Sometime during Thanksgiving, between the first bite of stuffing and the last touchdown or mention of an old grudge, someone will suggest that everyone at the table name something they're grateful for. And some people will roll their eyes. But they shouldn't. It turns out that being grateful and, more specifically, expressing gratitude, is good for your health.FULL ENTRY
November 22nd marks the fiftieth anniversary of the assassination of President John F. Kennedy. I am just barely old enough to remember that terrible day, but I do remember it--vividly. I recall sitting in my mother's brand new '64 Ford Falcon station wagon with the fake wood panel siding, parked in front of my older brothers' school. Mom had picked me up from morning kindergarten and we were waiting for my brothers to be dismissed--they got out early on Fridays-- when the announcement that made my mother gasp came over the radio: The president has been shot in Dallas.
It was only recently that I realized my memory is as inaccurate as it is vivid.FULL ENTRY
For decades now we've been hearing about rising rates of obesity and the health risks associated with excess pounds. But we've also heard that diets often fail, or even make people gain weight and that most diets are either ineffective or downright dangerous. No wonder my patients sometimes ask me: Isn't there any diet you'd recommend?
There is.FULL ENTRY
Until a few days ago, the most unpopular person on the Internet was the woman who posted this:
That woman has now been replaced as Most Hated in Cyberspace by the North Dakota woman who plans to withhold Snickers and Kit Kats from trick or treaters she deems overweight and, instead, hand them this note:FULL ENTRY
I didn't feel that great last week. I was tired, jittery, and had an upset stomach. Several of my patients mentioned they'd had similar symptoms and I concluded we all had a bug that's going around Boston: Red Sox fever.FULL ENTRY
Mark Twain once quipped: "Everyone talks about the weather, but nobody does anything about it." Is the same true of exercise? Despite a growing, multibillion dollar fitness industry, despite an increase in sales of treadmills, weights, and other home exercise equipment, despite public education campaigns like Let's Move, eighty percent of Americans--four out of five of us--do not get the recommended amount of cardiovascular and strength training. 41 million Americans belong to gyms--less than half of those actually go to them regularly.FULL ENTRY
A study by researchers at Brigham and Women's Hospital and Dana Farber Cancer Institute just published in the Journal of Clinical Oncology confirms what primary care doctors already know: marriage is often, but not always, good for your health. The study found that among more than a million people with common cancers such as colon, lung, breast and prostate, those who were married were more likely to be diagnosed early and stick through treatment, and survived longer than their single counterparts. WBUR's Commonhealth report about the study--"Nagging Wives Save Lives"--emphasized this particular finding: marriage benefits men's health more than women's.
The word "doctor" derives from the Latin verb docere: to teach and, as a doctor, I do often offer instruction. But when a woman in her eighties comes in for her annual physical and tells me she's still dancing, mowing her own lawn, and helping out her older neighbors, I have no illusions about which of the two of us should be doing the teaching.FULL ENTRY
In my practice, as in most medical practices, we accommodate patients' particular needs in all kinds of ways: wheelchair accessible rooms and hallways, interpreters of virtually all languages including American Sign Language, gowns and instruments in a wide range of sizes, information sheets and videos suitable for patients with a variety of educational backgrounds.
No one questions the appropriateness of these accommodations.
But what about when the doctor or nurse requires an accommodation?FULL ENTRY
Over 100 years ago, the great physician Sir William Osler said, "He who knows syphilis knows medicine." His point was that syphilis can affect so many parts of the body in so many different ways that its manifestations are a veritable encyclopedia of medicine. In the 1980's the same was said of AIDS.
Lyme disease is also a bit of a shape shifter, as I've been reminded this summer.FULL ENTRY
In the past few years, I've observed an epidemic of sorts: patient after patient suffering from the same condition. The symptoms of this condition include fatigue, irritability, insomnia, anxiety, headaches, heartburn, bowel disturbances, back pain, and weight gain. There are no blood tests or X-rays diagnostic of this condition, and yet it's easy to recognize. The condition is excessive busyness. It's one with which, as a fellow sufferer, I empathize especially.FULL ENTRY
During a recent visit to Dublin I was saw a neon sign in a pharmacy which read:
I was, first, amused by the wording. Dublin, home of George Bernard Shaw and Yeats and Joyce (and storytellers and bards in every pub) is a city with a deep and natural love of language--where even pharmacy signs are poetry.
But, next, I got to thinking. Am I "present" in my practice, even when I am in?FULL ENTRY
I also remember, years ago, the first time I entered an exam room and found the patient waiting for me tapping away furiously at a miniature keyboard with both thumbs. "My Crack-berry," he explained.
Is it appropriate or helpful to consider everything we eat/drink/do/watch/buy/use a lot an addiction?FULL ENTRY
For some reason, in my thirties, I began to feel anxious about flying. It happened--pardon the pun--out of the blue. I'd had no bad experiences and I am not particularly phobic. I know I'm in good company: my patients. One of the most common prescription requests I get is for anti-anxiety medicine for people who are afraid to fly. Fear of flying is very common, affecting 20%-30% of people. What, exactly, are we afraid of? Crashing, of course, and terrorism and then there's claustrophobia (fear of closed spaces) and acrophobia (fear of heights) and agoraphobia (fear of environments over which we have little control).
Now, there's something else to worry about in the air, something not common but much more common than most of the things we're already worrying about: a medical emergency.FULL ENTRY
A few years ago, while I was teaching in the hospital, a medical student presented the case of a man with coronary artery disease, diabetes, hypertension, and hyperlipidemia. When we entered the man's room I was surprised that the student had omitted a certain fact from his presentation: the man weighed well over 400 pounds.
No one argues that diabetes and blocked coronary arteries are diseases. And nobody argues that obesity, at least in part, causes these diseases--or that losing weight helps improve or even reverse them. But the question of whether obesity itself is a disease has been controversial.
The American Medical Association, the nation's leading organization of physicians, has just announced its stand on the question: obesity is a disease.FULL ENTRY
A fascinating op-ed piece by Brigham and Women's physician and Harvard Medical School professor Jerry Avorn appeared on June 11th in The New York Times. It's called "Healing the Overwhelmed Physician." What the 'overwhelmed physician" about whom Dr. Avorn writes is overwhelmed by may surprise you.
It surprised me.FULL ENTRY
In the aftermath of the Boston Marathon bombings, accounts of interactions like the one depicted in this brief video clip, in which a U.S. Marine who lost both legs in combat counsels a new amputee, reminded me of the power patients have to help heal other patients. Patient-to-patient healing occurs in many ways, formal and informal, from group medical visits to impromptu meetings.
In my most recent Boston Globe "In Practice" column, I wrote about patient-to-patient healing, including the story of a conversation between two of my own patients which was helpful in an unexpected way.
Have you experienced patient-to-patient healing?
I've invented a new medical term.
The Michael Douglas Factor: When a celebrity, even one with good intentions, uses his or her own condition to disseminate incomplete, misleading, or incorrect medical information.FULL ENTRY
True story: my late mom once lectured a guy who was nearly about to kill her. She warned him that his anger might lead to heart trouble.
She was driving on a country road and this guy started following her. When they reached her driveway, he jumped out of his car, pressed his red face against her window, and then backed away, saying: "Oh, so you're not the one who cut me off!" Mom rolled down her window and yelled after him: "Calm down, mister! Remember, your priority is your arteries!"
According to a study released this week by Harvard Medical School, Mom was right.FULL ENTRY
When Angelina Jolie announced that she'd undergone a bilateral mastectomy to prevent the breast cancer for which a genetic mutation puts her at high risk, I found myself, as a doctor and as a woman, full of admiration and gratitude for her...and also, in retrospect, for Betty Ford.FULL ENTRY
I confess I'm besotted with "Call the Midwife," the British series on PBS, now in its second season. It's based on the memoirs of a woman named Jenny Lee, who served as a young nurse-midwife in the slums of London in the late 1950s. What's so great about it? The usual stuff that makes a British series so appealing--the writing, the period costumes...those accents! But what draws me to the show is the portrayal of Jenny and the other nurses, pedaling around London on their bicycles to deliver babies and tend to the sick and poor. The nurses are knowledgeable and technically expert in matters of health, but equally interested in every other aspect of their patients' lives. Mother not bonding with baby? Elderly shut-in seeming lonely? Back on their bikes go the nurses. The show is like a fantasy of what nursing is like.
Except it's no fantasy. Park the bikes, lose the accents and the funny hats, and the nurses with whom I work are not so very different from Jenny Lee and her comrades.FULL ENTRY
"Just tell me the first thing that comes to mind," the doctor instructs the patient as he shows him the ink blots.
Not long ago I noted a certain older patient's name on my schedule. I really dreaded seeing her. It's not that I dislike her--in fact she's one of my favorite patients. It was just that I hated the prospect of seeing her looking as poorly as I knew she would. She'd been through so much: an accident resulting in devastating injuries followed by painful surgeries, and, worst, in the middle of
all that, the death of one of her adult children. Surely she'd be in awful shape, psychologically, if not physically. I mean, how much can one person take?
A lot, apparently.FULL ENTRY
Shortly after we moved here 23 years ago with our baby daughter, my husband and I went to a party. I met a man who had moved here 20 years earlier and asked him how long it took before he felt at home. “Hasn’t happened yet,” he answered.
But it did happen, eventually, for me.