Tag Archives: Diagnosis

Answering The Unasked Questions

Death sucks.

Yes, I realize that I am courting the obvious there, but I thought we needed to restate where we stand on the issue. Sure there are some occasions, some deaths, where the cessation of breathing is cause for celebration and I would not try to argue that.

For the most part, though, people who die don’t want to die.

Again, blindingly obvious, but stick with me. I do have a purpose to this.

See, we as civilians only have to deal with death on a fairly irregular basis. It’s not like we see it every day as part of our job. Because we, as civilians, are not doctors.

Shara Yurkiewicz is a fourth-year medical student at Harvard Medical School where she’s learning what it takes to become a physician. She’s taking classes about anatomy, about chemistry, about diagnosis of disease and all of that.

However, it’s what she’s going to learn outside of the classroom that will determine how good of a doctor she becomes. My wife, known to many as She Who Must Be Our Best Chance, also is a doctor. She’s an OB/GYN and she’s one of the best doctors I’ve ever met. Not only is she a dedicated physician, who continues her medical education every day, but she’s also got a tremendous stirrup-side manner. She connects with her patients as people, as sometimes friends.

And patients appreciate that. She didn’t learn that in a classroom, but it’s a big part of why she’s such a great doctor. Shara Yurkiewicz has plenty of time to work on her bedside manner, but, right now, she’s still learning some powerful lessons.

Thankfully, she shares a lot of those lessons with readers of her Scientific American blog “This May Hurt A Bit,” which follows her trials and tribulations as a medical student.

In a recent column, Ms. Yrukiewicz transcribes a conversation she Diversity can be accomplished with tiny, little steps and it's not all that hard, now, is it?had with a patient following his hip-fracture repair. It offers we civilians a gripping view inside the real-world learning medical students must go through to become effective doctors.

She thanks the patient for allowing her, a medical student, to watch as the surgeons worked to fix his hip. It’s a relatively bland conversation and I began to wonder why it was in her blog. Until we neared the middle and things — through no one’s fault — began to go downhill.

Very badly downhill.

I watched as they kept your eyes shut and handled your body just as gently as they had a few hours ago.

I listened to the final zip of the body bag. I don’t know who had the time to switch off the radio, but I’m glad they did.

I listened as the nurse asked God to rest your soul.

I watched you leave in a different kind of bed, to a different place. I’m not sure where.

You can learn a lot from watching. Thank you for letting me watch.

We fixed your hip, sir.

The operation was a success, but the patient died. It’s not an oxymoron, but a notice that physicians must understand the different values for success.

To become a good doctor, medical students need to understand that patients are not simply a presentation of diseases and symptoms. They are people, with lives and loves and desires all their own.

What Ms. Yrukiewicz doesn’t mention in her post is the next most important lesson a good doctor must learn: How to learn everything you can about what happened so it doesn’t happen again and then move on to the next patient, fully confident that the surgery will be a success and the patient will survive.

Her blog provides an interesting look into the world of student physicians. I’d recommend you dudes and dudettes go and give it a read. It’s always interesting to learn what the person on the other side of the white lab coat is thinking.


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Yoga Dad Turns Cancer To A Positive

Yoga dad Dennis Ingui has a story to tell that all you dudes need to hear.

Now, I don’t normally turn over the precious white space here at A Dude’s Guide very often, much less three times in less than a week, but this is a special case. See, a friend of mine told me about Dennis and, once she did, I knew I’d have to have him share his story here with all of you. It’s a long story, so I’m going to have a jump that I want you to follow and I think you will.

This yoga dad is more than a health nut, more than a cancer survivor, more than a business man. Although he’d probably fight against anyone telling him this, he’s a bit of an inspiration. But let’s hear the story from Dennis’ mouth instead of mine.

Despite completely changing my life starting with a yoga practice at the age of 48, I wouldn’t call it a mid-life crisis.  

My mid-life turnaround was brought about after a stunning diagnosis of prostate cancer and surgery. What began as a journey of recovery and self-discovery has grown into a new business venture, mentorship for other budding entrepreneurs and a path toward philanthropy, touching the lives of children and adults across the globe.

Born and raised in the Bronx, I’ve always been athletic and physically fit. Which meant I was thrown completely off guard after a cautionary check up with my urologist showed a slightly rising PSA test. I will never forget the moment I received a call from the doctor on my way to the airport for a business trip. Immediately, I turned the car around and my wife and I went straight to the doctor. Within a few weeks, I was scheduled for surgery.

Continue reading Yoga Dad Turns Cancer To A Positive

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Possible SIDS Breakthrough

Sudden Infant Death Syndrome is just about the scariest thing I can imagine.

Your little dude goes to sleep, perfectly healthy, and then just doesn’t wake up. The doctors have no reason for what happened. There is no explanation. He just. . . died.

Horrifying.

SIDS is just what it says in the name. An infant, usually under the age of 1, will go to sleep (which is why another name for SIDS is crib death) and then die during the night of no perceptible cause. In fact, doctors can’t definitively diagnose a death by SIDS. It’s a diagnosis by exclusion. That is, once all other alternatives have been crossed off the list, only then will doctors consider SIDS as a cause of death.

Despite not knowing what causes SIDS, a correlation has been found between SIDS and babies sleeping on their stomachs, which led the American Academy of Pediatrics to recommend that babies under the age of 1 should sleep on their backs. No one is sure why sleeping on a stomach could increase the likelihood of SIDS.

So. Unknown horror and no real idea what causes it.

Until now. Maybe.

Dr. Daniel Rubens, a physician and researcher at Seattle Children’s Hospital recently published a study that calls into question one formerly popular suspicion that SIDS children have a brain malformation that could lead to their deaths.

Instead, Dr. Daniel Rubens’ research has indicated that problems with hearing and the inner ear may be linked to SIDS.

His newest study, published in a journal called Neuroscience, shows that inner ear dysfunction in mice results in an inability to wake up and move away from a suffocating environment.

The theory is that babies can move into positions that restrict their breathing while asleep, and those with hearing impairment in at least one ear don’t have the automatic survival mechanism to rouse and reposition themselves.

Rubens has previously published work, based on research he did with Rhode Island newborns. Babies that went through SIDS often had been found to have a hearing impairment during their birth screenings, his report said.

Of course, this study, while intriguing especially when paired with Rubens’ other work, still is in the very early stages. The next step is a large-scale study and Rubens still is looking for funding for such a research project.

If these results pan out, it could be a major step forward in the prevention of SIDS. That said, however, it’s not time to panic if your little dudette was marked as having some sort of hearing issue in her newborn assessment.

Don’t panic, but definitely don’t leave this alone. I really believe you need to contact your pediatrician, reference this study and ask about any concerns regarding what to do about SIDS and your child.

Once again, the AAP recommends your child sleep in his or her back in a plain crib. That is, don’t lightly cover your child with a blanket or have a lot of stuff in the crib with the child. Empty out the crib come nap or sleep time and, if a cover is needed, swaddle the little dude tightly and lay him on his back.

Once again, don’t panic. But do take deliberate action to inform yourself and your pediatrician. Heck, it might turn out that Rubens ‘ work won’t come up as causative or even correlative in a large-scale study of humans. Still, it wouldn’t hurt to be on the lookout.

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