I checked in with Sandra to find out how she writes the column and what we can learn from it.
Here is our edited conversation.
Q. How do you select your ideas?
a: It must be something I haven’t written about. This should be a settled case. I need to know the ultimate diagnosis. Even though it is a solved case, there must be a mystery in it. And there has to be a human story.
Q. Once you select a case, how do you report it?
a: I ask for a chronology of events and medical records that confirm the diagnosis. The medical records and chronology enable me to see what really is a mystery, has it unfold in interesting ways. Will it be an interesting affair?
Then, I interview the patient, sometimes the parent, sometimes the spouse. The final step is to talk to the doctor who made the diagnosis or the doctor who is currently treating you. Any step along the way, the process can fail.
> Do you write about unsolved cases?
a. No, this should be a settled case. Many people write to me and say, “I have this problem, can you help me?” Unfortunately, I don’t do this. I once wrote about a lawyer in Detroit who went to the Unknown Diseases Program at the National Institutes of Health. She’s seen over 100 doctors and still doesn’t have an answer. But I thought his case was so unusual and interesting, I made an exception at the time.
Q. What are some of your most memorable medical secrets?
a: I wrote about a family who had frequent sore throats. They couldn’t figure it out. An enterprising vet got involved. It turned out that his cat could be a vector. When they finally treated the cat, no one got strep.
One of the strangest people was a woman who had serious kidney and heart problems. It turned out that she was eating too much licorice. It was really weird.
And I still vividly remember a State Department employee whose head itched terribly at night. She had also worked for a type of cancer. She had seen several dermatologists. It turned out that he had lice in his head for a whole year. How did they miss? That was really amazing.
Q. What have you learned about the medical system from writing about medical mysteries?
a. Medical care has become increasingly specialized. Doctors are only familiar with a small slice of what’s going on, yet diagnosis is an inherently complex process. I also think the time pressure is worsening. It’s like: “You have 10 minutes. Go.” It’s not going to work with a complex problem.
I also think that sometimes patients are not good at describing problems. People who tend to do better are organized and can describe their symptoms in a way that makes sense to a doctor.
Q. What is your best advice for patients to get better medical care?
a. Primary care doctors can really help a patient. I often see people who go straight to the experts. They may not have a primary care doctor, or they access urgent care when they are sick. This can be problematic. People really underestimate the role of a good primary-care physician.
The 2022 Well+Being Gift Guide
Need a gift idea? The Well+Being team shares our favorite finds for cooking, exercising, spending time at home, improving our mental health, gifts for your pet, and more.
Some gifts are practical and economical; There are other fixed expenses. I just bought the air fryer for my family members because it was recommended by our Eating Lab columnist Anahad O’Connor. Runners will appreciate the right running shorts, as recommended by fitness writer Kailyn Soong. Amanda Morris, who writes about disability, suggests hearing aid jewelry. Reporter Teddy Amenabar has found the perfect coffee mug for traveling.
There are so many to choose from, and each item brings us closer to living a healthy, fulfilling life. We hope they do the same for you and your loved ones this year.
Feeling full? Don’t worry. Your stomach probably won’t explode.
This week, a reader asked: I always feel like my stomach is going to explode after dinner on Thanksgiving. Can this really happen?
Sophie Baljora, MD, associate professor of medicine at New York University Grossman School of Medicine and gastroenterologist at NYU Langone Health, said that while theoretically possible, the likelihood of your stomach bursting from overeating is extremely low. She writes:
Your stomach is a tough organ, with thick muscular walls and a rich blood supply that can easily withstand a hearty Thanksgiving meal.
The stomach also has a remarkable ability to stretch from its resting volume without much change in pressure. Even before the first bite of turkey hits your mouth, the anticipation of it—whether through smell or sight—sends a signal to your brain that is transmitted to your stomach, telling it to prepare for a meal. As you eat, the stomach stretches, making more and more room.
But the stomach is torn. One case report involved a 24-year-old female patient who presented to an emergency room in Turkey with sudden abdominal pain, vomiting, and nausea after consuming an excessive amount of fruit. An abdominal surgery revealed that his stomach was perforated and contained approximately five liters of partially digested food, including grapes and pomegranates – clearly more than the amount that most human stomachs can tolerate.
To learn more, read Baljora’s full answer to Ask a Doctor: If I Eat Too Much, Will My Stomach Explode?
It was another busy week! Check out these stories from the team.
How exercise affects your Thanksgiving appetite: High-intensity exercise can reduce your appetite for a few hours. But regular moderate exercise can make you hungrier.
Inviting pets to a holiday feast? Know the foods you can’t share: Veterinarians offer guidance for a fun and safe holiday dinner with your furry family members.
9 tips for dealing with grief with kids during the holiday season: Check in with yourself and your kids, take care of yourself, and create new traditions.
My mother’s dieting influenced me too: My mother’s obsession with weight is not unique. Researchers have studied how a mother’s restrictive eating habits can affect her children, especially daughters.
What is the difference between RSV, flu and COVID-19? The three respiratory viruses are putting a strain on families and hospital systems. Here’s advice from infectious disease experts.
The ‘most common crippling hand condition’ you’ve never heard of: Often, people with Dupuytren’s contracture mistakenly believe they have arthritis or tendinitis, or that they have arthritis until their fingers start to bend. Doesn’t seem to be a problem.
Why it Feels Like Your Doctor Doesn’t Care: How Many Patients Define Care Listening, investigating, following up and advocating for results. This type of care takes time and resources that many doctors are not given, says physician Sherlyn Obuobi.
Please let us know how we are doing. Email me at [email protected]