Category Archives: Health

On Primary Care

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NaBloPoMo 2016, Letters to Pateints, Day 2

To Those Who Disdain Primary Care:

Maybe you don’t know what you’re missing.

“I don’t need a doctor, I never get sick.”  And yet, optimum health means so much more than the absence of illness.  I am called to steward your health as a whole person.  I value the chance to know you as such.  I seek to understand your temperament, your history, your past experiences, and how they influence your current perceptions and choices.  That is how I help you optimize your health—by reflecting your own patterns back to you, so you may determine how they serve you, and when they need updating.

So often our daily routines take the path of least resistance, like spring runoff tumbling inevitably downhill between the rocks and shrub roots of a mountainside.  Without attention and navigation, topsoil erodes and the landscape can get disorganized, unstable.  But with some intention and guidance, we can channel your energy and activities toward the mighty river of health.  There your strengths and motivation preserve the ecosystem that is your best you, for the long journey of life.

As a general internist, I have the privilege of getting the first call when something takes you down.  I get to hear the story first, to initiate the investigation.  If I know you already, I can apply history and context in the most personalized way.  Together we can examine and understand the mudslide triggers (there’s almost always at least one).  We can make an appropriate plan to slow the erosion, and then rebuild.  With each episode, our tools sharpen.  We become a team.

I relish the chance to help you dig deeper into your own capacities for self-care.  Each encounter is an opportunity to share and connect, in service of your long term health.  I want you to live not just to be an old man or woman, but a STRONG old man or woman.

But to do that, I need to know you starting now.  I need to connect with you early and often, in good times and bad.  It’s a relationship like any other.  I can’t help unless I see, hear, and understand.  There is no substitute for time and contact.  So think about it.  I’m here to help.

On Training

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NaBloPoMo 2016, Letters to Patients, Day 1

To The Patients Who Trained Me:

Thank you, from the bottom of my heart, and God bless you, every one.

To the elderly lady with heart failure, who donated your body to science so that I may learn anatomy:  You were the greatest gift.  Your heart was literally as big as your head, and at the time I just thought it was peculiar.  Now I understand the extraordinary adaptive capability of the human body, and I marvel at it every day.

To the inpatients who endured hours of repetitive interviewing and clumsy physical exams by us medical students, all in the name of teaching:  Your engagement in the midst of your own suffering testifies to the infinite potential generosity of humanity.  Your contribution to medical education cannot be overestimated.

To the kindhearted artist in my resident clinic, the first patient to page me for advice:  You showed me that I knew what I was doing, even in training.  You had classic of sinusitis, and I called in the appropriate prescription.  In a moment of sudden panic I wondered if I should have called my preceptor first.  No, I can do this, I realized.  I’m meant to do this.

To the articulate, confident housewife whose retired husband drove you to me in acute agitation:  I learned from you that life phases never cease to evolve.  Our relationships, however longstanding, hold infinite complexities that manifest in jarring and also predictable ways throughout life.  You taught me that stability is overrated, and also underappreciated.

To the wonderfully kind man, one of my first patients in practice, who came in with the nasal balloon:  Your patience and trust will humble me forever.  The emergency room doctor had placed the balloon for a prolonged nosebleed.  He instructed you have me take it out.  I had never seen such a device before, much less deflated and removed one.  You let me examine it, think it through, and finally just cut the tubing with scissors.  We bonded over that and you continued to teach me about collaboration and sharing between patient and physician all the while I knew you.

To all whom I encountered in those early years:  There are too many of you to name, too many to acknowledge fully.  But every one of you helped make me the physician I am today.  With each new meeting now, each applied principle and physical exam technique, I thank you and honor you, my esteemed teachers.

NaBloPoMo, Here We Come!

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The Cubs have won game 5 of the World Series.  Halloween is tomorrow.  In two days I will commit to publishing a post a day for 30 days.  Woo hoooooooo, bring it!!  It’s been a year since I tried this the first time, and I almost made it—26, I believe, and a few may have been reblogs of others’ work…  I felt embarrassed about the ‘failure.’  But then I got through the A to Z Challenge by the skin of my teeth this past April (last post at 11:30pm on April 30th), and that was much more fun.  So I’m trying again, yaaay!

I launched this blog 18 months ago to address physician-patient relationship.  I aimed to discuss communication, self-awareness, and emotional intelligence, as tools to rekindle that trusting, continuous bond that so many of us miss in medicine today.  Since then I have come around to the original theme occasionally, but not nearly as often as I had intended.  So I take this annual blogging event as an opportunity to refocus and try something new.

For Na Bo Po Mo 2016, I intend to write 30 letters to patients.  Some will echo routine conversations; others may reflect my musings on this vocation.  I may examine observations on the state of medicine today.  Or other things, who knows?  I will at least attempt to convey my deep love for the work and the people.  Maybe I can help fellow physicians and patients connect, or perhaps lend some perspective and awareness.

There is a lightness to trial and error.  When you try something new, you make a commitment, set an endpoint, and decide how you will measure the outcome.  But you don’t have to attach yourself to a particular outcome, just the process.  I commit to try my best and have fun, and see what comes out, in fewer than 500 words per post.  I wonder where this will lead?  Maybe it will turn into a monthly newsletter for my own patients?  A book?  A column somewhere?  Anything is possible!  I’ll never know until I try, and I like the openness of the adventure.

I hope you will visit often, and leave your thoughtful comments.

Let the journey begin!