A patient walks into the doctor’s office and says:
I hate feeling this way. Yes, I know it’s not cancer and it won’t kill me, but this shaking has made me a different person. I can’t sign my name. I drop and spill things all the time. I’m afraid to pick up my baby grandson. I don’t go out anymore because I’m embarrassed. And I don’t know what can be done. …
Steadying patients’ fears about shaking hands
In a recent People article, Jeopardy! host Alex Trebek shared some good news. Diagnosed with stage 4 pancreatic cancer in March, Trebek said he was told that he has been responding very well to his chemotherapy regimen, and that he’s in “near remission.”
He went on to say, “It’s kind of mind-boggling. … The doctors said they hadn’t seen this kind of positive …
How is Alex Trebek doing with his pancreatic cancer treatment?
Halfway into my four-week hematology consults elective at the county hospital during my fourth year of medical school, I was surprised that one of my patients was a 25-year-old woman from Romania — exactly my age. This was highly unusual, as most of the patients I had seen on this service were not this young, especially with a malignancy.
What was even more unique was that she had just arrived from …
The importance of being there for your patients
In my third year of medical school, I started a rotation at the nearby VA hospital. Walking toward the polished glass doors that morning, I saw my reflection — clean white coat, assured expression to cover up how lost I felt. It was my second clinical rotation ever, and my first time at the VA.
I found my team and soon met a patient I’d be seeing for the next month. …
Everyone has value. Even the angry man screaming at you.
In October of 2016, I returned to Bernard Mevs Hospital in Port Au Prince, Haiti. Hurricane Matthew, a category 4 hurricane, had touched down near Jeremie only four days prior. Hurricane Matthew caused significant devastation with over 2 million people directly affected, and over 500 reported deaths. As local health care facilities in southwest Haiti had limited capabilities to care for pediatric trauma patients, Bernard Mevs had arranged transport …
The horrors of the diseases that vaccines prevent
Earlier in June, the U.S. Food and Drug Administration (FDA) won a major legal victory by getting an injunction to prevent Florida-based US Stem Cell Clinic from offering its treatments. The company claimed to create stem cells from patients’ body fat and use these to treat a variety of serious illnesses, including Parkinson’s disease, ALS, and chronic lung disease. This company is just one of many that have sprung up …
Beware the claims of stem cell clinics
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 63-year-old woman is evaluated at a follow-up appointment after undergoing right hemicolectomy for colon cancer 1 year earlier. Her paternal grandfather had colon cancer diagnosed at age 75 years. She reports that she has been feeling well and takes no medication.
All physical examination findings, including vital signs, are …
MKSAP: 63-year-old woman after right hemicolectomy for colon cancer
Did you feel that? That little jolt in your stomach as you clicked on the headline? Perhaps, your muscles tensed for just a moment? Maybe your heart skipped a beat. What was that? An insignificant flutter? A meaningless moment to shrug off in your busy day?
Perhaps that fleeting feeling is explained by the stigma known all too well to sufferers of chronic mental illnesses. Stigma is fuelled by our fears …
This physician has a mental illness. And one day, he might be your doctor.
“I’ll put my cell phone away when you put your computer away,” said the patient.
These were the very words I heard upon opening the door and stepping into the exam room. As I stood waiting for him to look up, I was already looking at my computer for his name. Needless to say, I was aghast that a patient would say this to me. My first instinct was to defend …
“I’ll put my cell phone away when you put your computer away.”
After nearly 40 years as an internist, Dr. Ron Naito knew what the sky-high results of his blood test meant. And it wasn’t good.
But when he turned to his doctors last summer to confirm the dire diagnosis — stage 4 pancreatic cancer — he learned the news in a way no patient should.
The first physician, a specialist Naito had known for 10 years, refused to acknowledge the results of the …
Why so many doctors won’t break bad news to patients
After a severe fracture or removal of a tumor, what happens if a segment of bone is missing? The bone ends will try to grow into one another just as they do after routine fractures, but the lack of immobilization and the gap may be insurmountable despite how hard the bone tries to repair itself. The void instead fills with gristle-like scar tissue, which cannot restore stability. A wobbly false …
Recently, a friend’s mother asked me how to best support her daughter’s decision to breastfeed her first grandchild. The new grandmother questioned her ability to encourage her daughter’s decision because she had not breastfed her own child, and this lack of experience made her feel unqualified to provide support. With mixed emotions and a lingering sense of guilt, this new grandmother wanted to learn, from a pediatrician friend, how best …
Bottle-feeding grandmothers vs. breastfeeding daughters: advice from a pediatrician
Two recent patient experiences prompted this post. In the Wall Street Journal, Dana Hawkins-Simons described several years of being seen by specialist after specialist for her complaints of tiredness, dizziness, ringing in the ears, palpitations, shortness of breath and “brain fog.” She finally researched her symptoms and demanded that she be checked for vitamin B12 deficiency, which turned out to be the cause of her symptoms.
Recently, the …
When should you be tested for vitamin B12?
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I’ve always thought that I’ve understood illness and mortality very matter-of-factly. You live your life, you’ll most likely end up with some medical conditions along the way, and ultimately everyone’s life will come to an end because the body is not designed to function indefinitely. And do I cry at every funeral I attend? Absolutely. I understand physiologically and pathologically why things happen, but also realize human relationships will always …
How families maintain hope of improvement, regardless of logic and science
Appointments with my doctor make me nervous. That’s highly ironic, because I’m a doctor, a maternal-fetal medicine specialist who regularly deals with high-risk pregnancies. But ever since developing preeclampsia during my first pregnancy eight years ago, the thought of having my blood pressure taken triggers flashbacks and anxiety. The silver lining is that my experience has changed …
PTSD changed how this physician cared for pregnant women
If you went to go to a museum in New York City and saw a live heart encased in glass, still pumping and pulsating — it would be my heart, shredded into a thousand pieces all in disarray. But it still would be pulsating. This describes my life as a nurse.
Nursing was a vacuum that sucked me dry and left me dangling with nothing more to give. Three years left …
A love-hate relationship with nursing
Most Saturdays, I join a therapy session down the hall from where I do my walk-in clinic. A patient of mine has a weekly session just before the Alcoholics Anonymous meeting at noon in our big conference room.
Last weekend he told my behavioral health colleague that the people in the AA group who have the most solid recovery seemed to be the ones who claimed to carry a lot of …
The role of hatred in medicine
When I served as president of the New Jersey Neurosurgical Society, I met a lot of people from around our great state. One question that I heard from many parents and coaches was, “After a concussion, when is it safe to let a student-athlete return to play?”
It is an important question because hundreds of thousands of high school students in the USA suffer concussions annually. I have given this question …
How a neurosurgeon recommends approaching concussions
Would you take an exam without studying? Would you run a marathon without training? If not, why would you show up for surgery without physical preparation for a life-changing event? Few patients capitalize on the opportunity to improve the odds of a successful surgery and a speedy recovery. Recently, an explosion of medical research suggests cardiovascular training before surgery, or “prehab,”can make this happen. As operating room …
Shorten recovery with prehabilitation before surgery
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 48-year-old woman is evaluated at a follow-up appointment for elevated liver chemistry tests over the preceding 6 months. She reports no symptoms. She has type 2 diabetes mellitus and hypertension. Her family history is unremarkable. She drinks two glasses of wine one or two times per month. Her …
MKSAP: 48-year-old woman with elevated liver chemistry tests
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