Author's posts
Depression is a notification that the old patterns are not working
My energy level was plummeting as Mrs. Jones explained how much her shoulder, her knees, her back, her belly, her head, hurt. She was worn out. “And I don’t ever think I’ll feel better. I’ve felt like this for so long and I thin…
Thinking about frailty like slow-moving PTSD
A week after surgery, I removed my splint to take a shower. Now, unprotected, my wrist was made of glass. With my splint on, I was clumsy, but invincible. I did not feel frail until I removed my splint. The shower floor did not feel very different from…
When your doctor says you have dementia, don’t argue with her
I know you want to. I know you would rather have anything other than dementia—even cancer. I know you are happy with your life and want it to continue as it is. If it has to change, I bet you’d like to slowly become more frail until one night you just …
Dementia is worse when coupled with inadequate preparation
The chances that you or someone you love will be diagnosed with dementia are shockingly high. By age 65, your chances are already at 9 percent. Make it to age 85, and the chances go up to 33 percent. Of course, if you’re diagnosed with dementia, it wil…
A quick CT scan for the frail and elderly
First, you have to call up your daughter to pick you up and take you to the lab. It’s hard for the nurse to find your vein. The pain from his fishing around in your arm is not nearly as bad as the pain you always have in your hip, and back, and shoulde…
Warning: The medical system is fragile. And that’s OK.
Because everything around us usually works, it can be easy to forget how fragile some of the workings are. My patients see this with their bodies, as they fail, but not so apparent to them are the fragilities of the health care system that we doctors g…
The key to being an attending physician
When I graduated from residency, I was too worried about killing my first few patients to examine the meaning of being an attending physician. An early patient, a 97-year-old retired doc, brought it to my attention. “Being an attending physician means …
What it means to be an attending physician
Dr. Ryme had been retired at least thirty years from medicine when he met me, his last pupil. I was a freshly minted doctor, and he became the first teacher of a new course at my new school called “Life as an Independent Doctor.” At our first office vi…
After a spouse’s death, a physician is showered with gratitude
I saw Kaitlin (identifying information changed) and her husband Brandon seven days before she died. Kaitlin’s cancer had been in remission at our last visit, but this day she looked awful. I estimated she had less than three months to live. As I …
Asking patients the right questions isn’t as easy as you think
I made my 10:20 a.m. patient wait while I told my support staff about my day off. “I was getting an ice cream when I saw a car accident. By the time I got there, it was clear that there were no serious injuries and all I did was to distract the p…
