Here’s a joke I love: A man goes to an old-school psychiatrist who, at the first session, administers some Rorschach tests.
“Just tell me the first thing that comes to mind,” the doctor instructs the patient as he shows him the ink blots.
“Sex,” answers the patient.
“I see,” says the doctor. “And this one?”
“Sex.”
“And this one?”
“Sex again.”
“Well,” says the doctor, “I see we will have to work on your obsession with sex.”
“Me??” …
When I was growing up in the 1960s, at the height of the Cold War, there was always some smart aleck boy on the playground who had “facts” to share about the Soviets. His recitation was meant to emphasize how weird, how different, how other our arch enemies were. “They make you wear all brown and gray there.” “They eat only boiled cabbage and potatoes.” “They tell you what to …
One of the things about which I’m asked most commonly is calcium. Some of the confusion comes from the fact that our knowledge about calcium and health is evolving. A recent study showing that men who take calcium supplements have an increased risk of heart attacks is just the latest in an avalanche of sometimes conflicting information.
Here are a few of the questions I am most …
Not long ago I noted a certain older patient’s name on my schedule. I really dreaded seeing her. It’s not that I dislike her–in fact she’s one of my favorite patients. It was just that I hated the prospect of seeing her looking as poorly as I knew she would. She’d been through so much: an accident resulting in devastating injuries followed by painful surgeries, and, worst, in the middle …
There’s this weird feeling I get when I hear bad news, or even not that bad news, or even the possibility of bad news: a tingling that spreads across my forehead, down my face, into my jaw, and then to my chest, where it settles like a…no, not a lump…a void. I get the feeling every time I go for my annual mammogram or any other medical test, I wonder …
A psychiatric colleague once told me that the incidence of anxiety disorders went down drastically during the blitz, when London was under constant siege by German bombs in 1940-1941. I don’t know whether this is true, or even how you could measure such a thing under those conditions–but it makes sense to me. The patients I saw at Massachusetts General Hospital the day after the terrorist attacks just two miles …
When I entered the exam room I found my patient, a woman in her 80s who’d come in for a routine visit, holding a photograph. “I need to show you something,” she said. Some patients bring me photos at every visit–usually their kids’ or grandkids’ annual school pictures, or smartphone shots of a wedding or christening–but she never had before. I wondered what it might be.
She laid the photo on …
In an excellent recent cover article in the Boston Globe Magazine, Darshak Sanghavi explored a fascinating phenomenon: patients are less likely to sue doctors who admit they’ve made a mistake, particularly if they apologize for their errors. Innovative programs, such as one at the University of Michigan, encourage physicians to reveal their mistakes to patients, express remorse, and offer compensation to patients who may have been harmed by …
Mention the term “surgeon general” to anyone over 35 or so and they won’t think of the doctor who currently holds that position (that’s Regina Benjamin, who some have felt has not spoken or acted forcefully enough about threats to our nation’s health). Nor will they think of the surgeon general who released the famous 1964 report linking smoking with …
If you have not yet seen the fourth episode of the third season of Downton Abbey and wish to be surprised by it, read no further. And if you aren’t watching PBS’s addictive costume drama currently set in 1920–and, seriously, why aren’t you?–read on anyway.
This is about medicine, then vs. now.
First, to recap the medically relevant aspects of the story: Lady …
I saw 17 patients in my primary care practice yesterday. Six of them were coughing.
One of the most basic parts of my job is sorting out who’s a little sick from who’s very sick, or in danger of getting very sick. How do I do that when so many people have the same symptom? And, as a patient, how do you …
Many years ago, I wrote this essay in which I wondered why I receive so few gifts from my patients in the holiday season. I was prompted to write the essay by the memory of my father, an orthopedic surgeon in solo practice, whose patients showered him every December with foil-wrapped bottles of booze, tins of cookies, and all manner of goodies, including a “World’s Greatest Doctor Figurine.”
I speculated …
Suppose 20 children and 6 adults died at a school in a very short time period. And suppose there were clusters of similar deaths, many of young healthy people, around the country: at a movie theater, a shopping mall, a high school, a house of worship. Would you expect the Center for Disease Control to get involved in trying to figure out why these people died and how to prevent …
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In our practice, doctors have the option to administer influenza vaccines right in the exam room. The truth is, giving the flu shot only takes a couple of seconds. The syringes are pre-filled, so all you have to do is pop on a needle, swipe the patient’s upper arm with an alcohol pad, and jab.
It’s the conversation that precedes the flu shot that takes time.
Take yesterday. A very intelligent middle-aged …
Medicine, like law, the military, and many other professions, has its own language–a kind of verbal secret handshake by which its members recognize one another and close ranks against outsiders.
Sometimes, the use of technical terms, abbreviations, and other forms of jargon can impair patients’ understanding of their medical care. This article discusses the extent to which clinicians overestimate patients’ “health literacy“–with potentially dangerous results.
But sometimes, medical lingo has …
I was making a mental packing list for a fall weekend at the beach: sweatshirt, jeans, sunglasses, those sandal things–you know, for walking on rocky shoreline? Kind of ugly, but useful? I could picture them clearly–the rubber soles and webbed uppers–but their name escaped me entirely. A person’s name, maybe? I started to go through the alphabet letter by letter, hoping for a clue. But it was gone. Not “wait, …
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The Pap smear, in which a clinician gently scrapes and brushes cells from a woman’s cervix (the lower portion of her uterus or womb), swishes them in a bottle of fixative solution, and then sends them to the lab to determine if the cells show pre-cancerous or cancerous changes caused by the sexually transmitted human papilloma virus (HPV), is a pretty simple procedure that takes less than a minute to …
Medicine, like politics, sports, and everything else, has gotten sucked into a 24/7 sound bite culture in which the most complex issues are spun into a few provocative words on news sites, TV, and radio shows. Enraged readers and listeners then weigh in. As the old expression goes, much heat, but little light ensues.
But three recent stories involving medicine are worth a closer look, and cooler heads.
First, consider theRead more…
On a night flight from Boston to San Francisco a voice came over the loudspeaker. “If there’s a doctor on board, would you please identify yourself by pressing your call bell?”
I reached up to hit the button, shrugging nonchalantly in response to my seat mate’s questioning look. “Duty calls,” my shrug was meant to convey.
But I didn’t feel nonchalant. What I felt was approximately two parts excitement and one part …
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When I was a kid, my pediatrician was a friend of my parents who practiced out of a first floor office in his home across the street from ours. He was a wonderful man and doctor, I’m sure, but I was terrified of him because I associated him with the injections he gave me periodically. Even when he and his wife came to our house for dinner I hid–just in …
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