May 15th, 2010 by Edwin Leap, M.D. in Better Health Network, Health Tips, Opinion, True Stories
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Is there anything more wonderful than date night with the one you love?
Jan and I went out last night. It was a cold rainy May evening, and we drove down the dark highway in my truck. The bench seat is wonderful, because she can sit right next to me, where she has been for nearly 26 years now.
We were in jackets, and asked to sit next to the fire at the restaurant. Exhausted from a crazy weekend, we exhaled and ordered chips and cheese dip, then dined on soup.
When we finished we sat awhile longer, our drinks refilled by our attentive waiter. And we reflected, planned, laughed and told stories. We discussed the year past and the year to come. We basked in one another as we basked in the warmth. Read more »
*This blog post was originally published at edwinleap.com*
May 12th, 2010 by Edwin Leap, M.D. in Better Health Network, Health Policy, Opinion, True Stories
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There is discontent in the house of medicine. So many physicians struggle. They seem to wade through uncertainty every day — uncertain about diagnoses, about pain, about disposition. We find ourselves uncertain about our jobs, our futures, our finances.
The consultants we call are uncertain about their practices and whether they can remain viable in the coming years as medicine evolves into something we may find unrecognizable.
Some days, as I enter my 17th year of practice, I don’t know if I can bear to walk around our little department for 10 or 20 more years, like some gerbil on an exercise wheel. I am uncertain if I can bear the weight of more entitlements, more confabulated stories, more regulations, and manufactured drama. I wonder if I can endure decades more of circadian assaults on my brain. Read more »
*This blog post was originally published at edwinleap.com*
May 8th, 2010 by Edwin Leap, M.D. in Better Health Network, Opinion, True Stories
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Twice in the last few months I have encountered grief as rage. Both were in the setting of the cardiac arrest of individuals who were already very ill. One was aged, with severe, end-stage heart disease. One was of middle age, but with metastatic cancer and on hospice.
In one instance, family members became angry because we did not leave the body in the ER for eight hours so that everyone could come and pay their respects. (Which I always thought was the purpose of a funeral home.)
In another, a family was angry because we did not allow everyone back into the room during the resuscitation of their cancer-stricken loved one — a resuscitation the family insisted upon, and which required rescinding hospice status. From observing their demeanor, their presence would have caused total chaos. Read more »
*This blog post was originally published at edwinleap.com*
May 5th, 2010 by Edwin Leap, M.D. in Better Health Network, Opinion, True Stories
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It’s all too easy to try and quantify everything in medicine. We are, after all, under the widely held delusion that medicine is like physics. A thing that follows fixed, predictable mathematical models. A thing reproducible if only algorithm A is followed for this disease and algorithm B is followed for that disease.
This belief is also held by the government, which doesn’t want to pay for readmissions or mistakes. Because it is believed that all things in medicine can be known from an exam, some labs, some tests, and some studies.
Nevertheless, things happen. Disease are transmitted in public or by families. Medications don’t always work. Bodies change. Bodies age. Humans are non-compliant. Humans are suffering from physiologic phenomena we can’t yet comprehend. Viruses are synergistic with other diseases.
The immunity of our patients is affected by their happiness, their diet, their work history, their family. The algorithms necessary to make medicine anything like physics would be mathematically beyond comprehension. Read more »
*This blog post was originally published at edwinleap.com*
April 27th, 2010 by Edwin Leap, M.D. in Better Health Network, Humor, Opinion
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Our relatively new electronic medical record (EMR) product has prompts and clicks for everything imaginable. One of them, which we can use during the physical exam, is the long list of “constitutional” findings that we perceive on generally looking over the patient.
They include things like: Obviously ill, comfortable, uncomfortable, pale, well-nourished, well-hydrated, well-dressed, alert, chronically ill, contracted, emaciated — and so on.
But these descriptors don’t always cut it. I mean, people are both amazing and annoying, so why not add a few more to the list? Read more »
*This blog post was originally published at edwinleap.com*
