A Hierarchy of Clinical Observations
1 University of Washington, Seattle
When I was a house officer at Boston Children's Hospital, Herb Needleman was in great demand as a consultant for hospitalized children in emotional crisis. He was eclectic in approach, being trained in both pediatrics and child psychiatry, and down-to-earth in his recommendations. Herb also made a point of involving housestaff in his interviews and deliberations. I was repeatedly impressed by one inevitable occurrence in these interactions. Facile in our presentation of the pertinent medical history, physical findings, and laboratory tests, we would suddenly be at a complete loss for words when of person is she?" This loss of expressive function afflicted almost everyone, from medical student to senior resident to attending physician.
