By Hedy S. Wald
Take two Tootsie Rolls and call me in the morning. Self-prescribed for sweet tooth me. Not such a blasphemous “drug of choice” (I’m not even using caffeine!) but it’s New Year’s, that infamous time of resolutions. And I’d like to “kick the habit,” do all that stuff the nutritionist advised and ramp up the gym visits. Jogged 2 miles and took a 1/2 mile swim today to start the new year “right” – hopefully burned off the chocolate high. Fueled by endorphins and feeling oh so optimistic, I’m writing this blog. The question is – what happens on January 2?
The ongoing effort to implement and sustain behavior change has given me a profound appreciation for some of the struggles our patients (and even our colleagues and students) endure. Harnessing motivation can be tough and self-flagellation for not following through can make it tougher . . . this is where some self-compassion with an attitude of kindness and acceptance toward ourselves may make a difference (1). Self-compassion can promote self-improvement motivation given that it encourages us to confront mistakes or weaknesses without either self-deprecation or defensive self-enhancement. (2) According to Breines and Chen, “resolving to make changes can be scary, as roadblocks and setbacks are inevitable along the way. From a self-compassionate perspective, however, there is less to fear.” (2)
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By Robert Frysztak
Many stories have been written by physicians describing their personal experiences as a patient. But I cannot recall reading a similar perspective from a research scientist or medical educator, one who has intimate knowledge of anatomy and physiology paralleling or exceeding that of most physicians. I would like to share with you my personal story of my recent encounter with the medical community.
I was diagnosed 18 months ago with a medical condition that, initially, was thought to be relatively common. My family physician referred me to a specialist that started me on the standard conservative approach of a prescription medication. After 6 months of trying the various medications available with no sign of improvement, the scientist in me began asking questions. I wondered how long a normal patient would continue to follow along with their doctor’s recommendations if they were not having success. I explored all the medical research I could find on my condition. I reached out to colleagues here at the medical school, and even spoke to students and residents who were working with other doctors in the field. At this point, I decided to change doctors. My new physician really listened to me, looked at my research, and together we decided to try a new treatment regimen. This type of collaboration is probably rare, with most patients accepting both the doctor’s diagnosis and treatment plan without question…
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By Tim Lahey
Two days ago, Jimmy stuck a used needle into the soft skin of his forearm, and released 20 milligrams of black tar heroin and a bolus of bacteria into his blood.
The bacteria floated from vein to artery as he nodded, eventually sticking themselves to the ragged edge of his aortic valve. There they multiplied and burrowed until each systole whipped a two-centimeters of snot back and forth in his atrium.
Fevers came first, which Jimmy ignored while buying more black tar at a rest stop on I-91. A day later, little red stigmata appeared on the palms of his hands as plugs of snot lodged in small vessels there.
When he couldn’t breathe, Jimmy went to the ER. My medical student and I met him there as he shook in bed. A snarl of IV lines snaked under the covers.
Jimmy gave one-word answers to my questions, and did not open his eyes…
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By Manveen Saluja
A number of years ago a woman in about 50 year old presented to my office complaining of “walking on a vein” in her left foot. She reported having seen a number of physicians – 9 in total – with no successful resolution. She was told that there is no vein that could possibly roll under her foot, and her complaint was dismissed.
Her past medical history was significant only for a healed fracture in her left foot that occurred 9 years ago. She believes the sequela to the fracture is that “a vein rolls under her foot” as she walks. She does not experience pain in the foot, but she is very distressed because she can’t walk or dance as she could before the fracture. As I talk with her, I realize she has been experiencing this unpleasant sensation every time she walks for 9 years…
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By David Leach
On March 1st my aortic valve was replaced. I received extraordinary care, was discharged on the third postoperative day, and am doing very well. When I arrived from the operating room to the intensive care unit I had an endotracheal tube, two chest tubes, an arterial line, a jugular vein Swan-Ganz catheter, two 14 gauge intravenous lines, a urinary catheter, various chest leads monitoring my heart rhythm, a pulse oxygen monitor and I have rarely felt better. In fact I was filled with joy. The Society of Thoracic Surgeons rates the 1300 plus cardiovascular surgery programs in the U.S. and I was happy to discover that my local thoracic surgery program was highly rated. I was grateful to have a disease that was fixable and a surgeon who knew how to fix it. I was also terrified at what I would have to go through to get it fixed. I did not anticipate joy…
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