It is hard for me to digest the events of July 14 in Nice, France, as I feel especially close to them.
I was present at seven such annual patriotic ceremonies during my tenure as a student of medicine in a French government facility. I loved the street-fair atmosphere, where I sang at the top of my lungs and danced with a whole heart.
As a medical student in government service, a terrorist attack would have mobilized me into service of France, a nation I can only love, which gave me a medical education essentially free of charge, asking only for me to prove on an exam that I had what it takes.
I wear a tiny Eiffel Tower around my neck — I stroke it as I write. Read more on Terrorism In Nice…
The Catholics have a history of making heroes out of those who suffer the most. I really don’t know what kind of reaction this young man should expect from his “very Catholic” grandmother when she finds out he is using medical marijuana.
My patient is 27, on dialysis, and looking for a kidney transplant to stay alive. He takes medical marijuana to increase his appetite and well being, as well as minimize the pain and anxiety of his situation. I have promised that I will not stop trying to help him. We will go as far as we need to, raising funds if necessary. My help will likely include taking him “public,” using the media. Read more on How Can We Explain Medical Marijuana to a Catholic Grandmother?…
The patient was no Paris Hilton, and the clinic where I saw her is not someplace Ms. Hilton would ever frequent. But one thing the two women had in common was carrying a dog in a handbag.
I often see ladies carry in more than one bag – a standard handbag and perhaps a sack full of medical records. I’d never had anyone bring a purse-dog in to an interview, though. Read more on Is There Anything A Service Dog Can’t Do?…
My dear, remarkable father of blessed memory was no mere a musician. He was a Harvard-trained composer and arranger, played that complicated organ at his temple for fifty years, and was very, very serious about music.
In fact, he was so serious that only “serious” music could be played in our household. After all, he was a classmate of Leonard Bernstein, and studied under Aaron Copland and was one of the few fellowship students allowed to attend lectures by the great Stravinsky.
Now THAT’S serious!
As such, I missed out on popular music while growing up. I was not allowed “American Bandstand” after school. I was not give Beatles records. We didn’t even watch Elvis on Ed Sullivan.
Ahh – 19 years old! It is a magical age. At least it has been my experience in public mental health clinics.
You see, almost without exception any male of 19 years who appears in my office – is a really messed up and sometimes just, plain rotten fellow.
I don’t know what it is about 19.
One of the typical cases – though legally an adult — was functionally a kid, living with his parents and acting out the same kind of adolescent rebellion that most go through at 14 or 15 and out-grow by 17.
Oh, he had it all — One of those cylinders in his earlobe, spreading a hole from a small piercing to the size of a basketball. He told me it was “tribal.” He was a music major at a local, broken down branch of the state college. He wanted to be a performance artist.
I think it was in my first practice, straight out of residency, that I learned about sleep apnea. He was a private patient, a man about 40, who had his sleep apnea treated when some enterprising ENT (Ear, Nose and Throat doctor) fried his too-large tonsils.
Within the day or two it took the surgery to heal, he came to the office to tell me that his symptoms of anxiety and depression were totally gone. Well, if I had trouble breathing, I would be anxious and depressed too. You want to get that oxygen, continuously.
Even if the tests , which technology has simplified over the years, show that you’ve got plenty enough oxygen in your blood, the fear of losing oxygen has got to be significant. I remember, even as a little kid, with hay fever attacks, what it felt like to gasp for air. I can only start to imagine what it is like for those who gasp for air in the middle of the night.
So at a later time, a different patient shows up, a 53 year old man, and he tells me he wants some Xanax or at least some Ativan. I have someone count his respirations — 14 in a minute, not too bad. He is using the muscles in his neck to hike up his chest to breathe. He has recently stopped smoking, much to his credit, but still has a solid diagnosis of COPD, (chronic obstructive lung disease) and this guy got it in spades, but the question remains does he have sleep apnea?
We are lucky. His diagnosis was confirmed by a sleep study. This means someone had to watch and measure him all night. He is still shocked that I made the diagnosis just by asking questions. Not that it is hard to tell what is going on. I heard a little bit of wheezing without a stethoscope.
First things first — I was not going to prescribe anything that could depress his heart or breathing. That meant no Xanax. To say that he was not happy with me was — at best — a gross understatement.
Then I got up the guts to tell him the truth. “Until we treat your sleep apnea, your anxiety and depression are NOT going to get better.”
Now when I first started telling this to people, the relationship between depression and anxiety and sleep disorders may have been something someone could debate. Not now.
Read more on Sleep Apnea Links To Depression, Anxiety…
I was working in psychiatry at one of those university medical centers, in a big city in the middle of a sparsely populated state. This 54 year old Caucasian farm wife had been referred to me by a surgeon — a rare state of affairs, since most of the surgeons I knew at that time and place did not believe in psychiatry and would not have referred a patient unless out of desperation. No note, no phone call to the front desk of the psychiatry clinic, no nothing. She just walked in and explained that the surgeon had basically kicked her out and said she was crazy. I asked her why they sent her. Her answer is so burned into my consciousness that I can give it verbatim these many years later.
“It really bothers me that I don’t have a belly button.” Read more on Somatization Is Something To Talk About…