My French medical school professor of bacteriology, Mme. le Professeur Jeanne Orfila, stood in front of her (our) class near tears. She was not the sort of woman who frequently fell into that state, so I vividly remember the day she told us this:
“Prescribe antibiotics carefully, and only when you have to. Every time you prescribe antibiotics, you are creating more and more bacteria who will “learn” to make themselves resistant to antibiotics. So they will work less well against human disease. Read more on How Many Deaths Will It Take?…
Filed under Alternative Medicine, medicine, News by on Nov 5th, 2019. Comment. 
His mother had been seeing me and they had signed mutual releases. Mother wanted me to see him as soon as possible, because he was “nervous and unable to sit still at all.”
When he came, he denied a “nervousness” which his mother thought looked like “attention deficit disorder.”
I can’t treat what people don’t think they have.
He described problems with his girlfriend and his mother, since his mother had told him he could not go to a party in the home of his girlfriend’s family on the bad side of town, “where they would just as soon shoot you in the street as say ‘hello.'”
He sounded like he had pretty routine mother-and-girlfriend problems.
She contacted me on the weekend, worrying about him frequenting strip clubs, something I had not asked about and he had not told me about. Sometimes, she said he became so angry she physically feared him.
Their two narratives were simply inconsistent. I drew the line at her feeling scared of him physically.
I told her about “tough love,” and I told her if that happened again, to call the cops.
My husband reminded me of the ultimate authority in my profession — Hugh Laurie as “Dr. House” — who repeatedly said on television in public for all the world to hear, “Patients lie.”
Which one of them? Maybe both of them. I told her what I had told them; and would indeed, tell anybody who gave me the opportunity. I can try a session with the two of them together and help to resolve things, but I could not promise that it would resolve things. I would try. I always try as hard as I can to do the best that I can.
She said she knew this to be true.
I had told him and also told his mother on the phone, that the hardest thing a young man (or a young woman) ever had to do in his (her) life was establishing themselves as an individual distinct from parents. This usually meant a period of confusion before resolution. There may be (and there was) some confusion about vocational direction, too.
One can only press forward. The ability to communicate openly is precious, and irreplaceable.
- BE SURE TO CHECK MY FACEBOOK PERSONAL PAGE:
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Filed under Alternative Medicine, depression, Diagnosis, Disease, Family, life, medicine, Mental Illness, Personality Disorders, Psychology, relationships by on Oct 11th, 2019. Comment.
A new patient came in this week, referred by a trusted therapist. She had been sexually abused at approximately age 7. She was depressed.
She was on a combination of an antidepressant and a sleeping pill. It seemed to work as well an anything would. The medications were the same kind of medications that I would generally use. Older, reliable, out of patent (more than 7 years old) and thus available in cheap generics.
When I asked her how much of her depression it had made go away, she said “50%.” I ordered my usual list of blood tests. They seemed exotic to her.
We couldn’t even tell if they were things she got ordered in her “annual physical.” She had some kind of blood tests done a month ago. She was reluctant to have more drawn, so I told her we could get the old ones. She looked relieved.
?Relieved?
She was visibly overweight. She had paid a well-known diet center to follow their plan. She had gotten down to her “target weight,” then gone on to gain back most of what she had lost.
She was plagued by seborrheic dematitis. This is not usually a difficult thing to control. She could cut her hair (which went down past her shoulders). She could wash it daily with the prescription shampoo that her primary doctor had (correctly) prescribed. She could wear a little cap, perhaps like the sequiny little one that I showed her I had worn that day.
It was plain to see on her face that I was frustrating her, I just seemed to have more solutions than she had problems.
She asked me if she could return for her next appointment in a month.
She was not suicidal.
I made it clear that if I waited one month I would not increase her medication, for she would have to stay on the same if I were to wait so long until seeing her.
She didn’t mind.
She was not alone among my patients to feel as she felt. I have always failed to understand patients such as she.
Her previous psychiatrist and her previous therapist, had dragged her along for approximately two years.
She had contributed to paying their living expenses, with her fees. Maybe they had improved her status some. I mean, to be fair, I had not seen what she had been like when she started.
Depression is common. Far and away the most common of psychiatric illness, no matter what measurements or statistics you believe.
There are aspects of it that clinical trials of medication have shown, time and time again, get better. Things like sleep, appetite, mood, concentration.
Enjoying life, living your dreams, and such do NOT respond to medication.
Having the desire to correct things than annoy you and make your life better; that is somewhere between spirituality and magic for many of my wide-eyed depressed patients.
Sometimes I am angry at my colleagues. They seem to have accepted the limitations put upon them by government and insurance and economics.
This does not much help the patient.
It takes more than a couple minutes in my office to pump up these things.
I have said “stay tuned” before, but now I must try to bring this message to more media.
Science exists, and ought to be serving humankind.
Stay tuned.
Filed under abuse, depression, medicine, prescription drugs by on Sep 30th, 2019. Comment.
If you enjoy my memories of when I struck out on my own to France to attend medical school — an innocent abroad — you might want to read other entries on my Facebook page.
In this episode, after arriving in the small city of Amiens, I finally make it to the quartier de la rue Leon Blum where I would lodge. Read more on A Student Settles In…
It was August or so of 1973 when I traveled first to Amiens.
I had known I would never go to medical school in Paris. It seemed to me tradesmen striking was a sort of French National Pastime.
I decided to visit as many as needed of the official government medical schools and register. The cost was minimal and I had to pick the best, because my school’s heritage would be associated with me for the rest of my life. Read more on My Introduction To France And Locating My Medical School…
Filed under medicine, News by on Jan 4th, 2019. Comment.
Medical school in France was very cheap and open to anyone who wanted to enroll — at least for the first year. Only those who scored highest on year-end exams were allowed to continue to 2nd year.
Over 600 hopeful students enrolled that first year — but I worked extra hard and placed 38th. Only about a hundred were admitted. I was in!
Soon after I passed the “elimination contest” that was meant to let those of us who had scored best (and were allegedly the smartest) continue with the business of medical school. We had to get down to the business of learning things that we would need to function as doctors. Read more on My Training As A French Country Doctor…
Mature female patient: “So you’re Dr. Goldstein! Wow , you’re dressed so elegant! I mean I feel really self-conscious! I just threw on a t-shirt and shorts…”
Dr. G: “Don’t worry, darling. You got it right — I’m the one who’s supposed to get dressed up. Now, you’re not going to think much of me.” Read more on Dr. Estelle gets a new patient…smiling, laughing…
Filed under Alternative Medicine, depression, Diagnosis, Disease, Doctors, Education, Family, life, medicine, News by on Dec 24th, 2018. Comment.
I’ve read things by Dr. Pamela Wible before and she is definitely on a piece of the right track. Read more on “Patient Profiling” as a cause of medical error….
Filed under Diagnosis, Family, Government, Healthcare reform, life, medicine, News, politics by on Nov 10th, 2018. Comment.
She was an older woman, gray-haired and distinguished, one of those Canadian imports who had never forgotten her British roots. They were as close by as her slight English accent. I had known many people in Canada just like her, who would say “I’m just an old Brit” because that is what they felt like, in the “melting pot” America was alleged at one time to be, or in rich ethnic salad of Canada.
We knew her from her singing. We sang in a “showcase” of sorts in the San Diego region. My husband’s rich and jazzy baritone, my humorous songs or French songs long before my post-menopausal “croak” set in. Read more on Back To The Blitz…
Filed under Brain, depression, Diagnosis, Family, life, medicine, News by on Oct 23rd, 2018. Comment.
We are like horses with blinders on.
We see that a compound does one thing, and rarely think of it as capable of doing another. Read more on “Like Horses With Blinders”…
Filed under medicine, News, Research by on Oct 21st, 2018. Comment.