Patients and caregivers writing on KevinMD about the experience of illness and the health care system from the other side of the exam table: navigating care, the doctor-patient relationship, being heard, and what patients want physicians to understand. Physicians who have become patients write here too. For the record of what pain patients and physicians have said to each other about opioids and chronic pain since 2007, with patient authors cited at the same weight as physicians, see Opioids: what physicians and pain patients say, in their own words. For what patients, families, and physicians have said about dying, hospice, and the decisions families face at the end of life, see End of life: what physicians say, in their own words. For what women and the physicians who treat them have said about pregnancy, menopause, and the conditions dismissed for years, see Women's health: what physicians say, in their own words. For what physicians have said about consent, honesty, and who decides, see Medical ethics: what physicians say, in their own words.
Many months have passed since the spring day when I was hit with the news from my yearly mammogram, but those typewritten words are forever etched in my memory: “The density appears greater in left breast.”
My doctor comforted me with statistics showing that mammograms aren’t 100 percent accurate — but she also lost no time in sending me to a surgeon named Dr. Prewitt. Upon meeting him, I immediately felt …
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Do not underestimate the power of touch
In mid-February, thousands flocked to the opening of Black Panther, a highly anticipated film for a multitude of reasons. The most salient of these is its depiction of an African king as Marvel’s and cinematic screen’s first culturally-affirming black superhero. In fact, Black Panther’s success is due to its emergence as a counter-narrative to painful and dysfunctional representations of black life. By normalizing the presence of black royals, diplomats, and …
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A Black Panther for diabetics
I’ve written a lot about the tough challenges that those of us with chronic illness face (chronic illness includes chronic pain). I thought it would be constructive to take what I tend to think of as negatives and see if I could turn them into positives. Sometimes I had to dig deep to turn a negative into a positive; nevertheless, here are the results of my experiment.
Negative: I don’t look …
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Turning negatives into positives when you’re chronically ill
A T-shirt advertised online reads, “Keep calm and let the patient care coordinator handle it.” The shirt must be popular, or maybe just a source of gallows humor, for those engaged in this noble pursuit.
But the underlying question of who is coordinating our medical care is a serious one. By one estimate, inadequate care coordination costs between $25 to $45 billion annually. For the individual patient with a chronic illness, …
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Care coordination is more than a T-shirt slogan
Can you imagine flying home from a family vacation and having a first-time anaphylactic reaction in the air? Did you know that airlines are not required to stock their planes with easy-to-use auto-injectors that any adult or child could operate?
Francine’s family was flying back home from vacation on American Airlines. Her 10-year-old son, who had no history of food allergy, ate the warm mixed nuts they served and immediately had stomach …
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When your first food allergy reaction takes place in the air
Thanks to a surprising and devastating diagnosis, I know more than most physicians about what it’s like to live with the brain cancer known as glioblastoma, everything from self-titrating my anti-epileptic medications to making sure the right ICD-10 code appears on my MRI referrals. As much as I’d rather not have this expertise, I’ve …
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A patient’s expertise is often undervalued
There I was, an awkward 13 year old sitting in the doctor’s office. For the past two weeks, I had been complaining to my mom about rib pain, and she had scheduled a visit to the pediatrician. I was very active — I played softball constantly — and she wanted to be sure I hadn’t broken a rib.
“Where does it hurt?” the nurse asked me.
“Right here,” I said, pointing to …
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A #MeToo moment with a pediatrician
During a recent Las Vegas performance, an intoxicated concertgoer got on the stage and stood next to singer Celine Dion. This situation could have been handled in multiple ways, but Ms. Dion never lost her composure and handled the situation with grace and kindness. She brilliantly was able to diffuse the situation without anger while maintaining her dignity and that of the fan. The way she handled the situation and …
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What Celine Dion can teach us about patient care
As many readers are undoubtedly well aware, the doctor-patient relationship has a place of profound significance in health care. The critical importance of this relationship becomes magnified in oncology, where life hangs in the balance, and fear hangs over every soul that walks the invisible line between life and the everlasting night of undrawn death.
In the winter of 2015, a needle biopsy was performed on a mysterious tumor in my …
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Doctor-patient relationships would die without this one thing
The current state of health care in America, in my opinion, has been negatively impacted by Big Pharma, health insurance corporations, health care corporations and a plethora of governmental mandates. All have placed an immense burden upon our practicing physicians who spend much of their day doing paperwork and inputting into computers rather than face time with their patients. Some find it necessary to leave the profession. Please give us …
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Do you see me or your computer screen?
There is a strange and peculiar place in American society. Some say that when one enters this place, there are many odd-looking people walking about wearing white coats and wearing funny looking shoes. This place has a name. It is called Medical Zombie Land.
Entering into Medical Zombie Land for the first time, it is hard not to feel that one has been enveloped in a mysterious dimension of irrationality. Home …
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Are we living in a medical Zombie Land?
According to Hesiod’s version of an ancient Greek legend, because Pandora has opened a jar stuffed full of evil by the Olympian gods, “countless plagues, wander amongst men … earth is full of evils … Diseases come upon men continually by day and by night, bringing mischief to mortals silently.” Curiously that jar was closed before hope was also allowed to escape.
Is the legend an expression of how bleak the …
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Is there danger in hoping too much?
Healthy or not, everybody has his or her share of frustrations in life. The chronically ill don’t have a corner on that market! This piece focuses on frustrations that are unique to those with ongoing health issues. I’ve experienced all of them as a result of being chronically ill with a debilitating illness that settled in after I contracted what appeared to be an acute viral infection in 2001.
Here are …
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The most frustrating things about being chronically ill
My job as a standardized patient (SP) at several different medical schools means that I spend a lot of time being interviewed and examined by students at every stage of their education. Occasionally, the interview is of such a nature that the SPs are told to dress in a certain “costume” because it signifies to the student that there is something about our cultural representation that affects our medical care. …
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Are cultural sensitivities affecting care?
Until genuine rights are extended to all patients, the ongoing health-care-reform saga perpetrated by Congress and executive leadership will continue to fail the American people. Many Americans have suffered and died because of a broken health-care-delivery system. One of us lost a 19-year old son due to lack of certain patient rights – specifically the right to evidence-based medicine and the right to a complete discharge plan from his hospital. …
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Got real rights? Not when seeking health care.
It is not enough to know that a patient’s medical condition warrants an MRI. For most insurance companies, a diagnostic test of this sort requires what is known as a prior-authorization. But, the doctor saying the patient needs this test often fails. The insurance company has a certain guideline the patient must travel first before they will consider the test.
For example, a patient with back pain and numbness in one …
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How can patients navigate our complicated health care system?
I love my doctors.
I have an undiagnosable autoimmune disease. It’s mostly manageable, my lab work is perfect, and I rarely get sick. I get allergy shots and take blood pressure medication. I always have at least low level, mostly familiar, physical symptoms. Occasionally a new one appears. Sometimes it is scary.
I could have sued any or all of my doctors over the last decade-plus. I could be “livin’ large.” They …
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No one cares about the doctors
Since the Department of Transportation (DOT) requires an annual checkup, and getting a yearly physical is generally a smart way to take care of one’s health, it’s a wonder why many truck drivers tend to avoid their yearly exams. Are they tired of the long waits, which may seem like more time spent away from home and family? Do they fear that the stress of their jobs, and perhaps …
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Some patients are hesitant to see the doctor. Here’s how we can fix that.
Lori Wallace sits on a couch with her 11-year-old son and his new pet snake. It burrows under his armpit, as if afraid. Wallace is sure it’s not.
“If he was terrified, he would be balled up,” Wallace said. “See, that is why they are called ball pythons. When they are scared, they turn into a little ball.”
Wallace is dying of breast cancer, but a stranger wouldn’t know. She has a …
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The painful side of positive health care marketing