In Bill’s room were his doctor, a medical scribe, a physician assistant, and a medical student. Not an imposing group, but in that moment each of them knew more about what was happening to Bill than he did. They were strangers who held keys to his fate.
The doctor first instructed the scribe to generate an electronic note. Then, he turned his …
Shared decisions are important. This example shows you why.
No one wants to hear that they have a disease. And yet everyone will develop some degree of degenerative disc disease (DDD) — or degenerative spine disease — over the course of a lifetime. DDD refers to a combination of age-related and wear-and-tear-related changes that occur within the spine over time. It is very common and a natural part of aging.
Most …
A neurosurgeon teaches us about degenerative disc disease
For many women, pregnancy is a wonderful experience. There are, however, many changes and challenges the mom-to-be can expect, and back pain is one of them. The good news for pregnant women is that the development of severe or debilitating low back pain is very rare.
The incidence of symptomatic low back pain that is severe is about 1 to 2 percent. …
Back pain during pregnancy: Advice from a neurosurgeon
“It must be nice.”
Without a doubt, this is my least favorite colloquialism in the English language. Though not explicitly stated in the phrase, I have always felt that it implied luck and/or privilege rather than plain old hard work. I have a problem with that because very few things in this precious world are easily obtained, whether it is a fit …
It must be nice to be a doctor. Except when it isn’t.
As a wife and mother, I have days that are very difficult, especially since my husband is in training. I go several days in a row where I only see him right before bedtime, and some days he is unable to see our son at all. I often feel like I have no control of our schedule, and am lucky to …
Fellowship training, as viewed by a physician’s spouse
$28 million was awarded to a patient for a late diagnosis of a pelvic tumor, an osteosarcoma. This rare cancer presented as a case of low back pain and sciatica. The patient claimed that if the osteosarcoma had been caught earlier that the subsequent surgery would have been avoided.
Could doctors have done better in diagnosing more quickly?
These cases strike fear into all primary care doctors. Which patient has a …
When the back pain red flags aren’t enough
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 28-year-old man is evaluated for pain on the radial aspect of the right wrist that occurs with use of the thumb. The pain has been present for 2 weeks. He has never had this pain before and has not had any trauma. He works as a computer programmer and plays video …
MKSAP: 28-year-old man with pain on the radial aspect of the right wrist
I read with interest the recent article written by Dr. Rourke Stay, “What ESPN doesn’t tell you about MRI in professional athletes,” and couldn’t agree more. The bigger issue, however, is what ESPN may leave out of broadcasts about sports injuries. Prominent figures on the air often espouse their knowledge with enough charisma to convince even the most doubting fan that their opinion is more than just an armchair …
Consult experts in sports medicine when discussing players’ injuries
“Failure is not an option,” people sometimes say. I don’t agree.
I certainly have failed far more often than I have succeeded when I sought to do novel risky business adventures and/or create new products. Without failure, I would never have learned the lessons of life or the lessons of business necessary to succeed in these spaces. As a physician and surgeon, I can tell you that failure is part of …
Failure is part of advancing health care
I have to admit, I’ve been excited to see radiology slowly infiltrate into the mainstream of sports. Fifteen years ago, it was rare for the public to know when an athlete had an MRI. Now I hear people in the coffee shop saying:
“Man did you see Derrick Rose go down last night?”
“Yeah, we’ll just have to see what the MRI shows.”
In …
What ESPN doesn’t tell you about MRI in professional athletes
“Katie, If you go into surgery, you’re going to miss patients.” It was three in the morning in the ED; the resident was feeling the strain of a 24-hour trauma call, and I was loving it. I had spent the past half hour with a lovely, older woman whose foot had gone through the floor of her vehicle in a crash. We chatted about where she had been traveling, and …
Reflecting on an orthopedic surgery rotation
How informed are doctors? The answer is not obvious. Doctors know enormous amounts of data and have years of clinical experience. Many have solid science backgrounds and some conduct research keeping them at the top of their field. Most rely on published studies to make their decisions on which products to use.
However, only a small percentage of all published studies are level 1 studies: the studies with data that is …
Relax the rules for approving medical devices
In the academic world, there is an unspoken rule under which faculty, residents, and fellows collectively live and work. Educational programs are to be separate from industry and its financial stronghold.
I understand the rule and its application in certain scenarios and clinical departments. But I would like to challenge it within my specialty of orthopedic surgery.
As I finish up residency and look ahead to fellowship, I am constantly thinking about …
Industry and academia: There is some educational value
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This is an open love letter about my left leg.
I broke it at a roller derby scrimmage in Detroit on September 6. It was my third time representing the Glass City Rollers on the road and the beginning of a long ordeal that has given me plenty of opportunity to reflect on my body and my wellness goals.
Before this injury, my …
An open love letter to my broken leg
Each year as the holidays approach, countless medical families prepare for the dreaded release of the holiday schedule. Will the physician spouse be home this year? Will the non-physician spouse be packing up three kids under the age of five and traveling across the country alone to visit family they may only see once a year? It can be stressful. It …
Married to a physician: Holiday blessings in disguise
The phone rang one evening and a pleasant voice was on the other end. “Hi, my name is nurse so-and-so and I’m the educational coordinator for your upcoming knee surgery. Do you want to go to the patient orientation session?” she asked. “It’s very helpful to go over things before and after your surgery and to answer any questions you might …
A cardiologist undergoes knee surgery. Read what he learned.
Another day, another pacemaker, at least so it seemed at first.
The usual greeting the patient, answering the last questions, consent signing, placement of the IV, EKG leads, prepping of the surgical site and initiation of the preoperative antibiotics were all recent memories. He laid there, smiling, knowing he’d made the right decision after years of struggling with his arrhythmia in other ways. His heart was showing signs of slight weakening and …
When the patient treats the doctor
It finally happened. After years of sitting at John’s bedside through multiple serious bike crashes, I had one of my own. I’ve had plenty of time to build up a ridiculous amount of smugness about why he crashes and I don’t. “John is reckless; Staci is cautious. John rides like an airplane engine on a shopping cart; Staci uses her head.”
I …
A physician undergoes hip surgery: 10 observations from bedside
An excerpt from The End of Back Pain: Access Your Hidden Core to Heal Your Body.
The evolution of our species has been powered and guided by a survival advantage. Our unique adaptation for survival lies in the development of a brain that can plan, worry, and abstract. Perhaps the most …
The mind-body association with back pain
Mrs. D was my last patient. I retired several months ago, and for some time prior I informed my patients so as to give them time to decide where they would like their follow-up care.
Mrs. D was an elderly lady who I first met in the ER several years prior after a fall resulting in a displaced ankle fracture. She was pleasant and alert, understanding everything I was explaining after …
A physician’s last patient before retirement
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