[Congressional Record Volume 142, Number 58 (Wednesday, May 1, 1996)]
[Senate]
[Page S4562]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    JEFFERSON COUNTY MEDICAL SOCIETY

 Mr. McCONNELL. Mr. President, twice a year, the Jefferson 
County Medical Society conducts a mini-internship program to inform and 
educate those outside the medical professional about the practice of 
medicine. For 2 days, about 12 to 18 business professionals and 
government officials are matched up with several Louisville physicians 
to watch them perform their jobs. Recently, Melissa Patack, a member of 
my staff, had this unique and worthwhile opportunity. I ask that a 
summary of her experience be printed in the Record.
  The material follows:

  Jefferson County Medical Society Mini-Internship--April 16-17, 1996

       On April 16 and 17, 1996, I participated in the Jefferson 
     County Medical Society's Mini-internship program. During the 
     course of the two days, participants accompanied physicians 
     in their usual activities and had the opportunity to observe 
     first-hand the practice of medicine.
       On Tuesday morning, I met Dr. Kathryn Cashner, an ob-gyn 
     with a speciality in high risk pregnancies, at her office to 
     watch her morning appointments with more than a dozen women. 
     Dr. Cashner is a sole practitioner, with patients from all 
     socio-economic backgrounds. About one-quarter to one-third of 
     her patients receive Medicare benefits. This was a morning of 
     unusual normalcy, Dr. Cashner remarked. Virtually all of the 
     women were experiencing normal pregnancies, although several 
     of the patients were 4 to 6 months into their pregnancies and 
     seeing Dr. Cashner for the first prenatal visit. Dr. Cashner 
     counseled one woman who had a negative test result, but who 
     was immediately sent for a follow-up sonogram which turned 
     out to be normal. When I left Dr. Cashner at Audubon 
     Hospital, she was about to perform surgery on one of her 
     high-risk patients which would enable the patient to carry 
     her baby to full term. Dr. Cashner's practice brings her into 
     close contact with the lives of her patients; on one wall of 
     her office she displays pictures of all the babies she has 
     brought into the world.
       The afternoon brought me to Jewish Hospital to observe Dr. 
     Thomas O'Daniel, a plastic surgeon, performing a face lift. 
     Watching directly over his shoulder, I saw Dr. O'Daniel 
     perform the delicate task of reconstructing a 57 year-old 
     woman's face. The operation was a grueling, pain-staking 
     procedure of more than 6 hours. Dr. O'Daniel concentrates on 
     facial injuries and gets a great deal of satisfaction from 
     the work he does on children. The next morning, he was 
     operating to correct a child's clef palate. Last fall, he 
     traveled to Guatemala, where he and his staff operated on 75 
     children who suffered from clef palates and other facial 
     deformities.
       In the evening, I went to University Hospital where I 
     watched Dr. Robert Couch run the night shift of the emergency 
     room. The evening brought everything from walk-ins seeking 
     routine medical care to the airlift of two victims from a 
     head-on automobile crash, probably caused by a driver who had 
     too much to drink. The residents under Dr. Couch's 
     supervision were poised for action when the helicopter landed 
     and two women with broken bones, head injuries and internal 
     bleeding were wheeled in to Room 9. Within moments, life-
     saving actions were taken to get one patient breathing. X-
     rays were immediately taken and the young doctors made snap 
     decisions on the treatment for these endangered patients. 
     These emergency room doctors don't have on-going 
     relationships with their patients. They treat and move on to 
     the next crisis with enormous dedication.
       After an exhausting and exhilarating day, I returned the 
     next morning at 7:15 a.m. to Jewish Hospital to observe Dr. 
     Laman Gray perform a quadruple coronary bypass on a 67 year-
     old man. One stands in sheer amazement at the sight of the 
     human heart beating in an open chest cavity. When it came 
     time for Dr. Gray to stitch the new bypass vessels to the 
     aorta, the heart was stopped and then brought back to its 
     rhythmic beating when Dr. Gray completed his delicate work. 
     Dr. Gray had another operation scheduled for the afternoon 
     and in-between, he was dealing with 2 other emergencies, 
     including arranging for the airlifting of a heart attack 
     victim from another state to Jewish Hospital for care and 
     treatment.
       Wednesday afternoon, I accompanied Dr. Cindy Zinner on her 
     appointments at the Portland Family Clinic, a federally-
     sponsored community health center. Dr. Zinner specializes in 
     internal medicine and pediatrics, and that afternoon, was 
     working as a pediatrician. The Portland facility fills a 
     unique role by being accessible not only to those covered by 
     health insurance (including Medicaid) but also to the working 
     poor who lack employer-sponsored health insurance, and who do 
     not qualify for Medicaid. In observing Dr. Zinner treat 
     several seemingly routine ear infections and perform a number 
     of well-child examinations, the highly important role for 
     preventive medicine becomes readily apparent. Dr. Zinner 
     becomes a positive force in the lives of these struggling 
     families.
       These doctors, the residents, nurses and other assistants 
     with whom they work are dedicated to the care and treatment 
     of individuals from every part of our society. Each of the 
     doctors has chosen a very different career in medicine, but 
     all are devoted to the good health and life of the people 
     they treat. My experience was a significant educational 
     opportunity and I was privileged to watch these men and women 
     perform their work.

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