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Demystifying Medicine One Month at a Time

Category: narrative (page 1 of 15)

I Floated for NPR — To Achieve Some Inner Calm.

ObiTrio

When I was young, I avoided reading obituaries out of superstition that I or a family member might fall ill or die.

When I was pursuing a medical education, my fear lessened and I became fascinated by obituaries–especially the 2nd paragraph, in which the cause of death is mentioned (or speculated upon).

As I’ve matured, I now read them because they are a distinct form of writing–succinct, and in telling about the decedent’s life, amazing true stories of our time here on earth.

OBIT | Theatrical Trailer Exclusive from Green Fuse Films on Vimeo.


Three recent NYT obits caught my eye, because each one had an interesting connection to health care. In chronological order of when they died, here they are:

John Sarno was a physical medicine and rehab specialist at NYU for almost 50 years. He was adored by his patients, particularly those for whom he helped achieve relief from back pain. He authored several books on the topic, suggesting that most if not all of it was caused by unresolved anxiety and rage. He coined the term “tension myositis syndrome” as a catch-all for the most common form of back pain–muscular pain that in most cases is episodic or short-lived. The obituary discusses how his ideas were never accepted into the medical mainstream, despite the facts that his books sold millions of copies just by word-of-mouth, and his own skeptical physician colleagues turned to him for help.

Spencer Johnson started his career as a medical doctor, but decided against a career in clinical medicine. As the obituary states, “…while working in a hospital, he grew frustrated at seeing the same patients return with the same ailments, as if they were not trying to better their lives…” He went to work for a medical device company, becoming its director of communication. Learning how to write succinctly for lay audiences led him to his ultimate success–co-authoring the massive bestseller “Who Moved My Cheese,” a parable about pushing ourselves out of our comfort zones. It has since sold nearly 30 million copies worldwide and has been translated into 44 languages.

I love the quote he gave to a newspaper writer: “Most writers write the book they want to write. You’re much wiser if you write the book people want to read.”

Keith Conners was a psychologist most known for his work in the world of defining and diagnosing Attention Deficit Hyperactivity Disorder (A.D.H.D.). In the first half of the 20th century, hyperactive children with difficulty focusing were said to suffer from “hyperkinesis,” or the lovely moniker “minimal brain disorder.” Conners brought rigor to the field, and created the Conners Rating Scale, a 39-item questionnaire that became the gold standard for diagnosing A.D.H.D. Conners went on to become a critic of what has become a big industry, stating that A.D.H.D. is now diagnosed about three times as much as its actual prevalence. [If you are interested further in this topic, you can hear a podcast of my interview with author Alan Schwarz of “A.D.H.D. Nation” here.]

These doctor/writers all lived interesting and varied lives–I was simply struck by the proximity of their deaths and the loveliness of their obituaries.

Triage

The following is a guest post from Dr. Sarah Fraser:

During my surgery rotation as a third year medical student, my resident sends me to the Emergency Department to assess a new consult. She tells me to “make it quick” and I hustle down to meet my patient.

Mr. Jones is a 64-year-old male who rarely goes to the doctor. He has been vomiting for two days and has a fever. His heart rate is up and his blood pressure is low; his belly is swollen up like a beach ball. When I examine his abdomen, he winces in pain with even the lightest touch. The x-ray shows a bowel obstruction and free air in the belly, a sign of intestinal perforation. I know he needs surgery.

Stat.

I text my resident who tells me I have five minutes to get the paperwork in order before transporting him to the operating room. As I am about to start writing my note, a frail, elderly woman emerges from a different room with a troubled expression on her face.

“I need help. My husband’s IV is beeping and we need to shut it off.” There is fear in her voice.

I quickly decide that her problem is not an urgent one. The IV is probably beeping because the fluid is done dripping in, or maybe the line is kinked. But the man with the busted bowels–that is urgent. I need to devote every ounce of my attention toward finishing my note and getting that man into surgery.

“I’m dealing with an emergency right now, but your nurse should be back shortly.”

“We need to stop the beeping!” She is on the verge of tears.

“It’s probably nothing serious. I’m really sorry but I can’t help you right now.” I put my head down and continue writing.

“The help here is awful,” she says, returning to her room with her sick husband and his beepy IV.

A knot forms in my stomach as I continue with my note.

Was there time to have helped her? Maybe, but I had a short deadline and was feeling the pressure. Relieving the concerns of this elderly lady would have taken away from the care I was providing for a the very sick Mr. Jones. So I prioritized, and in doing so, I failed to address her request, leaving her disappointed and probably scared.

Though I didn’t realize it at the time, when I ignored one person and prioritized a sicker patient, I was doing something called triaging. Every day in the Emergency Department, doctors and nurses are forced to choose who needs help and attention more critically.

Before entering the field of medicine, I remember sitting in the Emergency Department as a patient with a fever and chills, watching others who came in hours later being treated before me. Nobody likes to feel ignored. What the general public does not always realize is that there is a triaging system, where patients are given a score from one to five based on how sick they are. It is a system that helps us deal with the sickest first, though it can lead to long wait times for those with less serious issues.

Though I postponed dealing with the concern of the elderly woman that day, I also learned an important lesson. In medicine, you need to assess and assign degrees of urgency, and in doing so, you can’t please everyone all the time. And you have to be okay with that. What matters most is that you prioritize to the best of your ability, and do your part to keep everybody healthy, and most importantly, alive.

Dr. Sarah Fraser is an author, family physician and human rights activist in Nova Scotia, Canada. She is author of Humanity Emergency, a poetry collection about the need for more compassion in the field of medicine. Her work appears in the Canadian Family Physician, Ars Medica and the Journal of Academic Psychiatry, The Coast, Capital Xtra and on kevinmd.com

Match Day 2017

Click on the link below to see an essay from NPR on learning from and working with foreign medical graduates.

All in honor of St. Patrick’s Day, which this year is also Match Day — when medical students learn where they will match for residency — the next chapter in their training.

Holiday Miracles

Dr. Kolbaba and his book

Happy holidays, dear GlassHospital readers.

A book recommendation for the season: If you like hearing positive medical stories, ones that are miraculous even, then order a copy of Dr. Scott Kolbaba’s “Physicians’ Untold Stories.”

Dr. Kolbaba is a longtime internist in Wheaton, Illinois. Over the years he’s experienced things that defy logic and rational explanation. The interesting thing is that neither he nor colleagues shared these stories, fearing ridicule or disbelief, until finally the dam broke.

He spent three years producing the book, interviewing 26 different doctors, all of whom have surprising, heartwarming medical stories.

Dr. Kolbaba includes short biographical material on each of the contributors to his book.

Though the word miracle is used throughout, and the presence of God is alluded to, there is no specific religious tradition espoused in the book–so you can decide for yourself about the degree of providence within.

I hope your holidays bring peace and comfort to you and your families.

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