Happiness in this World

“Maybe this is all from anxiety.”
“You think?  I mean, yeah, I am anxious, but it feels more like it’s from the symptom than causing the symptom.”
“Still.”
My colleague and friend—and physician—and I were discussing the sudden onset of intense nausea I’d started to experience roughly three weeks after I’d been released from the hospital, as I [...]

Most people who come to see me complaining of fatigue are worried something is wrong with them physically but turn out only to be sleep deprived.  Sleep seems to be something we all wish we did more, making us for the most part a chronically and persistently sleep-deprived society.  Though studies suggest large differences exist [...]

Clark (not his real name) came to see me complaining of substernal chest pain.  At first, he said, it had come on only with exertion, but in the last two weeks it had begun to bother him at rest.  It radiated to his jaw and was associated with some mild nausea and sweating.  He’d been [...]

For a doctor, every patient death is unpleasant.  My first thought when it happens to me is always, “What mistakes did I make?”  I go back through the sequence of events that led up to my patient’s death and ask myself if, given what I knew at each point along the way, I should have [...]

With all the shouting going on about America’s health care crisis, many are probably finding it difficult to concentrate, much less understand the cause of the problems confronting us.  I find myself dismayed at the tone of the discussion (though I understand it—people are scared) as well as bemused that anyone would presume themselves sufficiently [...]

Everyone gets hurt.  Not everyone heals at the same rate, however—not because of inherent differences in genetic makeup and physiology but rather because of differences in behavior (as well as the type and severity of the injury).  Two of the most common misconceptions about healing relate to which behaviors actually promote it and what exactly [...]

I once came up with a metaphor I thought perfectly captured the sheer mass of material my classmates and I were expected to memorize in our first two years of medical school:  it was like being asked to enter a grocery store and memorize the names of every product in the store, their number and location, [...]

My patient smiled a toothless grin and told me, “I feel fine, doc.”  But he was far from it.  His liver enzymes had risen into the thousands, his skin was a pasty yellow I didn’t need the benefit of sunlight to see, and his albumin (a protein whose level indicates the liver’s functional capacity as [...]

The first patient I ever saw as a first year resident came in with a litany of complaints, not one of which I remember today except for one—he had headaches.  The reason I remember he had headaches isn’t because I spent so much time discussing them but rather the opposite:  at the time I knew [...]

My patient, Mrs. Withers (not her real name), was forty-five and morbidly obese.  “I swear I’ve cut my calories down to almost nothing,” she told me, “but I haven’t lost a pound!  I eat the exact same thing every day:  a banana for breakfast, a turkey sandwich on wheat bread for lunch, and a piece [...]