The Problem With Being Too Persuasive

Photo: aspearing

When I was a first-year resident, I admitted a 34-year-old HIV-positive man to my inpatient general medicine service for fevers.  On physical exam, I found a large lesion on his right retina near the macula (the retina’s center).  I called up an infectious disease specialist, who confirmed what I’d suspected:  he had CMV retinitis. Continue reading…

The Neurology Of Near-Death Experiences

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I’ve never had a patient confess to having had a near-death experience (NDE), but recently I came across a fascinating book called The Spiritual Doorway in the Brain by Kevin Nelson, M.D. that reports as many as 18 million Americans may have had one.  If true, the odds are not only that some of my patients have been among them, but also some of my friends.  Which got me wondering:  just what does science have to tell us about their cause? Continue reading…

The Rippling Effect

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Several years ago, a graduating medical school class invited me to be a guest at their graduation dinner.  A resident with whom I’d worked previously had also been invited and was scheduled to speak.  When the time came for her to make her remarks, she began by telling a story of a former mentor of hers who, she said, had once told her, “Someone is always watching you.” Continue reading…

When A Beloved Pet Dies

Photo: wsilver

Several years ago, my wife and I had to put down one of our cats.  Minnie was really my wife’s cat, having journeyed with her from Vancouver to Chicago almost a decade earlier.  At some point during that time Minnie had developed a urinary tract infection that had damaged her kidneys.  After that, according to my wife, her personality changed.  By the time I met her, Minnie was no longer friendly and affectionate but somewhat aloof and disdainful (and, yes, I know this is the baseline personality of many otherwise healthy cats). Continue reading…

Pronouncing Someone Dead

Photo: Tim Green

When I was an intern in internal medicine, I admitted a patient to my service with pancreatic cancer.  Pancreatic cancer is a bad one; back then, only ten percent of patients with it would be alive within five years after being diagnosed.  My patient was a farmer in the full bloom of late middle-age health when he began rapidly losing weight. Continue reading…

The Caregiver's Manifesto

Photo: LaPrimaDonna

How many patients have I known over the years who’ve found themselves caught in the quicksand that is caring for a chronically ill loved one?  Too many to count, so I’ll recount just one.  Mrs. S is an elderly woman married to a retired university law professor, who has been slowly losing a battle with dementia.  Once a witty, intelligent, and self-deprecating delight of a man, over the years I’ve been caring for him, he’s gradually changed into a cantankerous, vitriolic, shell of his former self, now barely able to remember the day or month, much less the year. Continue reading…

The Six Reasons People Attempt Suicide

Though I’ve never lost a friend or family member to suicide, I have lost a patient (who I wrote about in a previous post, The True Cause Of Depression).  I have known a number of people left behind by the suicide of someone close to them, however.  Given how much losing my patient affected me, I’ve only been able to guess at the devastation these people have experienced.  Pain mixed with guilt, anger, and regret makes for a bitter drink, the taste of which I’ve seen take many months or even years to wash out of some mouths. Continue reading…

Preparation Prevents Piss-Poor Performance

skierOne day, about a year and a half ago, my wife and I were walking along a street near our home when she grabbed my arm and suddenly exclaimed, “I think that woman is in trouble!”

I followed her gaze to a car stopped at a light and saw to my horror a woman being prevented from exiting the passenger side door by the man who was driving.  He held her hair clumped in his hand.  She was screaming and crying and trying to free herself to no avail. Continue reading…

How To Keep Your Child (And Yourself) Safe From Strangers

child

Photo: Tasslehoff Burrfoot

It seems almost every few months a story of a child abduction saturates the news.  Amber alerts occur several times a year in many localities.  Stories of children who vanished years or even decades past re-run every so often as reminders that some families remain locked in grief even as the rest of us have moved on—all of which leaves many of us with the impression that none of our children are really safe. Continue reading…

Only Three Ways To Die

nursing home

Photo: DerrickT

“The absolute truth, Dr. Lickerman?” Emily (not her real name) said to me, tears sliding down her red, swollen cheeks.  “It was a relief.”

She wasn’t referring to being fired from a job she secretly despised or having a divorce finalized from a husband she no longer loved.  She was describing instead how she felt about the death of her mother.

Her mother had been diagnosed with Alzheimer’s dementia ten years earlier and had finally died after a short seven day stretch of refusing to eat or drink.  Emily had debated whether or not to have a feeding tube placed in her mother’s stomach to keep her alive but ultimately decided doing so would only prolong her death rather than provide more meaningful, quality-filled days of life. Continue reading…