I wish I had known earlier that survivorship care is neither a do-it-yourself project nor is it something that I can simply hand off to experts. There is no stable set of signs, signals and test protocols that, if followed assiduously — and that come up negative — means I am protected from a recurrence, new cancer or late effects of treatment. Observation, expertise and self-knowledge by both me and …
“Forty-two-year old male, chronic pain syndrome,” the chart reads.
I’m a third-year medical student doing an elective at a physical medicine and rehabilitation clinic, and this is my first time seeing Joe.
Sitting expectantly in the exam-room chair, he’s a gaunt man with a long face and dark tattoos down his arms. Wire-rimmed glasses, stringy ponytail, faded jeans and leather jacket complete the look.
“Nice to meet you,” I say. “I’m Angela, a …
Sometimes, it really does take one to know one. Not every counselor can work well with every patient. It is hard to understand how people can presume to know bereavement and grief when they have lost no one of significance in their lives. Surely everyone has experienced loss at some time. However, the death of a tame woods animal is usually, qualitatively, very different from the death …
To designer and architect Michael Graves, paralyzed from a rare virus and in a wheelchair since 2003, the ultimate indignity came one day while he was a patient in a top-ranked hospital: “I was in a Hoyer Lift.” (a body sling mounted to a metal structure, used to help lift and move a patient). “The nurse was moving me from the bed …
There has never been a time in my life when I’ve owed a lot of money. That certainly has changed this past two years as my husband and myself find ourselves with medical debt that we may never pay off . As you can guess, we have no health insurance — we can’t afford it and even if we did have an extra $650 a month we couldn’t obtain it …
Having cancer has infected me and many others with the irritating tendency to view any persistent, troubling symptom through the lens of a recurrence or a diagnosis of a new primary cancer. A friend of mine who is nearly five years post-kidney cancer treatment casually remarked the other day that he needed to see a doctor about his sore ankle: it could be arthritis, but it might be cancer, of …
A recent Wall Street Journal article about how post-traumatic stress syndrome can be caused by cancer and stroke brought to mind the variety of responses many people experience in response to cancer diagnosis and treatment. The lingering intensity of those responses – physical, psychological, social and behavioral – can affect whether and how we attend to the tasks of survivorship; that is, monitoring and addressing the unique health challenges that follow treatment …
As a medical educator in a hospital setting, I often tell first-year medical students about disparities in health care and about the vastly different quality of care that hospitals deliver, depending on their resources.
I tell my students how important it is to advocate for patients, to learn to navigate the healthcare system and to work respectfully with health professionals in order to get optimal care for your patients.
When my own …
Have you ever felt that claims about the effects of our access to new and more health information overshoot the mark? For example, you may be searching for help in understanding some ambiguous findings from diagnostic tests. Perhaps you think you are having troubling side effects from your new medication but then it may just be a reaction to something you ate last night. You may be hunting high and …
I’ve had my share of unsuccessful experiences with doctors and at medical clinics, including being intimidated by them. But after twelve years of chronic illness, I’m happy to report that I’m doing better in this uncomfortable setting. Here are six strategies to help minimize the odds you’ll be intimidated and to help ensure you make the most of the short time allotted …
At first we thought it was funny when the doctor said, “Fatigue. That’s a tough one. At 75-years-young, your chronic conditions are catching up with you, sapping your energy.”
That was the end of exploring the presenting problem at my husband’s twice a year primary care visit.
On the way out to the parking lot, we said we’d like to be bugs on the wall when, 25 years from now, someone says …
Helpless. That is how I felt when my mother found out she had a fibroid the size of a cantaloupe living in her uterus. In my role as a medical student I might have dismissed the finding as nothing serious, telling my patient, “Don’t worry, it could be much worse.” But as a loving son I was not quite as cavalier. At first my mother resolved to ignore the fibroid, …
Over the years, since the early 1990s, I’ve been treated for depression. Initially adjustment disorder, and lately, major depression. Perhaps I’m just getting older, and the “black dog” heavier. Then, I ponder all the changes I’ve encountered and wonder if they haven’t played a part. It may surprise you, but I’m thinking primarily of setting right now, and how much the therapeutic scene has morphed over those same years. I …
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Hospital transport arrives to take my daughter just after 9am. We’d been told her ultrasound and x-ray were scheduled for 10am, an hour away. Jess and I exchange a look. She’s just about to take another swig of the laxative drink she’s been drinking since 8:30.
“I’ll go with you,” I say.
“We’ll make sure there’s a bathroom nearby.”
Strike one for the Golden Cocoon.
We get to the ultrasound department, and are left …
Most healthcare professionals do not consider themselves to be in the field of sales. However, healthcare professionals do sell something so they are in sales! Even if you may not have the titles of “salesman” or “saleswoman,” you are still in sales. Everyone sells something. Kindergarten teachers sell something (i.e., the value of education). What do healthcare professionals sell? We sell the benefits of treating illness and promoting wellness. During …
I am a 47-year-old female. In December of 2010, I had surgery to remove a 2 inch atrial myxoma (a heart tumor) in my left atrium. The costs for that were astronomical. That is not what I am writing about. I am writing about what happened in the months after my surgery and a cure that cost $9.19 if you don’t count all of the unnecessary doctor visits and …
As the director of a health education program at a public university, my work is predicated upon the belief that greater knowledge is the key to improving health outcomes. If patients and healthcare professionals simply had better access to the latest information on a particular medical topic—if they simply knew more about a diagnosis, treatment, or prevention strategy—then we’d surely see improved health outcomes.
I have come to realize this assumption is wrong. …
What we look for when we participate actively in our health care differs from what our clinicians, employers and health plans believe will result when we shift from being passive to active participants.
We don’t have the same goals in mind. Does this matter?
Ask patients who use the phrases “patient engagement,” “patient participation” or “patient empowerment” about their goals and we talk about having some measure of control over our health …
The mother, clearly agitated, came to my office holding a bottle of liquid antibiotic prescribed for her daughter’s ear infection. She asked, “How the hell am I supposed to get this into her ear?”
She could not read the directions, which said to give the medication by mouth.
A survey conducted between 2008 and 2010 by the Adult Literacy Program at Einstein’s Fisher Landau Center for the Treatment of Learning Disabilities found …
We entered the hospital with great anticipation. Our baby was overdue and with no signs of delivery, I was admitted and was to be induced the following morning. Three days later our baby would be our greatest blessing on Thanksgiving Day.
It wasn’t until weeks later that we found ourselves scratching our heads over costs we incurred bringing our daughter into the world. We were fortunate to have had fantastic health …
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