GJZH
04-03-2007, 12:53 AM
This book is an interesting read and should be read by all Chronic Pain Patients...It had me in tears reading the first chapter....I think I suspected this but did not want to admit something he states about most doctors. Judith Hall, a researcher from Northeastern University states that the doctor is supposed to be emotionally neutral and evenhanded with everybody, and we know that is not true. Hall discovered that the sickest patients are the least liked by doctors, and that very sick people sense this disaffection. Overall, doctors tend to like healthier people more. Why is this? Many doctors have deep feelings of failure when dealing with diseases that resist even the best therapy; in such cases they become frustrated, because all their hard work seems in vain. So they stop trying. In fact, few physicians welcome patients like Anne Dodge warmly.
I certainly hope our Pain Docs do not feel like this about us...I doubt that Pain Docs feel like this or they would not go into this field. They must know that most of us are not going to get better...though some might. My pain doc told me what most docs have already ...to expect to always be in pain...I will never be pain free...I think the surgeon that did my lumbar spine already dreads seeing me...I can see it in his face ....I feel guilty when I see him...It is an awful appointment and I have to see him this month for my annual appointment...It will be one year since my surgery....I am really not much better since before the surgery...In fact, today I went shopping with my son and I was in such pain I almost cried and had to keep finding places to sit...Standing is an impossibility and walking is difficult as well....
Maybe rhizotomy will help...I have hypertrophic degeneration of the facets and hyerptrophic spurring throughout the lumbar spine...They cannot read much else...there is too much arcing...but I have sciatica type pain down the front and back of the legs...burning pain...so maybe Rhizotomy would help at this juncture...I just had two injections into the hips and that has helped tremendously...so we will see....It is awful to think though that a doctor does not want to see you or regrets taking you as a patient...I was so hopeful about this surgery and my surgeon...I really like him and would hate to think he dreads seeing me...I really do try to be upbeat with my docs...not all gloom and doom...There has only been one time that I let down my guard and cried...and I vowed to never do it again...I always wear make-up and try to look bright and cheerful whether I feel that way or not...Maybe it would be best not to go back...
http://www.nytimes.com/2007/04/01/bo...juhPOL1kE8z1Hg
First Chapter
‘How Doctors Think’
By JEROME GROOPMAN
Published: April 1, 2007
Anne Dodge had lost count of all the doctors she had seen over the past fifteen years. She guessed it was close to thirty. Now, two days after Christmas 2004, on a surprisingly mild morning, she was driving again into Boston to see yet another physician. Her primary care doctor had opposed the trip, arguing that Anne's problems were so long-standing and so well defined that this consultation would be useless. But her boyfriend had stubbornly insisted. Anne told herself the visit would mollify her boyfriend and she would be back home by midday.
David Carmack
Jerome Groopman, author of the book "How Doctors Think."
Related
'How Doctors Think,' by Jerome Groopman: Where Does It Hurt? (April 1, 2007) Anne is in her thirties, with sandy brown hair and soft blue eyes. She grew up in a small town in Massachusetts, one of four sisters. No one had had an illness like hers. Around age twenty, she found that food did not agree with her. After a meal, she would feel as if a hand were gripping her stomach and twisting it. The nausea and pain were so intense that occasionally she vomited. Her family doctor examined her and found nothing wrong. He gave her antacids. But the symptoms continued. Anne lost her appetite and had to force herself to eat; then she'd feel sick and quietly retreat to the bathroom to regurgitate. Her general practitioner suspected what was wrong, but to be sure he referred her to a psychiatrist, and the diagnosis was made: anorexia nervosa with bulimia, a disorder marked by vomiting and an aversion to food. If the condition was not corrected, she could starve to death.
Over the years, Anne had seen many internists for her primary care before settling on her current one, a woman whose practice was devoted to patients with eating disorders. Anne was also evaluated by numerous specialists: endocrinologists, orthopedists, hematologists, infectious disease doctors, and, of course, psychologists and psychiatrists. She had been treated with four different antidepressants and had undergone weekly talk therapy. Nutritionists closely monitored her daily caloric intake.
But Anne's health continued to deteriorate, and the past twelve months had been the most miserable of her life. Her red blood cell count and platelets had dropped to perilous levels. A bone marrow biopsy showed very few developing cells. The two hematologists Anne had consulted attributed the low blood counts to her nutritional deficiency. Anne also had severe osteoporosis. One endocrinologist said her bones were like those of a woman in her eighties, from a lack of vitamin D and calcium. An orthopedist diagnosed a hairline fracture of the metatarsal bone of her foot. There were also signs that her immune system was failing; she suffered a series of infections, including meningitis. She was hospitalized four times in 2004 in a mental health facility so she could try to gain weight under supervision.
To restore her system, her internist had told Anne to consume three thousand calories a day, mostly in easily digested carbohydrates like cereals and pasta. But the more Anne ate, the worse she felt. Not only was she seized by intense nausea and the urge to vomit, but recently she had severe intestinal cramps and diarrhea. Her doctor said she had developed irritable bowel syndrome, a disorder associated with psychological stress. By December, Anne's weight dropped to eighty-two pounds. Although she said she was forcing down close to three thousand calories, her internist and her psychiatrist took the steady loss of weight as a sure sign that Anne was not telling the truth.
That day Anne was seeing Dr. Myron Falchuk, a gastroenterologist. Falchuk had already gotten her medical records, and her internist had told him that Anne's irritable bowel syndrome was yet another manifestation of her deteriorating mental health. Falchuk heard in the doctor's recitation of the case the implicit message that his role was to examine Anne's abdomen, which had been poked and prodded many times by many physicians, and to reassure her that irritable bowel syndrome, while uncomfortable and annoying, should be treated as the internist had recommended, with an appropriate diet and tranquilizers.
Go to the link to read the remainder of the first chapter.....
I certainly hope our Pain Docs do not feel like this about us...I doubt that Pain Docs feel like this or they would not go into this field. They must know that most of us are not going to get better...though some might. My pain doc told me what most docs have already ...to expect to always be in pain...I will never be pain free...I think the surgeon that did my lumbar spine already dreads seeing me...I can see it in his face ....I feel guilty when I see him...It is an awful appointment and I have to see him this month for my annual appointment...It will be one year since my surgery....I am really not much better since before the surgery...In fact, today I went shopping with my son and I was in such pain I almost cried and had to keep finding places to sit...Standing is an impossibility and walking is difficult as well....
Maybe rhizotomy will help...I have hypertrophic degeneration of the facets and hyerptrophic spurring throughout the lumbar spine...They cannot read much else...there is too much arcing...but I have sciatica type pain down the front and back of the legs...burning pain...so maybe Rhizotomy would help at this juncture...I just had two injections into the hips and that has helped tremendously...so we will see....It is awful to think though that a doctor does not want to see you or regrets taking you as a patient...I was so hopeful about this surgery and my surgeon...I really like him and would hate to think he dreads seeing me...I really do try to be upbeat with my docs...not all gloom and doom...There has only been one time that I let down my guard and cried...and I vowed to never do it again...I always wear make-up and try to look bright and cheerful whether I feel that way or not...Maybe it would be best not to go back...
http://www.nytimes.com/2007/04/01/bo...juhPOL1kE8z1Hg
First Chapter
‘How Doctors Think’
By JEROME GROOPMAN
Published: April 1, 2007
Anne Dodge had lost count of all the doctors she had seen over the past fifteen years. She guessed it was close to thirty. Now, two days after Christmas 2004, on a surprisingly mild morning, she was driving again into Boston to see yet another physician. Her primary care doctor had opposed the trip, arguing that Anne's problems were so long-standing and so well defined that this consultation would be useless. But her boyfriend had stubbornly insisted. Anne told herself the visit would mollify her boyfriend and she would be back home by midday.
David Carmack
Jerome Groopman, author of the book "How Doctors Think."
Related
'How Doctors Think,' by Jerome Groopman: Where Does It Hurt? (April 1, 2007) Anne is in her thirties, with sandy brown hair and soft blue eyes. She grew up in a small town in Massachusetts, one of four sisters. No one had had an illness like hers. Around age twenty, she found that food did not agree with her. After a meal, she would feel as if a hand were gripping her stomach and twisting it. The nausea and pain were so intense that occasionally she vomited. Her family doctor examined her and found nothing wrong. He gave her antacids. But the symptoms continued. Anne lost her appetite and had to force herself to eat; then she'd feel sick and quietly retreat to the bathroom to regurgitate. Her general practitioner suspected what was wrong, but to be sure he referred her to a psychiatrist, and the diagnosis was made: anorexia nervosa with bulimia, a disorder marked by vomiting and an aversion to food. If the condition was not corrected, she could starve to death.
Over the years, Anne had seen many internists for her primary care before settling on her current one, a woman whose practice was devoted to patients with eating disorders. Anne was also evaluated by numerous specialists: endocrinologists, orthopedists, hematologists, infectious disease doctors, and, of course, psychologists and psychiatrists. She had been treated with four different antidepressants and had undergone weekly talk therapy. Nutritionists closely monitored her daily caloric intake.
But Anne's health continued to deteriorate, and the past twelve months had been the most miserable of her life. Her red blood cell count and platelets had dropped to perilous levels. A bone marrow biopsy showed very few developing cells. The two hematologists Anne had consulted attributed the low blood counts to her nutritional deficiency. Anne also had severe osteoporosis. One endocrinologist said her bones were like those of a woman in her eighties, from a lack of vitamin D and calcium. An orthopedist diagnosed a hairline fracture of the metatarsal bone of her foot. There were also signs that her immune system was failing; she suffered a series of infections, including meningitis. She was hospitalized four times in 2004 in a mental health facility so she could try to gain weight under supervision.
To restore her system, her internist had told Anne to consume three thousand calories a day, mostly in easily digested carbohydrates like cereals and pasta. But the more Anne ate, the worse she felt. Not only was she seized by intense nausea and the urge to vomit, but recently she had severe intestinal cramps and diarrhea. Her doctor said she had developed irritable bowel syndrome, a disorder associated with psychological stress. By December, Anne's weight dropped to eighty-two pounds. Although she said she was forcing down close to three thousand calories, her internist and her psychiatrist took the steady loss of weight as a sure sign that Anne was not telling the truth.
That day Anne was seeing Dr. Myron Falchuk, a gastroenterologist. Falchuk had already gotten her medical records, and her internist had told him that Anne's irritable bowel syndrome was yet another manifestation of her deteriorating mental health. Falchuk heard in the doctor's recitation of the case the implicit message that his role was to examine Anne's abdomen, which had been poked and prodded many times by many physicians, and to reassure her that irritable bowel syndrome, while uncomfortable and annoying, should be treated as the internist had recommended, with an appropriate diet and tranquilizers.
Go to the link to read the remainder of the first chapter.....