Doctoring & Healthcare

All Articles in the Category ‘Doctoring & Healthcare’

Seeker.

Chemo SeekerSeeking perspective and cure. If it’s true that life is all about your perspective, I know this Friday sunshine will help.

This past week has been a total mind melting experience. Cloudy and cold, too. With my mom’s chemotherapy and subsequent complications, my perspective of medicine has changed again. Forever. Being the patient, or in this case the patient’s daughter and advocate, reminds me how hard it is to sit on the other side of the white coat. Power differentials, hierarchy, miscommunication, communication, laboratories, computers, research, trainees, and simple distance sit between the provider and the patient. They take up all sorts of space.

Invisible yet room-filing.

Above is a photo of my mom directing her chemotherapy. She felt that if she gave the chemo direction (via her powerful words and a Sharpie), the chemo’s accuracy would improve. Got to give her credit. Speaking up (even to your chemotherapy) is always essential in medicine. Read full post »

Tweet This, Cut That: Live Twitter Feed From The OR

Twurgery?

On the right side of my screen I’m watching a live Twitter feed from Swedish Hospital in Seattle.

Tweeting commenced soon after 8am this morning and was performed by 4 observers in an operating room in Seattle. Those 4 observers were in the presence of a surgical team who was performing a tumor resection on the kidney of a 69 year-old patient from California. The man had consented to the scenario, surgery, observers, twittering and all. While the surgeon did his job, his maneuvers, goals, and timed procedures were detailed on Twitter in a live feed.

It’s 10am on Wednesday as I write. I’m watching the twitter feed populate into my screen.

I must say it gives me an eerie feeling.

During medical school I assisted (translation: watched in awe and was likely told to be quiet) on a nephrectomy (removal of one entire kidney) for the same reason—a kidney mass. I remember well what the surgery looked like. This is the first time I know what it tweets like. Read full post »

Things You Can Hide Under A White Coat

Drs Swanson and BisseyFlashback: fall of 2006 standing with my partner, Dr Jeff Bissey at The Everett Clinic. In some strange third trimester hormone cloud (or pregnancy delusion), I consented to a photo shoot when our new clinic was just opening. Rotund & posing at the new computer in exam room 12. After the Cindy Brady photo amalgam, I feel I’ve got little to hide. This photo is a fine example of all the things you can hide under a white coat. Even little boys!

For three years during residency, I nearly lived in that white coat and kept it buttoned up to the top. Some people criticize the white coat for it’s role in establishing hierarchy in the doctor-patient relationship. Really though, sometimes we wear it just for the pockets. Sometimes for the things we hide (a sleeveless shirt mid-July?). Don’t you wonder what your doc has hidden underneath that coat? As you can see here, late fall 2006 I was hiding something, indeed. Yes, F was born 3 weeks later.

Many pediatricians don’t wear white coats claiming it scares children. I’ve never really found that; really, it seems I’m just as scary to an 18 month old with or without it on! I think some toddlers have made their opinion about me far before I show up in the room. Something about the smell of an exam room, maybe. You know those people who say they could never work in a hospital or clinic because of the smell. Well, those 18 month olds remember…

See him there, all tucked inside, but then simultaneously reaching for the keyboard? I remember the photographer saying, “Just pull the white coat out a little farther forward, Dr Swanson”.

Click into the full post if you need help finding F in the photo. Read full post »

Cross Your Fingers I Don’t Pull A Cindy Brady

Wendy Sue Brady

I’m going to be on TV tomorrow. Cross your fingers I don’t pull a Cindy Brady. Remember the Brady Bunch episode, “You Can’t Win Em All” where Cindy takes a test and wins the opportunity to go on live TV to compete in a game show? When the red light goes on she is rendered silent and freezes. She spends the entire time on TV staring hopelessly at the light. Please world, don’t let me freeze; don’t let me pull a Cindy Brady. Thank goodness it’s no game show…

Tomorrow morning, you can watch me discuss insights on toddlerhood and typical development, live (in Seattle) on local NBC. Gulp.

But just for the record, or maybe to provide merit to my personal don’t-pull-a-Cindy-Brady-pep-talk, what gives me insight on toddlerhood is probably not just my MD/pediatric board certification or the articles I read every day to write this blog. Rather, it might be the confluence of all these roles, my effort to understand medicine from the vantage point as mother to 2 boys. Being a parent helps me frame and understand the data, putting it into perspective. Maybe why I’m willing to talk about toddlerhood on TV.

When I finished residency, got pregnant and eventually had given birth to F, a long time family friend of the husband, Dr Arne Anderson, wrote a letter to congratulate us. He was a pioneering pediatrician with Minneapolis Children’s and practiced pediatrics for decades. In the letter he said, “And now the real Professor of Pediatrics moves in.”

Agreed. I learn a lot from my kids. Tune in tomorrow morning to see if you concur.

NBC Kong 6/16 around 8:15-8:20am, tomorrow, Thursday February 18th.

161 Years Later

Elizabeth Blackwell, MDToday while I was waiting for an elevator in downtown Seattle, a man whisked in front of me and another women to get in the elevator.  The woman had on a fancy coat and red, powdery lipstick. She stopped me as I was getting in and said, “Oh, it’s going down.” I stopped and waited and thanked her for alerting me to getting on the wrong elevator. I liked her. It didn’t really faze me that the man had pushed ahead of us a bit, but he had. The woman looked over at me and said, “what a man, can’t even wait for a woman to get on.”

I said, “well, chivalry really is dead.”  As if to state the obvious but also assert the okay-ness I had with it all. Then I said (maybe over-stepping my boundary with this stranger), “funny thing is, yesterday was January 11th and that marked the day that the first woman in the United States was awarded her MD.  And that was over 150 years ago.  So, if I lose the chivalry over those years and gain the opportunity to practice medicine as easily as I do, it seems a pretty good trade off.”

The woman just kind of looked at me, smiled, almost laughed a bit, and then stepped forward as the elevator re-opened. When we got in and headed up she said, “well, at least he’s not on our elevator.” Read full post »

Verbatim: The Wife

One little thing that really gets under my skin if you must know is the title, “The Wife.” When I hear it, it rings through me, moving and shifting my electrons in just the wrong way.

I’m sure most of you wives or mothers out there on planet earth don’t really mind it. But I do.

Here is how I often hear it. Let me set the scene:
Exam room, child center stage, father stage left.  Meaning no harm (or disrespect) the dad says, “Oh, and the wife wanted me to ask you about this rash.”

I remain calm, usually leaking no erratic response, remark, or expression. This is my issue, I’m sure. But the internal alarm goes off.  Just something about that woman being distilled to “the wife.”

“My wife wanted me to ask you about this rash.”               No alarm.
“His mother wanted me to ask you about this rash.”          No alarm.

But,“The wife wanted me to ask you about this rash.”     Alarm-tastic.

With permission, I’m going to refer to my partner and husband, father of my children, as The Husband. Just to even the field. For today and maybe tomorrow, too. He’s ok with it; I’ve cleared this.
Thank you, husband, The Husband.

Magic

magicSometimes good health feels like magic.  Lately more than ever.  I’ve had a number of friends and family diagnosed with serious medical problems and medical set-backs in the last few weeks.  Like patients that I have been fortunate enough to care for with serious illness, it scares me, makes me sad, sometimes wakes me up at night. These episodes in illness are disorienting to the order of things. These diagnoses, uncertainties and realities are especially weighty this month amidst bags of gifts, holiday music, lit trees, and piped-in joy. Fear amidst cheer. Ultimately, these diagnoses and fears feel really real and make the rest of life blur. I suppose I just feel more angular, vulnerable and then compassionate right now. Ever-aware of the good health that surrounds me, too. Perspective defined. Read full post »

Another Day, Another H1N1 Recall

OuchlessOuch. Another recall. But this time for the ouchless shot, the nasal mist H1N1 vaccine. The CDC announced last night that there is recall of about 4.7 million doses of nasal spray H1N1 immunizations. These are nasal spray vaccines used in children (and adults) over the age of 2 years. This is just a set-back in protecting our country (and the globe) from the harms of H1N1. No, not a safety concern. Not conspiracy. Rather, a concern that doses are losing potency over time. Think shelf-life. The issue or concern is that these shots may not have the potency level we want over time to remain effective. It’s like that old watercolor you made for your mom in 5th grade fading in the sun.  Or when you run out of Kool-Aid mix and you stretch it to make more.  The worry is these doses may be less effective with time. Read full post »

Verbatim: Fastballs In The Exam Room

BaseballVerbatim: a repeating entry of things overheard while taking care of kids in my clinic.

One of the best parts of my job is coming to know the families I care for.  It sounds trite. It’s true.  Over the few years in practice, they have come to know my style, I suppose.  I’m direct.  I don’t want families to have to guess what I’m thinking.  I share stories (both the mess-ups and successes) of raising my own kids.  I can be self-deprecating at times if I think it’s important and true.  Like I said yesterday, it’s hard to do this parenting thing, and hard to do it well and feel glamorously successful all the time.  We don’t get a lot of thank-yous from our own children for the labors of providing safety, a roof, food, humor etc.  But we do get them.  Reward enough, of course. Read full post »

Happy Birthday Blog

Happy Birthday, Blog.  Welcome.  Welcome to Children’s. I hope life unfolds easily for you.

We’ve been waiting for you.  Prepping the room, painting the walls, putting things in piles. We’re hoping for great things from you.  I painted the walls yellow, not knowing what flavor you’d be.  I hope we can make you prosper. Read full post »