Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A quiet, contemplative man of inaction can be the true healer

Michael Kirsch, MD
Physician
November 26, 2013
Share
Tweet
Share

I’m sending a patient downtown to see a pancreatic expert. He’s a young man who didn’t fully appreciate the health risks of a former alcohol addiction. He’s been sober for well over a year, but alcohol toxicity can be unforgiving and permanent.

We don’t fully understand why some alcoholics develop cirrhosis and other complications while others seem to skate by without a scratch. While I want folks who have the strength to conquer addictions to regain lost health and opportunities, many life choices lead to irreversible consequences. Life is often an unfair mystery. We witness this in medicine often. Some smokers live well into their 80s, while others become tethered to oxygen tanks or contract cancer. Trim athletes who eat seaweed salads seasoned with probiotics keel over while obese Whopper-swallowers wallow their way into old age.

My guy has chronic pancreatitis, a known consequence of alcohol abuse. Most of us don’t pay much attention to our pancreas, until it’s not performing well. His is sick and is causing him pain. He’s got a ball of fluid hanging off the tail of the pancreas, which shouldn’t be there and is not going way. In fact, it has enlarged some as seen on his most recent CT scan.

There are three things that doctors love to do.

Enter any orifice possible. Why do you think that gastroenterologists, ENT (ear, nose and throat) , urologists, proctologists, gynecologists and pulmonologists are always smiling?

Stretch any narrowed tube in body. If a cardiologist finds a narrowed coronary artery on a cardiac catheterization, the impulse to stretch it will be overpowering convinced that this has to be a good idea even if medical studies have refuted this.

Drain fluid. Doctors like to do this because it’s cool and it always sounds right to patients and their families. We welcome telling patients afterward that we’ve successfully shrunk their fluid collection by 50%. Patients then become 50% relieved. It sounds right that we should attack an abnormal fluid collection and that eliminating it is the ideal objective.

Here are the unasked questions?

Does the orifice need to be violated or do we do just because we can?

Is the narrowed artery, bile duct or artery actually a medical threat that needs to be stretched, or do we widen these narrowed structures because we can convincing ourselves and others that we have averted a medical crisis?

Is the fluid we drain actually bothering or threatening a patient or should it have been just left alone?

My patient is not getting better under my care and I want the advice of an expert. I cautioned the patient that the mere presence of abnormal fluid doesn’t mandate its removal. I am hopeful that he will receive a sober assessment.

Sure, we all like men of action, medical swashbucklers wielding tools and weapons to slice into our diseases and make us well. Would we rather watch a warrior slay a dragon or a farmer plant seeds?

ADVERTISEMENT

Sometimes, a quiet contemplative man of inaction is the true healer.

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower. 

Prev

I am not a disease, I am not a checklist

November 26, 2013 Kevin 4
…
Next

Digging deeper into the new cholesterol guidelines

November 26, 2013 Kevin 4
…

Tagged as: Gastroenterology

Post navigation

< Previous Post
I am not a disease, I am not a checklist
Next Post >
Digging deeper into the new cholesterol guidelines

ADVERTISEMENT

More by Michael Kirsch, MD

  • Are Ozempic patients on a slow-moving runaway train?

    Michael Kirsch, MD
  • AI-driven diagnostics and beyond

    Michael Kirsch, MD
  • The surprising truth behind virtual visits

    Michael Kirsch, MD

More in Physician

  • What burnout does to your executive function

    Seleipiri Akobo, MD, MPH, MBA
  • Dealing with physician negative feedback

    Jessie Mahoney, MD
  • Why CPT coding ambiguity harms doctors

    Muhamad Aly Rifai, MD
  • Moral injury, toxic shame, and the new DSM Z code

    Brian Lynch, MD
  • The problem with the 15-minute doctor appointment

    Mick Connors, MD
  • Honoring medical veterans and health care heroes

    Gene Uzawa Dorio, MD
  • Most Popular

  • Past Week

    • Rebuilding the backbone of health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why you should get your Lp(a) tested

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • The paradox of primary care and value-based reform

      Troyen A. Brennan, MD, MPH | Policy
    • Why CPT coding ambiguity harms doctors

      Muhamad Aly Rifai, MD | Physician
    • Reimagining medical education for the 21st century [PODCAST]

      The Podcast by KevinMD | Podcast
    • A pediatrician’s reckoning with behavior therapy

      Ronald L. Lindsay, MD | Physician
  • Past 6 Months

    • Rebuilding the backbone of health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The dangerous racial bias in dermatology AI

      Alex Siauw | Tech
    • When language barriers become a medical emergency

      Monzur Morshed, MD and Kaysan Morshed | Physician
    • The dismantling of public health infrastructure

      Ronald L. Lindsay, MD | Physician
    • The high cost of PCSK9 inhibitors like Repatha

      Larry Kaskel, MD | Conditions
    • A neurosurgeon’s fight with the state medical board [PODCAST]

      The Podcast by KevinMD | Podcast
  • Recent Posts

    • A question about maternal health and the rise in autism [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why early diagnosis of memory loss is crucial

      Scott Tzorfas, MD | Conditions
    • Rethinking stimulants for ADHD

      Carrie Friedman, NP | Conditions
    • Why young people need to care about bone health now

      Surgical Fitness Research Pod & Yoshihiro Katsuura, MD | Conditions
    • What burnout does to your executive function

      Seleipiri Akobo, MD, MPH, MBA | Physician
    • The paradox of primary care and value-based reform

      Troyen A. Brennan, MD, MPH | Policy

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Rebuilding the backbone of health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why you should get your Lp(a) tested

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • The paradox of primary care and value-based reform

      Troyen A. Brennan, MD, MPH | Policy
    • Why CPT coding ambiguity harms doctors

      Muhamad Aly Rifai, MD | Physician
    • Reimagining medical education for the 21st century [PODCAST]

      The Podcast by KevinMD | Podcast
    • A pediatrician’s reckoning with behavior therapy

      Ronald L. Lindsay, MD | Physician
  • Past 6 Months

    • Rebuilding the backbone of health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The dangerous racial bias in dermatology AI

      Alex Siauw | Tech
    • When language barriers become a medical emergency

      Monzur Morshed, MD and Kaysan Morshed | Physician
    • The dismantling of public health infrastructure

      Ronald L. Lindsay, MD | Physician
    • The high cost of PCSK9 inhibitors like Repatha

      Larry Kaskel, MD | Conditions
    • A neurosurgeon’s fight with the state medical board [PODCAST]

      The Podcast by KevinMD | Podcast
  • Recent Posts

    • A question about maternal health and the rise in autism [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why early diagnosis of memory loss is crucial

      Scott Tzorfas, MD | Conditions
    • Rethinking stimulants for ADHD

      Carrie Friedman, NP | Conditions
    • Why young people need to care about bone health now

      Surgical Fitness Research Pod & Yoshihiro Katsuura, MD | Conditions
    • What burnout does to your executive function

      Seleipiri Akobo, MD, MPH, MBA | Physician
    • The paradox of primary care and value-based reform

      Troyen A. Brennan, MD, MPH | Policy

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...