What medical mysteries can it teach us about getting better healthcare?
I checked in with Sandra to learn more about how she wrote the column and what lessons we can learn from it.
Here is our edited conversation.
Q: How do you choose your ideas?
a: It must be something I didn’t write about. It should be a solved case. I need to know the final diagnosis. Although it is a solved case, there must be a mystery. And there must be a human story.
Q: Once you choose a case, how do you report it?
a: I ask for a chronology of events and medical records confirming the diagnosis. The medical records and chronology enable me to see whether this was indeed a mystery, and whether it was revealed in an interesting way. Would this be an interesting case?
Then I interview the patient, sometimes the parent, sometimes the spouse. The final step is to talk to the doctor who diagnosed you or your current treating doctors. Any step along the way, the process can fail.
Q: Do you write about unresolved issues?
a. No, it should be a solved case. So many people write to me and say, “I have this problem, can you help me?” Unfortunately, that’s not what I do. I once wrote about a Detroit lawyer who went into the Undiagnosed Diseases Program at the National Institutes of Health. He’s seen over 100 doctors and still doesn’t have an answer. But I thought his case was so unusual and interesting, I made an exception at that time.
Q: What are some of your most memorable medical mysteries?
a: I wrote about a family who kept suffering from frequent sore throats. They couldn’t figure it out. Share an adventurous vet. It turns out that their cat may have been the carrier. When they finally treated the cat, no one had streptococcus.
One of the strangest – there was a woman who had serious kidney and heart problems. Turns out she was eating a lot of licorice. That was really strange.
I still distinctly remember a State Department worker who had a very itchy head at night. She even had a form of cancer. She has seen many dermatologists. Turns out she’s had head lice for a whole year. How did they miss that? That was really amazing.
Q: What did you learn about the medical system from writing about medical mysteries?
a. Medical care is becoming increasingly specialized. Doctors are aware of a small part of what’s going on, but diagnosis is an inherently complex process. I also think time pressure is getting worse. It’s like: “You have 10 minutes. Go.” This will not work with a complex problem.
I also think patients are sometimes not very good at describing problems. Those who tend to perform the best are organized and can describe their symptoms in a way that is understandable to a physician.
Q: What is the best advice you would give patients for better medical care?
a. Primary care physicians can really help a patient. I often see people who go straight to the specialists. They may not have a primary care physician, or use urgent care when they are sick. It can be problematic. People really underestimate the role of a good primary care physician.
2022 Well + Being Gift Guide
Need a gift idea? The Well + Being team shared our favorite finds for cooking, exercising, spending time at home, improving our mental health, gifting your pets, and more.
Some gifts are practical and affordable; Others are obvious bragging. I just bought air fryers for my family because Eating Lab columnist Anahad O’Connor recommended it. Runners will appreciate the perfect running shorts recommended by fitness writer Kelyn Soong. Amanda Morris, who writes about disability, suggested hearing aid jewelry. Reporter Teddy Amenabar has found the perfect travel coffee mug.
There are so many to choose from, and each ingredient has brought us closer to living a healthy, fulfilling life. We hope they do the same for you and your loved ones this year.
feeling full? do not worry. Your stomach probably won’t explode.
A reader asked this week: I always feel like my stomach is going to explode after eating Thanksgiving. Could that really happen?
While it’s theoretically possible, it’s extremely unlikely that your stomach will explode from overeating, said Sophie Balzura, MD, associate clinical professor of medicine at New York University Grossman School of Medicine and gastroenterologist at NYU Langone Health. she writes:
Your stomach is a powerful organ, with thick muscular walls and a rich blood supply that can easily hold up to even a hearty Thanksgiving meal.
The stomach also has a remarkable ability to expand from its comfortable size without a significant change in pressure. Even before the first bite of turkey hits your mouth, anticipating it — whether through smell or sight — sends a signal to your brain that’s delivered to your stomach, telling it to get ready for food. While eating, the stomach expands, creating more space.
But a stomach rupture occurred. One case report concerned a 24-year-old female patient who visited an emergency room in Turkey with sudden abdominal pain, vomiting, and nausea after eating an excessive amount of fruit. An abdominal surgery revealed that her stomach was perforated and contained nearly five liters of partially digested food, including grapes and pomegranates – a volume clearly exceeding the volume most human stomachs can hold.
To learn more, read Balzura’s full answer on Everyday Health: If I Eat Too Much, Will My Stomach Explode?
It’s been another busy week! Check out these stories from the team.
How exercise affects your appetite on Thanksgiving: Intense exercise can suppress appetite for a few hours. But regular moderate exercise can make you hungrier.
Invite pets to the feast? Learn What Foods You Can and Can’t Share: Veterinarians Offer Guidelines For A Fun And Safe Vacation With Your Furry Family.
9 Tips for Dealing with Grief with Kids During the Holiday Season: Check in with yourself and your kids, show yourself some nurturing, and create new traditions.
My mom’s diet affected me, too: My mom’s obsession with weight isn’t unique. Researchers have studied how a mother’s restrictive eating habits can affect her children, especially daughters.
What is the difference between RSV, influenza and covid-19? Three respiratory viruses overwhelm families and hospital systems. Here’s advice from infectious disease experts.
The Most Common Disabled Hand Condition You’ve Never Heard Of: People with Dupuytren’s contracture often mistakenly assume they have arthritis or tendonitis, or don’t notice a problem until their fingers start to bend.
Why your doctor doesn’t seem to care about you: Many patients define care as… Listen, investigate, follow up and defend findings. This kind of care takes time and resources that many doctors don’t have access to, says Shailene Obobe, MD, MD.
Please let us know how we are doing. Email me at email@example.com.
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