I can’t believe how many people come in to my office telling me that I don’t understand that their pains are from “getting old,” and that everyone, as they get old, has aches and pains and that is how it is. Read more on How Old Is Your Doctor?…
Filed under Aging, Doctors, End Of Life, life, News by on Dec 27th, 2017. Comment. 
She was an active patient, who I am still trying to see once a week until I direct her in how to survive and flourish in the universe. She was in her forties, depressed and anxious. She had “a little panic attack,” some chest pain and the feeling her breath was cut off. I wasted no time sending her to an Emergency Room, (or, if she really did not feel it was that bad, to an Urgent Care — what we used to call it a “doc in a box”) because it is cheaper, sounds less foreboding, and any doctor who is sentient and has a pulse and is on duty would send her to an Emergency Room if anything was really wrong.
Chest pain or tightness or shortness of breath or a “tight feeling, like a vice” could always be a heart problem, and could always be life threatening until proven otherwise. I tend to send even the most mild discomforts of this nature, that people had for years to primary physicians for a “cardiocentric examination.” For “auscultation,” the old fashioned Latin-origin word for a good listening to the well as generally an electrocardiogram and sometimes even an echocardiogram.
Filed under Diagnosis, Disease, Doctors, End Of Life, Family, life, medicine, News by on Jul 12th, 2017. Comment.
Filed under Aging, Brain, depression, Disease, End Of Life, Family, News by on Mar 2nd, 2017. Comment.
Filed under depression, Doctors, End Of Life, Family, Government, military, News, Stress by on Sep 11th, 2016. Comment.
People are not wired the same.
Individual differences are the spice of life and medicine. I love people, their verbal discourses, because they are so delightfully individual.
To me, the biggest problem with medicine is something I actually never heard anybody else discuss. I call it “norming.”
Maybe there is no other way to get started on developing a new treatment that could help many people who have similar afflictions.
But people are so different that what is life-saving for one may be poison for another. Read more on Dangers of Energy Drinks…
Filed under End Of Life, News, Stimulants by on Jun 24th, 2014. 1 Comment.
I don’t think we plan what our real specialties are going to be.
I frequently tell patients I am an expert on getting through menopause now that I have been able to come through my own relatively unscathed.
I became somewhat of an expert on Asperger’s because I diagnosed many elements of it in my father and just about all criteria in my brother.
They both carried additional diagnoses of bipolar (a.k.a. ‘manic-depressive’) illness. Neither one was in any way typical.
Both surely had their problems in life. My father was assisted considerably by his domineering mother who gave him lots — I mean lots — of direction. She even helped him choose a wife — my mother — who took care of the things in life that were difficult or even impossible for him. Read more on From Sandy Hook to Santa Barbara — Asperger’s Syndrome And Violence…
Filed under Asperger's, Brain, Diagnosis, End Of Life, News, Research by on May 28th, 2014. Comment.
Okay, let me get this straight —
Medical care costs are over $7,000 a year for seniors who keep on living, and over $37,000 a year for seniors in their last year of life.
That study was done nearly 20 years ago – so adjusted for inflation, that comes to: Read more on To Die Or Not To Die…
Filed under End Of Life, News by on Feb 14th, 2014. Comment.
Filed under End Of Life, News by on Oct 18th, 2013. Comment.
I have spent as little time as possible on the staff of hospitals. The interface between doctors and administrators has always seemed to be dominated by petty politics. People are interested in money, and secondary to that, some vague sort of reputation or power.
A large and prestigious Midwestern hospital used to have a certain kind of meeting every few months. This hospital had only the vaguest of University associations — just enough to make it look academic and research oriented. I knew perfectly well it was neither.
It was a luncheon meeting of the medical staff and a few administrative types — uncommonly well-catered. There were about 25 folks, but only two other women who looked as uncomfortable as I was.
The meeting was to discuss certain hospital statistics, including some case details. As the meeting agenda was passed around, the head of the hospital reminded us of the meeting “rules.” We were gently reminded that no recordings were permitted and neither were extraneous notes. We each received an agenda, which were carefully counted out as they were distributed. We were told that at the end of the meeting they would be collected — and counted — before any of us could leave. Read more on Hospital Accountability Is An Ideal (Not Always Reality)…
Filed under Diagnosis, Doctors, End Of Life, medical errors, medicine, News, prescription drugs by on Sep 24th, 2012. Comment.
Recently, a patient’s widow called to cancel a routine assessment because the patient suddenly died. There had been no freak heart attack and it had not been one of those undiagnosed cancers. He just “died, suddenly, in his sleep, I guess,” she said. That got me thinking.
The first class of drugs I think about, when I think of sudden death, are the stimulants. I remember when someone decided that everyone who was going to get stimulants needed to have a “cardiocentric” examination first. Doctors asked a lot of questions about chest pain, and administered an electrocardiogram. These precautions were especially interesting because they were – of course – used before prescribing Ritalin. Many child psychiatrists had laughed at me when I cautioned usage of this job, claiming it was the safest medication ever invented. Once – at the peak of my massive weight — an endocrinologist offered me a prescription of Meridia, to get rid of my excess weight. He did not think the fact that there had been a “few” reports of sudden death should get in the way of my using it. Read more on Sudden Death in Psych Patients — From Medicine…
Filed under depression, Diagnosis, End Of Life, medicine, prescription drugs by on Aug 19th, 2011. Comment.