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In response to “Stuck in Despair” (Spring/Summer 2016): In the current system of physician training, the least experienced and least knowledgeable doctors (the interns and junior residents) are burdened with the most work and responsibility. The interns and junior residents need senior residents, fellows and attendings to share more equitably in the workload so that they are able to provide patient care that they can be proud of, rather than feeling bad about their inability to do their perceived best under an antiquated system of training that can no longer be justified.

Gerson Paull

(H.S., pathology, 1983–89) Atlanta, Georgia

We Need More Trainees

What is missing in this important article (“Stuck in Despair,” Spring/Summer 2016) is a possible solution of having trainees work fewer hours and having more trainees. The competition for medical school is intense, with many highly qualified applicants never gaining admission. There is a growing need for primary care physicians. There are high-need areas with no physicians. The barrier to training more physicians is cost. Fewer hours by more trainees could address this problem.

Barbara Howard ’75

Assistant Professor of Pediatrics, Johns Hopkins University School of Medicine

An Exhausting Burden

Kudos to those involved in this effort. This week is the fifth anniversary of my Alpha Omega Alpha young physician son’s death. He spoke of how exhausting residency was and that after being chief resident, how unprepared he felt to enter “real life.” Thank you for efforts to save future young physician lives!

Claire Bearp

(Facebook)

Too Much Paperwork

Certainly the new financial focus and business model of modern medicine, with its time-consuming, extensive, and sometimes irrelevant or even fabricated documentation, can make one cynical about one’s “calling” as a physician, and contributes to a dispirited and frustrated psyche that makes one susceptible to depression and its consequences.

David Zee ’69

Professor of Neurology, Johns Hopkins University School of Medicine

Reversing a Tragic Trend

I am so encouraged that such brilliant minds are coming together and have identified the causes of this tragic trend. I sincerely hope word gets out to those already in the medical profession that there is help, this is a problem that is treatable and that we have a long way to go to reverse the stigmas that hinder treatment. As a health professional, I find myself encouraging anybody who is struggling to get help, and I would love to see this conversation happen more.

Elaine Trovato

(Facebook)

A Better Name for Congestive Heart Failure?

I read with interest your article about new treatments for congestive heart failure (“No Losing Heart,” Spring/Summer 2016). This brought back my reaction when I first heard the term back in the late 1970s. I was a physicist and new to nuclear medicine. To me, “heart failure” had dire connotations. I remembered a story I had read in high school. Someone told the young protagonist that his friend had died (mysteriously, in prison) of heart failure. Only later did he realize that all deaths can ultimately be attributed to heart failure.

I soon learned what CHF meant to physicians and that a person can live with it for many years. My mother-in-law did just that. I thought then and still think that there should be a better name for this condition, one that more accurately describes the actual state of the patient and sounds less fearsome to the uninitiated. “Weak heart” comes to mind. So does “cardiac insufficiency,” but that is too long and, I believe, means something else. I suggest that the Johns Hopkins community come up with an appropriate term and begin to work it into everyday usage.

Ken Douglass

Instructor, Assistant Professor, Division of Nuclear Medicine