“Perfect patient”

“I’m going to tell people you said that,” I told the Oral Medicine doctor who said it to me today.  I am sure she said it in jest, but I don’t think she realized just how funny it was since she lacks the context to appreciate the full irony.

Her reason for declaring me the perfect patient was that since this is an intermittent thing that comes and goes, I’ve started taking pictures of it.  And I brought those pictures, on the iPad…not the phone.  Which was good, because since it was an appointment at a teaching hospital (one of the local B.A.T.H.s), this meant the intern, med student, and ?resident? who I allowed in for the appointment didn’t have to strain their eyes to see the pictures.  I like my phone (did I mention I got a new phone for christmas?  An iPhone.  It’s neat.) but it’s not the best for more than personal use.

“Look at the red dots on the soft palate…” she instructed her charges as we scrolled through the pictures labeled “March 2011, severe”.  Ahh, the red dots.  Yes.  However, I personally found the two big ulcers on the hard palate much more compelling, but what do I know?

“Can you send me those pictures please?  The one of the blister too…” (October 2011, mild)  Yes.  And I can return when I am symptomatic for a biopsy.  Done and done.  And relatively quick and painless.  She wasn’t bad, interpersonally, not this time anyhow.

great idea!

Just reading the news this AM as I wait to do what I need to do with various, er, containers.

Here’s an excerpt from an interesting story – what a great idea!
He’s not a patient, but plays one for class
Students studying geriatrics in Maine live for weeks in N.E. nursing homes
By June Q. Wu
Globe Correspondent / July 19, 2010
Full story at the Boston Globe

Matthew Sharbaugh checked himself into a nursing home recently, complaining of chronic pulmonary obstructive disease, congestive heart failure, and right-side weakness from a recent stroke. He is 24.

Sharbaugh had signed away his youth for the next 12 days to play the part of an 85-year-old man in ailing health at the Old Soldiers’ Home in Chelsea.

A second-year student at the University of New England College of Osteopathic Medicine in Biddeford, Maine, Sharbaugh is one of six students living in a New England nursing home this summer as part of the school’s Learning by Living experiment, founded in 2005 to provide students interested in geriatrics with firsthand experience of the care of the elderly. This year is the first the program has expanded to include a facility in the Boston area.

Sharbaugh, who keeps a daily journal chronicling his observations, said last week: “I never really noticed how hard it is to live like this. I just always thought of old people as grumpy people who are easily upset.’’

By his fourth day, Sharbaugh, of Simsbury, Conn., came to appreciate the patience needed to cope with the daily frustrations facing wheelchair users: a misplaced TV remote, a notice posted too high.

Adjusting to his new life took time. His wheelchair beeped alarmingly every time he tried getting up or shifting his weight. His diet of pureed foods did little to satisfy his appetite. The first time he showered, he was unable to turn his wheelchair and ended up washing just the left side of his body.

Going to the bathroom became an art. With a twinge of shame, Sharbaugh learned to coordinate his bathroom trips with nurse shifts to avoid asking the same care provider for help more than once.

From his wheelchair, Sharbaugh also picks up on details that can enhance or detract from the quality of care for elderly patients.

He notes the importance of communicating at eye-level with the patient, of explaining medical procedures to the elderly and not simply to their adult children.

“It’s extremely difficult to hear the medical jargon and not know what it refers to,’’ Sharbaugh wrote in his journal. “When I have my practice, I will have to be sure to explain the patient’s care in terms that he or she will understand.’’

Established by his gerontology professor, Marilyn Gugliucci, Learning by Living is billed as the only program in the country that allows students to live for two weeks as patients in participating nursing homes, which willingly forgo the revenue, roughly $300 a day for 12 days, to support the initiative.

Gugliucci, who is the College of Osteopathic Medicine’s director of geriatric education and research, said she hopes to expand the program into a national fellowship for students interested in geriatrics.

….“There is a face and story behind every patient,’’ Sharbaugh wrote. “The patient should not be viewed by the conditions that ail them, but by the person beneath the disease.’’

Good site

Hey, it’s another cool site. Bad Cripple by blogger William Peace. So far, I’ve spent most of my time on there reading up on his experiences with the Obama campaign and accessibility. It’s making me want to go and fix up all my posts with pix (I’m certain I don’t always provide alternate text). I’m looking forward to reading more by William and I encourage you to check out his excellent blog.

Nice site

Hey I just ran across a great section of what is looking like a pretty neat site, IBS Treatment. The section I came in through has patient reviews of various IBS drugs, with both an American version and a UK specific listing. The latter is a bit small, and I don’t know if this reflects a true low number of UK specific IBS drugs or if the database just needs to be grown. To write a review, you must be diagnosed with IBS. The site is run by Sophie, who also has an IBS blog.


Thank you to Catherine at Women 4 hope who listed No Harm in her five new blogs for Blog Day which I missed hearing about entirely due to my complete self absorption at this time of year. Classes started last week – earlier every year it seems – and I start teaching this week. My blogging here has been slim while I’ve been prepping the course material. I’m really hoping to steer some of the students towards a health-psych project since it’s a field which is gaining popularity, it’s a new program in my department, and it is truly interesting. There’s even been some high profile news stories in this general area, such as the report on the study of implicit bias effects in doctors’ treatment recommendations for chest pain patients in the ER.

There’s only so much you can cover in a short intro research course, which means most of the really interesting stuff is out. Still, the last time I taught it I had a group of young women who did a very nice project on students’ attitudes towards mental illness and the effects of positive or negative portrayals of mental illness (and the mentally ill) in the media. Theirs was the best design and had some lovely, interpretable, and interesting results. It’s always gratifying to see the students pull off something like that given the constraints of the course (which are considerable, believe me).

On the bright side, at least this year I was reminded in time to celebrate Talk Like a Pirate Day on September 19th (thanks to Bubblewench).