Patients and caregivers writing on KevinMD about illness and the health care system from the other side of the exam table: navigating care, the doctor-patient relationship, being heard, cost, 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 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 pay and who is left out when physicians leave insurance, see Direct primary care: what physicians say, in their own words. For what patients, families, and physicians have said about dying, hospice, and the decisions families face, see End of life: what physicians say, in their own words. For what physicians and family caregivers have said about growing old, dementia, nursing homes, and caring for aging parents, see Aging and dementia: what physicians say, in their own words.
Pity me as I wish to be pitied. That is the plea of the tortured protagonist in Leo Tolstoy’s brilliant 1886 novella, The Death of Ivan Ilyich.
Tolstoy was born in 1828 into Czarist Russia’s landed gentry. Though orphaned at a young age, he enjoyed the typical privileges wealth and title afforded—passive income, summers in the country, and enrollment at Kazan University. But it was later, after dropping out of school and …
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Ivan Ilyich gives voice to the agony of the afflicted
“Where there is love of humanity there will be love of the profession.”
-Hippocrates
Reading some of the blog posts and comments on the Internet, you might get the impression that a majority of American doctors hate their jobs. Actually, according Family Practice News, only 35% of my colleagues are unsatisfied with their careers, but that is still a remarkable number.
Are Hippocrates’ words implying an answer to why some doctors today don’t …
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Why doctors and patients have turned against each other
I would have told you, on our first visit, that I don’t do well with soft science. But you appeared rushed, with an office full of patients, and I did not feel that I needed to explain my personality. You see, I am a logical and rational thinker, and my primary goal in life is to understand the world around me. I need proof. And then I probably need even …
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The pivotal role of social media in patient support
Kids will swallow or poke up their noses, or into their ears the strangest things. I remember during my student days, I was doing a rotation in pediatrics when a 6 year old came into see us. I went in to take the history and her mom told me that her daughter had a very pungent odor to her, which she couldn’t get rid of.
I examined the patient and …
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Kids and their fascination with foreign objects
Sturdy and thickly-built, long since widowed, cheery in a sardonic sort of way, tough and opinionated, Flora’s European roots ran deep; she’d been an Italian farm girl, and she’d rather be in her garden than anywhere else. The only reason she agreed to come inside and go to the doctor was that her bowel movements had finally gotten too painful, and too bloody to ignore. Which she had been doing, …
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Discussing a colostomy in a patient with rectal cancer
Print out the eye chart, cover one eye, and see how you read it from 20 feet out. I failed line 8 abysmally.
I went for my annual check-up, and I must say, this doctor was thorough. In fact, he was too thorough. He told me way more than I ever wanted to know.
During the two-hour examination, I found out I’ve gained weight (too much ice cream), my blood pressure …
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Appropriately dejected after an annual physical
What is fibromyalgia and what exactly what does exercise have to do with the treatment and long-term outcome of the condition? A recent study published in Medicine & Science in Sports & Exercise is helpful in understanding the relationship between fibromyalgia and exercise and how clinicians (and patients) might find better strategies for treatment.
Fibromyalgia is a clinically defined pain syndrome estimated to affect about 5 per cent of the general population with criteria for …
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Exercise can help treat fibromyalgia
Ever dream of quitting your job, moving somewhere deliciously tropical and spending the rest of your days doing what you love (and even making a good, or great, income from it)?
This story isn’t about me, though some of you may know that I spent 2004-2008 living my dream life in Mexico (Puerta Vallarta and Los Cabos), making much of my income from my writing, dancing, coaching and speaking and occasional …
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Quitting your job and living the dream
How many times have you said to a friend or relative in need, “Let me know if there’s anything I can do to help,” and when you didn’t hear back, fail to follow-up? I’ve lost count of the number of times I did just that—fail to follow-up when I didn’t hear back from someone in need, even though I would have been happy to help in any way I could.
Yet, …
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How to ask for help when chronic pain or illness strikes
As the new school year begins, it’s only natural that there’s more awareness about learning and behavior issues. One of the most controversial topics that came up frequently is ADHD, or Attention Deficit Hyperactivity Disorder. It’s thought that 2-4% of children have this condition, and a shocking 50% of children with this condition are on some form of prescription medication. Not only is it seen in children, but adults …
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ADHD and the lack of quality sleep
Our first assignment for medical school involved reading and discussing Anne Fadiman’s The Spirit Catches You and You Fall Down, which describes how a clash of two cultures (medical and recently immigrated Hmong), miscommunication, and misunderstanding led to tragedy. Poignantly narrated, the book had the take-home message: if a patient does not agree with a physician’s reasoning why a disease developed and how it can be cured, then even the best …
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What do you think caused your disease?
Year: 2002
Setting: Gleneagles Hospital, Singapore
Position: Private general practitioner
I am the first and only non-Anglo-Saxon, foreign, private general practitioner in the city-state and the physician of reference for 14 embassies, consulates and a high commission from Europe, Asia, South America and Africa. One afternoon, a nurse comes into my consulting room saying that an ambassador from a European country has had an accident and that he insists on being seen immediately.
I …
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You cannot treat a patient against his will
I walked up to the closed door and paused, exhaling a deep breath weighted with disappointment, trying to clear my thoughts for the conversation about to come. My clenched fist was briefly suspended, mid-air, ready to knock. Beyond the door, I could hear muffled conversation and movement.
A calm, pretty woman stood beside me. An emergency department case manager. She held a notebook and pen, ready to jot down any useful …
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How our resuscitation efforts would be interpreted by fate
A torn meniscus. It did not disable but it impaired, and unpredictably. My stomach learned quickly to tighten at the sound of A.’s peculiar whimper in response to a crippling pain that would shoot through her at seemingly innocuous movements of the afflicted leg. We have health insurance of sorts, the type that will help you keep your home if tragedy strikes, but that does not shield you from the …
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The inability to locate price anywhere in the hospital
No pediatrician can answer the question: “What’s the most important thing I can do to keep my child healthy?” without listing three of four things. I’m no different, but right now family dinners are at the top of my list. You could argue that immunizations, car seats, bike helmets, 9-1-1, sleep, or good hand washing are just as important, and I won’t disagree. But it’s hard to overlook the overwhelming …
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Why the family dinner is important for your kids
As a geriatrician in a locale with many elderly retirees, I am frequently asked how long mom or dad (or both) can stay in their home and live safely and successfully. It is clearly a complicated issue even if the individuals involved are cognitively and mentally intact, physically capable and financially able to pay for support and help.
There is much to consider. Are the patients physically able to maneuver within …
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Patient safety in the elderly staying at home
