profession, so we are progressing stably.
What are the challenges of working in Istanbul as a physician? Besides, what is the vision that working in a cosmopolitan city brings to you?
Every physician working in a big city like Istanbul is overwhelmed by the density. Since medicine requires being attentive for as long as possible, the workload, which is far more than it should be, causes me, my colleagues and all healthcare professionals to wear out. Especially the long distance between home and work and heavy traffic are other reasons for this wear and tear. One of the difficulties of working in Istanbul is that it is the most populous and visible city in Turkey, which makes the existing cost of living even more pronounced.
The biggest advantage of working in such a metropolis is that many technological opportunities are available here almost for the first time. In addition to medical technologies, congresses and seminars are also frequent in this city, which is a center of attraction. Not to mention the presence of soul-nourishing art activities. In addition, “the presence of the sea” is the most important plus. Although it is not visible from every street, it has always been good for me to know that the sea is accessible in this city where I spent my childhood.
Unfortunately, there are incidents of violence in health. What do you think about this issue?
Only underdeveloped, wild and barbaric organisms attack the owner of the hand that heals them. They injure or kill. In the world and especially in the Middle East, there is a growing anger towards the so-called educated (even polarized) professionals. In my opinion, the sole reason for this anger is the inequality in income distribution. For years, the rulers have tried to convince the public that the reason for the inequality in income distribution is not poorly managed economies, but the over-earning of the schooled class, and unfortunately they have succeeded. The anger against everyone and everything that is different from oneself caused by this process has mostly affected health workers who have devoted years of their lives to healing people and who harbor a lot of compassion and kindness in them.
The patient’s relatives who attack a physician because their patient has died should not forget that no physician wants to lose a patient. He is as saddened by this loss as the patient’s relatives…
I have had colleagues who had a knife at their throat because they did not give a fake report. I guess no other professional group is asked to forge documents as easily as physicians are.
[su_quote]Violence cannot be justified and rationalized under any circumstances.[/su_quote]
When we try to explain these incidents of violence abroad, none of them can believe what they hear. The solution to this process is education and deterrent punishments that are applied immediately without delay. Many countries take away the social security rights of those who attempt such violence, let alone engage in it. This is what needs to be done.
As a physician who has worked in this profession for many years, what are your wishes and expectations from the society on March 14th Medical Day?
No one should doubt that we physicians will always take matters into our own hands and strive to perform our duties perfectly, regardless of the conditions we find ourselves in. In 1915, all of the first class medical students who went to the Çanakkale War were martyred at Anafartalar and Conkbayırı, and in 1921, Mektebi Tıbbiye-i Şahane could not graduate.
I look at the past 20 years: There were moments when I was over the moon with happiness. There were also moments when I fell asleep in my hospital uniform out of exhaustion and cried until my eyes were dry from sadness. But at every moment I was grateful to be a member of this sacred profession.
My only expectation from society is that they remember that we are all members of this country, mountains, stones, forests, trees, rivers and fish. We are all Turkey together. We should no longer have to talk about violence; “How can better equipped physicians and health workers be trained? How can the health of our country be raised higher, to the level of contemporary civilizations? ” We should seek answers to these questions.
I congratulate the medical holiday of my esteemed professors, brothers and sisters who have practiced medicine in the past, my dear colleagues who are currently practicing and my esteemed students who will do so in the future. I wish you many more years to practice this profession, which will live as long as humanity exists, with pride and peace of mind…
original text of the interview: https://www.tr.fikrikadim.com/2023/03/13/14428/
