Like most Americans, when I learned that twenty children and six adults had been massacred in Newtown, Connecticut, I recoiled. Like most parents, my next thought was for my own son, the image I retain of his happy, smiling self for one moment replaced by an image of his tiny body lying twisted on the ground. Even as I write these words, an emotion I rarely feel—one I often can’t …
Why should I try to find compassion for Adam Lanza?
My heart began pounding as I listened to the sound of the dial tone in my ear. After three rings a woman answered groggily and uncertainly, “H-hello?”
“Mrs. Peterson?” I asked. My voice trembled slightly. It was 2 a.m., and I’d awakened her from what I imagined had been a troubled sleep.
“Yes?”
“This is Dr. Lickerman. I’m calling from the hospital.” I paused. “I’m calling about your husband.”
There was silence. Then a breathless, “Yes?”
“Mrs. Peterson, …
How to deliver bad news to patients: 9 tips to do it better
When I was ten I once found myself walking with my brother on a Lake Michigan beach when we came upon a half-empty bottle of beer. Curious, I picked it up and looked inside at the swirling dark liquid. Then, impulsively, I took a sip. It was hot, having baked in the sun for who knows how many hours or days, and tasted awful.
I never took another drink of alcohol …
How I learned to appreciate the struggles of others who don’t fit in
According to Nichiren Buddhism, the reason we’re all here is to enjoy ourselves, to be “happy and at ease.” Though this may sound like a license for lasciviousness and hedonism, in reality it’s far from it: enjoying ourselves, as most of us know from experience, is far harder than it sounds. To develop lives in which we can freely enjoy each moment requires far more work—far more self-development—than many would …
Enjoying ourselves is far harder than it sounds
I vividly remember the first day my medical school classmates and I met our cadavers in the anatomy lab. Large body bags lay on metal tables that had been bolted to the floor. I remember the sheer size of the bags best. No doubt existed in my mind that dead human bodies indeed lay within them. And yet part of me couldn’t quite grasp that I was actually going to …
Strive to maintain our compassion for others
We can’t, of course, plan the way we’re going to die (with the obvious exception of suicide). We can, however, live in such a way that reduces the likelihood of our dying from certain diseases. Which is why it’s now almost universally accepted that we should exercise regularly, not smoke, drink only in moderation (if at all), avoid too much fat in our diet (and now probably too much carbohydrate), …
What is the best disease from which to die?
I once had a patient in whom I found a small breast lump. She was only thirty-two, and the lump was soft, non-tender, and mobile. But it was new. She examined her breasts monthly and was certain that she hadn’t felt it the month before. And she had a family history of breast cancer.
So, I asked myself, what to do? Her age—as well as the lump’s characteristics on exam—made the …
5 questions every patient needs to ask
Student loan debt is at an all-time high at a little over 1 trillion dollars, a figure that now, for the first time ever, exceeds our nation’s credit card debt. Higher education has never cost more, the rate of rise of college tuition having exceeded in recent years the rate of rise of many other services. Perhaps as a result of this, as well as of the difficulty in obtaining …
Take the time to educate yourself before forming an opinion
The notion that dying is a right seems nonsensical to argue: death is given to all of us equally without the need of anyone’s sanction. The right to die well, on the other hand—well, that’s another matter entirely. A good death is, in many cases, something our fellow human beings have great power to grant or deny, and is therefore, sadly, a right for which we must indeed fight.
The …
A good death is a right we must fight for
I had a patient once—a fellow physician—who came to see me complaining of mid-back pain. When I examined him, I found I could reproduce his pain by pressing firmly on the spot he said was hurting him. He said pressing there also made the pain radiate around to his stomach, a phenomenon known as “referred pain” that meant his pain was almost certainly caused by a trigger point. I …
How early closure can cause doctors to misdiagnose
I had a patient once who wanted an exercise stress test even though he had neither symptoms nor risk factors to suggest the presence of coronary artery disease (such as chest pain with exertion). I argued vociferously against it. However, extenuating circumstances (not relevant here) prompted our mutual decision to go ahead with it anyway. To our surprise and dismay, it came …
Why doctors can’t screen patients for every disease
Americans spend an astounding 34 billion dollars on alternative medicine annually. Given that so many of us put our faith in alternative care, I wanted to clear up some common misconceptions about it to help people make wiser choices when and if they turn to it.
What is alternative medicine?
In general, alternative medicine is used to describe practices outside the bounds of conventional medicine. …
Alternative medicine problems patients need to know about
When I was an intern in internal medicine, I admitted a patient to my service with pancreatic cancer.
Pancreatic cancer is a bad one; back then, only ten percent of patients with it would be alive within five years after being diagnosed. My patient was a farmer in the full bloom of late middle-age health when he began rapidly losing weight. An abdominal CT scan ordered by his primary care physician …
Doctors play a role in helping people through transitions with rituals
First aid is defined as the immediate care given to an acutely injured or ill person. It can literally be life-saving so it behooves all of us to know some basic principles.
What follows are some rules that cover common conditions and general practices:
First aid rules that everyone needs to know
A few years ago, a patient of mine was diagnosed with lung cancer. A metastatic work up revealed a small mass in his liver that had the radiographic appearance of a benign liver cyst. But in the setting of a newly diagnosed lung cancer, we couldn’t be sure it wasn’t a metastatic lesion, so we decided to biopsy it. Due to scheduling issues, we couldn’t get it done for seven …
Using denial to control a patient’s anxiety
Eating right, exercising, avoiding the sun or using sunscreen, moderating alcohol consumption, abstaining from tobacco use, getting mammograms, Pap smears, colonoscopies—almost every measure we’re asked to take to safeguard our future health is difficult. It’s a strange paradox that we have to work in some way, to expend energy, and experience discomfort of some kind in order to gain benefit in life.
Wouldn’t it be nice if the most pleasurable things …
Positive reinforcement can motivate preventive behaviors
Email, Twitter, Facebook, MySpace, YouTube, Delicious, Digg, LinkedIn, blogs (of course), and scores of others—all part of the new and wonderful ways we can now connect with one another electronically, each with its own culture and unique set of rules.
In one sense, the planet has never been more interconnected. And yet, this interconnectedness, while wonderful, hasn’t come without cost.
Isolation
Much has been written about the dangers of Internet addiction. From pornography …
Costs of communication on email, Facebook and Twitter
When I was a second-year medical student I remember thinking, after meeting with an attending physician in a physical diagnosis class, how impossible it seemed that my brain would ever contain as much medical knowledge as his.
And even if somehow one day it did, how would I ever be able to call on it, manipulate it, twist it, bend it, and turn it upside down with the same apparent ease …
Difficult needs to be embraced in medicine
Though I’ve never lost a friend or family member to suicide, I have lost a patient.
I have known a number of people left behind by the suicide of people close to them, however. Given how much losing my patient affected me, I’ve only been able to guess at the devastation these people have experienced. Pain mixed with guilt, anger, and regret …
6 reasons why people commit suicide
Part four of a series. See also parts one, two, and three.
When dealing with your doctor’s biases, you have on your side a fact I firmly believe to be true: most doctors want to do a good job and help their patients as best they can. So what exactly can you do to maximize your doctor’s ability to help you?
1. Position your symptoms and requests carefully. Don’t demand medications …
Help doctors to best care for their patients
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