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

We shouldn’t be our own doctors, but we can’t forget what we know

David Galinsky, MD
Physician
June 3, 2020
Share
Tweet
Share

Like a lot of doctors my age, I was too busy to have checkups, working 60 hours a week plus night and weekend call. But that all changed in 2013 when at age 67, my dentist felt a submental lymph node. A CBC had 35,000 white cells, and I had chronic lymphocytic leukemia. When I told my wife that patients with CLL live a long time and die of something else, I promised her that I would see an oncologist and that I wouldn’t try to be my own doctor. I picked a senior oncologist at my local hospital whom I knew to be calm and friendly. He reassured me that despite my ZAP70 mutation and very low immunoglobulin levels, he would just get periodic blood tests and follow me along. But, I did a PubMed search on ZAP70 and found that in six years, I would be on chemotherapy. A year later, I retired from clinical practice and took a one day a week job in state government. Reading PubMed and understanding medical literature differentiated me, a doctor, from the usual patient.

Three years later, I was at medical grand rounds, where a visiting oncologist described the novel CLL treatments that he was working on. I said to myself, “I want him.” I realized that I would be better off switching my care to a super-specialist. That was the second time that being a doctor gave me the advantage over the average patient.

By age 73, my white count was 300,000, my platelets and hemoglobin were dropping, and I was tired. So, when I was offered the chance to participate in a clinical trial of three targeted medications, I signed right up. Being a doctor put me in the right place to get the best treatment, a third time where my profession gave me the inside track.

Throughout, I repeatedly said, “I’m not the doctor; I’m the patient.” When I developed the worst cold of my life, which developed into bronchitis, I ascribed it to my immune deficiency. I had frequent infusions and checkups, where I showed the care team my sputum. No one suggested that I get a culture.

As part of the trial, I had CT scans every three months. The first two showed innumerable lymph nodes consistent with CLL. It was after the second one that a pulmonologist colleague heard me cough in the hallway and suggested that I had Mycobacterium. I told him that I just had a CT scan and it wasn’t there. He told me that he had seen patients with leukemia who had Mycobacterium. Two months later, I was still coughing and expectorating when another pulmonologist who knew that I had leukemia told me that I probably had Mycobacterium.  The next week I had a CT scan that showed a tiny focus of nodularity in the posterior, right, upper lobe. My oncologist thought that it was not significant. However, I knew that it was. I ordered an AFB culture that came back positive for Mycobacterium Avium. Now my pulmonologist colleague is treating me with appropriate antibiotics; after two months, my sputum is gradually decreasing. When I tell this story to non-medical friends, they frequently respond, “What would happen to someone who wasn’t a doctor?”

The answer is complicated. By being a doctor, I maneuvered myself into a clinical trial so that I received the newest treatment for my leukemia. But, because of the way medicine is segregated into silos, one brilliant specialist is not an expert in everything. As a doctor, I associate with many doctors, including pulmonologists, who alerted me to the possibility of Mycobacterium. As an internist, I immediately knew that nodularity, no matter how tiny, in the setting of four months of sputum, was likely Mycobacterium. Being a doctor resulted in my traveling through this adventure to a salubrious outcome. I had the best leukemia treatment, from the best oncologist, the best advice from doctor colleagues, and I also had the medical background to recognize the significance of an abnormal CT scan.

We shouldn’t be our own doctors. But we still have to use our medical knowledge to get the best possible treatment for ourselves. We have to trust the doctors whom we chose, but we can’t forget what we know.

David Galinsky is an internal medicine physician and emeritus staff, Lankenau Medical Center.

Image credit: Shutterstock.com

Prev

An oath to Darnella Frazier

June 3, 2020 Kevin 1
…
Next

The USMLE needs better pandemic communication [PODCAST]

June 3, 2020 Kevin 0
…

Tagged as: Oncology/Hematology

Post navigation

< Previous Post
An oath to Darnella Frazier
Next Post >
The USMLE needs better pandemic communication [PODCAST]

ADVERTISEMENT

More by David Galinsky, MD

  • Is the Goldwater Rule hindering us?

    David Galinsky, MD
  • It is time for the Supreme Court to help stem gun deaths

    David Galinsky, MD
  • The unvaccinated and a history of cynicism

    David Galinsky, MD

Related Posts

  • Doctors: Never forget the importance of eye contact

    Suneel Dhand, MD
  • Why do doctors who hate being doctors still practice?

    Kristin Puhl, MD
  • Doctors: It’s time to unionize

    Thomas D. Guastavino, MD
  • Doctors die. But the good ones leave a legacy.

    Jaime B. Gerber, MD
  • When doctors are right

    Sophia Zilber
  • We’re doctors. We signed the book.

    Jonathan Peters, MD

More in Physician

  • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

    Yousuf Zafar, MD
  • The hidden rewards of a primary care career

    Jerina Gani, MD, MPH
  • Why doctors regret specialty choices in their 30s

    Jeremiah J. Whittington, MD
  • 10 hard truths about practicing medicine they don’t teach in school

    Steven Goldsmith, MD
  • How I learned to love my unique name as a doctor

    Zoran Naumovski, MD
  • What Beauty and the Beast taught me about risk

    Jayson Greenberg, MD
  • Most Popular

  • Past Week

    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why I left the clinic to lead health care from the inside

      Vandana Maurya, MHA | Conditions
    • How nature is inspiring the future of pain medicine

      Varun Mangal | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • How nature is inspiring the future of pain medicine

      Varun Mangal | Conditions
    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • Affordable postpartum hemorrhage solutions every OB/GYN can use worldwide [PODCAST]

      The Podcast by KevinMD | Podcast
    • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

      Yousuf Zafar, MD | Physician
    • Psychiatrist tests ketogenic diet for mental health benefits

      Zane Kaleem, MD | Conditions
    • The hidden rewards of a primary care career

      Jerina Gani, MD, MPH | Physician

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

    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why I left the clinic to lead health care from the inside

      Vandana Maurya, MHA | Conditions
    • How nature is inspiring the future of pain medicine

      Varun Mangal | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • How nature is inspiring the future of pain medicine

      Varun Mangal | Conditions
    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • Affordable postpartum hemorrhage solutions every OB/GYN can use worldwide [PODCAST]

      The Podcast by KevinMD | Podcast
    • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

      Yousuf Zafar, MD | Physician
    • Psychiatrist tests ketogenic diet for mental health benefits

      Zane Kaleem, MD | Conditions
    • The hidden rewards of a primary care career

      Jerina Gani, MD, MPH | Physician

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...