fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

Not That Old a Dog …

I don’t know how to share this without sounding like I am bragging. Maybe I am bragging — but not about my ability. I am proud that I learned a skill not usually taught to MDs. A while ago, a long-held interest in massage led me to learn more bodywork; then I worked with a DO, a doctor of osteopathy. I would feel someone’s back and say to my DO colleague, “Mike, I think she’s out here.” Mike would feel and grudgingly reply, “Pretty good hands for an MD.” He would then do osteopathic manipulation therapy (OMT), and the person would feel better — immediately! I thought, “You get to fix people? I want to fix people!”

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Dr. Sarno Saved Me!

Back in the 1980s, I was not a family physician but an engineering manager who had been experiencing occasional back pain for several years. Then one summer I overdid it windsurfing, and for the next two and a half months I was bent over in sheer, excruciating pain that I now recognize was a muscle spasm that would not remit.
 
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Just a Little Twist

The ache was in a familiar spot: in my mid thorax, starting over my spine and spreading a little to each side. It showed up a few times a year, always in the same place. It wasn’t terrible. I went to work, shopped for groceries, walked the dog, kept living my life. Maybe I woke up more often at night. Okay, maybe I woke up every hour and maybe sometimes I had trouble getting back to sleep. And maybe I had to cut back on the ibuprofen because it added epigastric pain to my back pain. But it wasn’t bad. I certainly wasn’t going to see a doctor. For one thing, I am a doctor, and I know back pain is self-limiting. For another, I’m a fat doctor, and the last thing I needed was a lecture from a well-meaning colleague about my weight. So I put up with the backache.
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Her Father’s Back

I first saw “Mary” as I entered the exam room. She was lying on the table in tears, complaining of a three-year history of excruciating back pain. She had seen two neurosurgeons and an orthopedist (my specialty), had had an MRI and, despite great hesitancy on the part of the neurosurgeon, had had a (failed) back surgery: her pain had been relieved for three days before it recurred exactly as it had been before.  Following a second MRI, she had been referred to me because the neurosurgeon thought I was a “pain specialist,” whereas really I was interested in mind-body medicine as it related to the orthopedic patient — how emotional and psychological stress lead to pain.
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Not Even Forty…

His wife left him that morning. That’s what he told the police officer who arrived on the scene after his large truck plowed into the back of my little red car. “I wasn’t paying attention. I was speeding up as I hit her.”

Ahead of us, an elderly woman had disobeyed her doctor’s orders not to drive while on pain medication. She decided to make a left turn by cutting off multiple lanes of traffic. My brakes held as all my weight went into them. I had less than a second to be thankful for missing her.

As I was loaded onto the ambulance, my neck and lower back were already in pain. And my knee–my beautifully ACL-reconstructed right knee, scrupulously brought back to strength over months of rehabilitation–had slammed into the dashboard of my car. It was throbbing.

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An Editor’s Invitation: My Aching Back

Back pain is as common as rain. It’s one of the most frequent concerns that patients bring to me as a family physician.
And I can identify with that pain–at least a little bit.
I had back pain as a teenager. I remember going to see a doctor about it. She examined me, took a pointless X-ray and then offered me something priceless: reassurance. “You’re a muscular guy,” she said, even though I weighed a scrawny 120 pounds.
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