Wednesday, January 20, 2016

Sunday, January 10, 2016

--ists

  I learn something new, if not every day, at least frequently.  Not long ago, I was introduced to the term "Hospitalist" when one came to visit me after my knee surgery, then I learned about "Intensivist,"  from billing, I seem to recall.  The latest is "Electrophysiologist."  Their expertise lies in the aspects of cathether ablations of heart rhythm disorders, and implant pacemakers, defibrillators, and implantable loop recorders.

Monday, January 4, 2016

Rigid? Or rigged?

     It was the first time I accompanied the patient to the neurology appointment. The doctor conducted several exercises for strength and flexibility, I'm supposing.  "Squeeze my hand as hard as you can.   Extend your arms and don't let me push them down."  Then the doctor tried to flex his leg when bent, and said his muscles were so rigid it was like lifting concrete.  He tried it twice, with the same result.  The doctor concluded the visit by deferring any diagnosis to the ultimate specialist at the Movement Disorder facility.
    At today's visit to the primary doctor, when asked, I mentioned the neurologist's comment on the muscle rigidity in the legs.  The primary doctor performed the same movements, but with complete ease.  He seemed a little baffled.  At home, I attempted the same movements with similar ease of results.  I asked the patient what he thought about the extreme differences in flexibility.
    My Occam's razor has sliced through to conclude that when one's hearing aid batteries are weak, the word "Relax" can be heard as "Resist."
 

Forget About It

    Dave's primary doctor--I taught his sister back in the day, when she was a high school junior and he was a mere seventh grader.  I vaguely remember seeing him as a little kid.  I have not seem him since then. He and Dave used to play  golf together at the Battenkill.  A number of years ago, during those halcyon days, a noted artist painted pictures of the Golf Course and some of the club members, which included the doctor's then wife,  offered them for sale.  Marilyn spent several hundred dollars for a painting of the 6th Hole, a serenely beautiful scene, even if you're not into golf.
    Somehow it fell to the doctor to deliver the painting, when it became available.  Through ill fortune, I happened to be the one to answer the phone when he called for directions to our house. He was calling from his car, and I made the assumption he was driving from Greenwich, the home of the golf course.  So I directed him from there.  But it turned out he was calling from Cambridge, so he got lost.  I can't remember how the painting finally got here: probably Dave picked it up at the Battenkill. Naturally, I felt embarrassed to have sent a doctor, of all people, on a wild goose chase.  But all worked out, and hopefully was forgotten.
   Today I drove Dave to his doctor's appointment, which I have been doing since the fall, on June 17.  Before that, I never even went with him to his appointments, much less into the room.  But a few weeks ago, I changed that and went with him into his neurologist's office, and today for the first time into his primary doctor's office.
   The doctor greeted Dave and then turned to me and said he thought he remembered meeting me. Dave offered that I used to teach in Cambridge, but the doctor said that would have been when his sister was there.  Then, said the doctor, he thought it might have been when he delivered a painting of the golf course.
   I said, "Gulp!"

Real Simple

   I don't have much opportunity to engage in conversation these days.  But in the past month, two different medical professionals, and also a family member, have mentioned the same term.  Occam's Razor is evidently a touchstone in the world of medical diagnostics.  Simply put, it espouses the principle of parsimony.  The assumptions introduced to explain a thing must not be multiplied beyond necessity.  What can be done with few assumptions is done in vain with more.The simplest answer is often THE answer.  Now if we know what we're talking about, why not just say it?