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Robert A. Fink, MD, FACS

My practice is that of general neurosurgery. I have taken care of people with spine disease (neck as well as back), have had the usual number of brain tumor cases; and, in the past, have had a fairly strong emphasis on trauma cases, both acute and more chronic. I have not restricted my referral base, accepting all forms of insurance which will accept me as a provider, and I am a fully-participating physician in the Federal Medicare Program. I will also accept Medicaid/Medi-Cal patients if they are referred by another physician. I have engaged in this practice for almost 50 years, having begun my practice in Northern California in 1969.

My practice is centered in the East Bay portion of the San Francisco Bay Area, and my primary hospital, where I served on Active Staff is Doctors Medical Center, San Pablo, California, a District Hospital, partially supported by public funds, and the home of a Regional Cancer Center for the East Bay. For the past 43 years, I have served as Active Staff at Herrick Memorial Hospital and Alta Bates Medical Center in Berkeley, California, and recently became Affiliated Staff (Emeritus) at Alta Bates. I also served as Chief of Surgery and Medical Director of the Neurological Intensive Care Unit at Herrick from 1980 to 1988.

After many years of traditional office-based clinical patient care, including an active schedule of operative neurosurgery, I recently began to concentrate on a consultative practice, in which I offer recommendations in complex neurosurgical cases, including forensic evaluations, peer review activities, participation in Internet-based organizations in the specialty; and I remain engaged in the teaching of medical students at the University of California School of Medicine in San Francisco, where I hold an appointment as Clinical Professor of Neurological Surgery.

In the course of our consulting practice, I have performed Independent Medical Evaluations; and in the forensic area, I have served as consultant to both Plaintiff's and Defense Bars, roughly in equal numbers; as well as participating in a number of criminal cases as a medical expert.

I have also participated in a number of national and Internet-related discussion groups dealing with the current radical changes in health care delivery, and an article, "The Decapitation of Health Care" has been published on the Internet; this dealing with the potential deterioration of American medicine under economic pressures from Government and private industry. Please feel free to read this article, and feedback is appreciated.

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The Emotional Side of Medicine

sailing on the san francisco bay

The practice of neurological surgery, a "high-tech" and sophisticated branch of medicine, deals with issues that produce, often in a sudden and cataclysmic fashion, deep impact upon patients and families. Thus, the victim of a brain tumor, a major physical trauma, severe and chronic intractable pain, a sudden loss of livelihood, and major medical expenses, is suddenly faced with an overwhelming assault on his or her well-being and interrelationships with family, job, and community.

Traditional mental health disciplines (psychiatry, psychology, rehabilitative counseling) often do not supply the resources which patients need as they are recovering from their medical condition. Such disciplines are often oriented towards "fixing the problem", developing accommodations between patient and employer, managing legal controversies (common in cases of Workers Compensation injuries); and these disciplines, while valuable in themselves, often do not prepare a patient and his/her family for the major adjustments which must occur after neurological injury and/or illness. Such adjustment requires "re-education"; this for both patient and family, and often, what is needed is much more than traditional "therapy" (psychotherapy and drugs), but rather a "return to school", an Emotional School where the patient can learn and develop the skills necessary to return to a happy and productive life after the medical issues have stabilized.

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Emotional Literacy

In the past several years, I have had the good fortune of becoming aware of a new concept in the educational and mental health disciplines. This concept, called Emotional Literacy has been described and adapted by a colleague, Ilene L. Dillon, M.S.W., a Family Therapist in the San Francisco Bay Area, where I practice; and I have been working with Ilene in situations where patients require more than just "high-tech" medical and surgical therapy. In particular, Ilene and I have written chapters in a medical text dealing with end-of-life issues and family support in Critical Care venues. In October, 1998, Ilene and I were married, and we share office space together.

Just as historical writings speak of the "Seven Deadly Sins", there are, in the human psychology, the "Seven Lively Emotions". These are:

    Mountain Mists
  • Anger
  • Fear
  • Grief
  • Guilt
  • Hurt
  • Jealousy
  • Loneliness

Each of these quite normal emotions can serve either to assist a recovering patient to adjust to new demands of life; or, as often occurs, the uncontrolled and misunderstood reactions to these powerful feelings can multiply the pain and suffering of one who is already dealing with the effects of major illness. Ilene is the author of a series of manuals on these seven emotions, and has lectured extensively on these and other related topics.

These publications, low in cost, are available for purchase via Ilene's Web Page, or by sending e-mail directly to ilene@emotionalpro.com.

Ilene is a Licensed Clinical Social Worker and Marriage, Family, and Child Counselor, with a private practice in Kentfield, California; just north of the Golden Gate Bridge in the San Francisco Bay Area, and she also has limited office hours in our Berkeley Office near the campus of the University of California. Write to her.

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