Doctors don't always look after themselves very well. I've known plenty who drink to excess, are overweight, and exercise very little.
I once interviewed an NHS consultant, in his 40's, for a general population health survey, and his blood pressure was through the roof: when he saw the results he was pretty shocked.
Me: Won't these CT scans (6 months monitoring) be harmful? Onco: Yes, somewhat, but you will die of something else first. Me 72 at the time, 82 now with COPD, various issues from chemo.
Me: You're my age but you are still working. PCP: Yeah, but you have a lot more troubles than I.
I feel this. As an icu nurse I frequently fight the feeling that I'm just waiting around for my own awful diagnosis. Turning 50 this year did not help. I remind myself that not everyone everywhere is critically ill. It's hard when you're around it all the time.
This is so familiar. It happens to nurses as well. When my oldest child was three he coughed when he lai down at night. I was convinced he had Cystic Fibrosis. He had allergies. I always think of the worst thing first.
When as a dental student, I concur: TMJ pain and the occlusion discrepancies that contributed to it waned as the years passed. Thanks for the memories--good and bad (the latter of which reminded me of my matriculation prior to the HIV epidemic--no gloves!!).
Great piece! It takes me back to my days in nursing school when I diagnosed myself as being pregnant, though I had been celibate for almost a year. But all the other signs lined up perfectly! So strange.
As a retired nurse I see how much my life with sick and dying people has enriched my own experience of aging. I’m very grateful for pain free days, and I call on my memories of people suffering chronic pain to keep me strong when pain threatens to overwhelm me. I saw first hand the kind of courageous benevolence some people carried with them into the most horrendous illnesses. They were and are my best teachers. It’s very hard being human, but having had a career that let me be close to all kinds of people dealing with illness and dying makes the struggles more bearable.
What a wonderfully written piece. And it’s not just you docs~ those of us who work alongside you go through the same M3SD! I was in the office laboratory and started in the years we still pipetted by mouth and worked ungloved with blood, urine, sputum, and poo. When AIDS appeared, I had a fearful conversation with one of my docs and he just laughed and said “If you never picked up Hep B in all this time why are you worried?” 🤷♀️ I haven’t caught COVID yet either, but for sure my turn is coming.
Three Men in a Boat, Jerome K Jerome’s 19th travelogue, has a hilarious introduction about this very disorder.
Speaking of the relative health of doctors, again without stats to back this up, I was always struck by the near total lack of obesity in my med training. In the midst of an obesity epidemic, I can think of only one larger colleague out of my hundred+ fellow med students.
The obesity issue is interesting. The most currently acceptable explanation would be that the presence of obesity affects the likelihood of getting into medical school.
Of late, retired and with more time, I've subscribed to the concept that over-processed foods have contributed to the obesity epidemic. That said, sedentary lifestyles and work patterns haven't helped. But, I suspect genetics also plays a role. To borrow a line from somewhere else, "It's complicated"...
The only advantage to have been born with chronic health issues that were supposed to shorten my life is KNOWING that Osler was correct when stating “the best way to live happily is to develop a terminal disease and then take care of it”. It’s not an exact quote nor am I positive that Osler said it, but here I am at 57 - and thrilled that I will continue to die living rather than live dying.
When I was diagnosed with ankylosing spondylitis in 2000, I was told that within 5 yrs I’d be wheelchair-bound. Every single day I wake up and can stand/walk is a good day. 22+ yrs of weekly methotrexate injections have left me chronically thrombocytopenic but again I’m able to walk so for now it’s a trade off I’m more than happy to make. I always figured my AS would eventually drive me out of my field (NICU RN), turns out it was a freak complication from spinal fusion surgery for sciatica (which was unrelated to my AS). Life is funny like that sometimes. I just keep taking that next step and continue moving forward.
Love that. One of my greatest joys in retirement (retired early due to compromised health, a stroke of luck despite it, and music royalties!) is helping nurses in recovery - whether born with a bottle, using to cope, or iatrogenically. Nurses in monitoring in my state get two therapy groups a week as desired, and will never pay a dime. Paying it forward is gratitude in action. And I wish you continued success and Godspeed regarding your AS
The missassessment of risk is ubiquitous. Navigating the Scylla of underestimating and the Charybdis of overestimating risk may be one of the keys to improving medicine. Physicians that can't get it correct will not be able to educate patients who are also not getting it right.
Spitzer, S & Shaikh, M., (2022) Health misperception and healthcare utilisation among older Europeans. The Journal of the Economics of Ageing. doi.org/10.1016/j.jeoa.2022.100383.
Never had M3SD to any degree, but I am having a hard time thinking of a doctor I might trust with my health. All the really good ones have retired , like me! After 33 years in medicine, you appreciate what experience has taught you.
When I have to change PCPs I "interview" them. Are we compatible? Do they read extensively? What's their baseline knowledge on several topics I'm concerned about? Are they paternalistic (a definite deal killer)? At this point, I need to be able to engage in shared decision-making and I do not need a special office visit to explain my lab (normal) lab results.
I, too, didn't experience M3SD. Then again, I'd had years of EMS experience where I likely was exposed to all sorts of hazards I could see, and didn't get sick, or die as a result.
Good stuff! Of course, the "immortality thing" during our training years (and the early years of practice) is an illusion or a delusion, take your pick. While reading your tale I was reminded of two fellow residents in my surgery training program who died before they could finish (a fairly famous program lasting 6 to 7 years after the MD). One from leukemia, the other from adenocarcinoma of the appendix. And then . . . . some of our senior faculty began to "age out" and die. A pair of rude bumper stickers popular in that era also came to mind (one false and one true): One of them said, "Nixon was Framed" and the other, "Shit Happens".
Doctors don't always look after themselves very well. I've known plenty who drink to excess, are overweight, and exercise very little.
I once interviewed an NHS consultant, in his 40's, for a general population health survey, and his blood pressure was through the roof: when he saw the results he was pretty shocked.
Moral of the story: Physician: heal thyself!
Me: Won't these CT scans (6 months monitoring) be harmful? Onco: Yes, somewhat, but you will die of something else first. Me 72 at the time, 82 now with COPD, various issues from chemo.
Me: You're my age but you are still working. PCP: Yeah, but you have a lot more troubles than I.
Grateful for every morning, I'm still alive.
I feel this. As an icu nurse I frequently fight the feeling that I'm just waiting around for my own awful diagnosis. Turning 50 this year did not help. I remind myself that not everyone everywhere is critically ill. It's hard when you're around it all the time.
This is so familiar. It happens to nurses as well. When my oldest child was three he coughed when he lai down at night. I was convinced he had Cystic Fibrosis. He had allergies. I always think of the worst thing first.
When as a dental student, I concur: TMJ pain and the occlusion discrepancies that contributed to it waned as the years passed. Thanks for the memories--good and bad (the latter of which reminded me of my matriculation prior to the HIV epidemic--no gloves!!).
Great piece! It takes me back to my days in nursing school when I diagnosed myself as being pregnant, though I had been celibate for almost a year. But all the other signs lined up perfectly! So strange.
As a retired nurse I see how much my life with sick and dying people has enriched my own experience of aging. I’m very grateful for pain free days, and I call on my memories of people suffering chronic pain to keep me strong when pain threatens to overwhelm me. I saw first hand the kind of courageous benevolence some people carried with them into the most horrendous illnesses. They were and are my best teachers. It’s very hard being human, but having had a career that let me be close to all kinds of people dealing with illness and dying makes the struggles more bearable.
What a wonderfully written piece. And it’s not just you docs~ those of us who work alongside you go through the same M3SD! I was in the office laboratory and started in the years we still pipetted by mouth and worked ungloved with blood, urine, sputum, and poo. When AIDS appeared, I had a fearful conversation with one of my docs and he just laughed and said “If you never picked up Hep B in all this time why are you worried?” 🤷♀️ I haven’t caught COVID yet either, but for sure my turn is coming.
Thanks so much or your kind words. Adam
No coincidence that it matches the Kruger-Dunning curves...
Three Men in a Boat, Jerome K Jerome’s 19th travelogue, has a hilarious introduction about this very disorder.
Speaking of the relative health of doctors, again without stats to back this up, I was always struck by the near total lack of obesity in my med training. In the midst of an obesity epidemic, I can think of only one larger colleague out of my hundred+ fellow med students.
The obesity issue is interesting. The most currently acceptable explanation would be that the presence of obesity affects the likelihood of getting into medical school.
Adam I would like to know your thoughts on the latest pronouncement that obesity is a disease and therefore not the overweight patient’s fault.
Take a look at this. Probably answers the question.
https://sensiblemed.substack.com/p/are-we-powerless-in-the-fight-against?utm_source=profile&utm_medium=reader2
Excellent! Thank you. I must have missed that one.
Of late, retired and with more time, I've subscribed to the concept that over-processed foods have contributed to the obesity epidemic. That said, sedentary lifestyles and work patterns haven't helped. But, I suspect genetics also plays a role. To borrow a line from somewhere else, "It's complicated"...
The only advantage to have been born with chronic health issues that were supposed to shorten my life is KNOWING that Osler was correct when stating “the best way to live happily is to develop a terminal disease and then take care of it”. It’s not an exact quote nor am I positive that Osler said it, but here I am at 57 - and thrilled that I will continue to die living rather than live dying.
When I was diagnosed with ankylosing spondylitis in 2000, I was told that within 5 yrs I’d be wheelchair-bound. Every single day I wake up and can stand/walk is a good day. 22+ yrs of weekly methotrexate injections have left me chronically thrombocytopenic but again I’m able to walk so for now it’s a trade off I’m more than happy to make. I always figured my AS would eventually drive me out of my field (NICU RN), turns out it was a freak complication from spinal fusion surgery for sciatica (which was unrelated to my AS). Life is funny like that sometimes. I just keep taking that next step and continue moving forward.
Love that. One of my greatest joys in retirement (retired early due to compromised health, a stroke of luck despite it, and music royalties!) is helping nurses in recovery - whether born with a bottle, using to cope, or iatrogenically. Nurses in monitoring in my state get two therapy groups a week as desired, and will never pay a dime. Paying it forward is gratitude in action. And I wish you continued success and Godspeed regarding your AS
Whoever said it, it is a great sentiment. Thanks for sharing.
Adam
Thank you for sharing insights.
The missassessment of risk is ubiquitous. Navigating the Scylla of underestimating and the Charybdis of overestimating risk may be one of the keys to improving medicine. Physicians that can't get it correct will not be able to educate patients who are also not getting it right.
Spitzer, S & Shaikh, M., (2022) Health misperception and healthcare utilisation among older Europeans. The Journal of the Economics of Ageing. doi.org/10.1016/j.jeoa.2022.100383.
I love the Scylla and Charybdis of risk estimation, I will definitely be using that.
Thanks, Adam
Never had M3SD to any degree, but I am having a hard time thinking of a doctor I might trust with my health. All the really good ones have retired , like me! After 33 years in medicine, you appreciate what experience has taught you.
When I have to change PCPs I "interview" them. Are we compatible? Do they read extensively? What's their baseline knowledge on several topics I'm concerned about? Are they paternalistic (a definite deal killer)? At this point, I need to be able to engage in shared decision-making and I do not need a special office visit to explain my lab (normal) lab results.
I, too, didn't experience M3SD. Then again, I'd had years of EMS experience where I likely was exposed to all sorts of hazards I could see, and didn't get sick, or die as a result.
Good stuff! Of course, the "immortality thing" during our training years (and the early years of practice) is an illusion or a delusion, take your pick. While reading your tale I was reminded of two fellow residents in my surgery training program who died before they could finish (a fairly famous program lasting 6 to 7 years after the MD). One from leukemia, the other from adenocarcinoma of the appendix. And then . . . . some of our senior faculty began to "age out" and die. A pair of rude bumper stickers popular in that era also came to mind (one false and one true): One of them said, "Nixon was Framed" and the other, "Shit Happens".
As a long practicing physician I applaud your perspective and appreciate the self-reflection. thanks Adam.
Terrifically written; neat perspectives from a Doc. Clever personal ending.
Thx
I love pride for “keeping it broad.” 🙂