Tuesday, December 30, 2008

Farmer's Lung

By Richard P. Holm MD

We call it the "South Dakota syndrome", said the Mayo Clinic kidney specialist to a room full of doctors at a conference on the intensive care patient.

I think I was the only South Dakotan there; it was some 1200 miles away. 

"These SD farmers wait until they are next to death from kidney failure and appear at the Mayo Clinic with words like: "I'm feeling a little weak lately but I don't want to complain"" he said.

As I heard this I was both a little proud and yet very dismayed. We don't want to look like whiners around here.

The problem with this denial and cover-up is that not only do we lose the opportunity to diagnose a medical problem early, but often precautions are not taken which could prevent a lot of trouble later. 

This goes for all systems of our body: the kidney, the brain, the heart, the colon, the skin and the hearing. 

But this is especially true for the farmer's lung. Here's the take home message: Don't cover up symptoms. If your cough lasts longer than 2 weeks, go in and see your doctor.

An ounce of prevention is worth a pound of cure. Don't go into that silo or pit when you shouldn't, avoid unnecessary exposure to toxins and dust, and I can't stress this point enough; wear a mask! 

I would rather the South Dakota syndrome mean we are a bunch of hard working but careful people who live long and are able to enjoy a full and easy breathing retirement someday.

Creative Listening

By Richard P. Holm MD

We all know people who are never happy. Contrast those with individuals who almost always seem interested, satisfied, and enjoying life. What is it that makes the difference? 

Numerous studies have shown that people find self-fulfillment when they have strong social support, sense a spiritual meaning to life, and last but not least, are able to find time to be physically and creatively active. I think it's that creative element for many that is so elusive.

Obviously we would all be better and happier if we allowed for our creative parts to come out, but how does one do that in a loud and cacophonous world? All the noise out there makes it difficult to create music of our own. I would submit that true creativity begins not with making more clamor, but with very concentrated listening. For example, the improvisational jazz sax is best when played in sync with piano and base.

As a med student I had a physician teacher, he was a cancer specialist, who taught by example on how to find fulfillment by creatively approaching patients with ears wide open, listening with all concentration. He was known as one who could perceive the nuance, the hidden pain, the color of the mood, sensing the broken heart& He said the creative person is one that is open-minded and listens.

I remember learning about his reputation as a true healer, one who creatively found a way to bring the patient back to health relying not only on the knowledge of medicine but also of human nature. He had the capacity and confidence to know when to cure, and when to move to comfort, to let go, to sing the lullaby&

Whatever job or talents we possess, each of our lives could be so full and balanced if we learned to let go of unneeded and rigid rules and fears, opened our minds, and creatively listened, truly listened with all of our might.

Monday, December 15, 2008

Medical Education

By Shawn  Vuong

The decision to go to medical school is a big one.  Dr. Holm brings up a good point, why do people chose to go to medical school?  I think there are many reasons why a person would want to pursue medicine, but Dr. Holm hit the big one, "to help people."  

If you're interested or have a child who is interested in pursuing medicine that's great. But remember doctors are not the only ones who work in the health care field.  Physician assistants do similar work to that of a physician and have a lot of autonomy, schooling is also much shorter.  Nursing is a great career choice for those who want to work directly with patients.  Nurses are more involved in direct patient care than physicians, and if that's what gets you up in the morning consider nursing school. Also, with nursing school there is a lot of room for growth with nurse anesthetist programs, LPN programs, and many others. And there are much more than nurses and PA's, consider social workers, psychologists, dentistry, physical therapy, occupational therapy, and many others.  

If you are interested in helping people, there is a wide variety of options out there not just medical school. 

Why Go To Medical School?

By Richard P. Holm MD

Why do we choose the paths that we take in life? Certainly some of it is just happenstance, a chance occurrence that came about for no particularly reason. I believe, however, that often we are influenced to take on challenges by seeing other people fulfilled by doing good things. 

I remember, as a kid, watching on black and white television, a Hallmark-Hall-of-Fame version of Arrowsmith, by Sinclair Lewis. This was a 1920's story about a Midwest boy who goes to the East coast to med school, comes back to practice medicine in a small town, and there develops a special interest in infectious diseases. 

The hero goes on a quest to halt an epidemic on a tropical island, has a tragic love with great heartbreak along the way, and then, of course, saves the day in the end. There was something about the compassion this physician had for using science to help people that intrigued me. 

Growing up in a small community I experienced the typical cuts and colds, bumps and bruises of a kid. There the good doctor, who was also a respected community leader, cared for me. One day during my high school freshman biology class while dissecting a frog, it came to me, "Maybe I should be a doctor!" 

It was at that moment I started pointing in this direction, and here I am 45 years later, still thrilled by the challenge.

What is it that triggers a person to apply to medical school? Is it an idealistic wish to make a difference in the world; the intellectual challenge to use science to discover something new; or the model of someone who provides one-on-one caring and healing to the sick or dying? 

I would say almost 34 years after graduating from medical school, that practicing medicine is a little bit of all those things, but mostly it is about trying to do what you can to help people, and the reward in knowing that sometimes you are able to help.

Whatever the experience, or example, or dream that moves a kid down the road toward a health care profession, I would call it a very good thing. 

Thursday, December 11, 2008

Doctor Shortage Makes Headlines

Dr. Chen with the New York Times makes the public more aware of the extreme situation known as the doctor shortage.  She wants people to know, "its three strikes and game over" and we are already at strike 2.  So soon-to-be president Obama please remember to address the physician shortage before mandating/allowing people to have insurance and putting us at strike 3.