The story of Anne Dodge ... the author chose this story to be part of his introduction of the book for a reason. Why do you think this is? Do you have a personal story that you were reminded of as you read the introduction?
Quote from the book that stood out to me... "But that is exactly what Falchuk did not do. Instead, he began to question, and listen, and observe, and then to think differently about Anne's case."
Quote from the book that stood out to me... "But that is exactly what Falchuk did not do. Instead, he began to question, and listen, and observe, and then to think differently about Anne's case."
Anne Dodge was an appropriate story to lead off the book for a couple reasons. I think her story demonstrated a number of points Groopman made during the course of the book. Plus, her situation was a pretty extreme case, a non life threatening condition that has become as severe as hers, and that it had gone on for fifteen years. On a personal note, I worked with someone about a decade ago that had this diagnoses (gluten intolerance/allergy), so I was reading the story and waiting to see it ruled out. Dodge's case was pretty sad, that she not only was ill for so long, but that she was diagnosed and treated as someone with a mental illness. Eating disorders are scary, and in general, people that have issues in this area are very difficult to treat or to trust. Obviously, if she was being treated, her doctors didn't believe all or part of what she had been saying, for fifteen years.
ReplyDeleteI really liked Falchuk's approach, I don't care whats been going on or what diagnoses are in your records, start from the beginning. I think that there is a danger in following other people without asking questions, no matter how smart or respected the person. After fifteen years, starting over was very overdue.
Anne Dodge's case was a great way to start off the book. Falchuk’s approach to Anne’s problem was admirable to me. I agree with Jason in that it can be hard to move beyond the issue of a documented eating disorder, especially if the patient is about 80 pounds. Being able to disregard 15 years of medical history in the case that every one of Anne’s many doctors overlooked something took guts. This was a great example of how taking the time to listen to the patient’s story without making prior assumptions could be the best way to get to the bottom of a problem.
ReplyDeleteOne of the most fascinating issues in this chapter to me was that physicians, despite what you want to believe, do make judgments of their patients that affect the care the patient receives. In Anne’s case, some physicians who may not have liked to deal with the issues of a patient with an eating disorder may not have taken the time to listen to her story. It made me think of how judgments, as much as I try to avoid them, could affect my patient care in the future. Being aware of this will help me keep my practice of pharmacy in check as I interact with a variety of patients in the future.
To switch gears up, I bet we all agree the story of Maxine Carlson is shocking, but say she added to the story that the only thing that helps the pain is vicodin. I know it would take a lot of attentiveness for the pharmacist not to label her a "seeker" and disregard her condition.
ReplyDeleteI agree that this was an extreme case to start off the book. It was frustrating knowing that Dodge was suffering for 15 years, with an "undiagnosed" condition. I can't imagine what would have happened to her if she had a more life-threatening situation. This summer, my sister was undergoing a similar situation. She was experiencing consistent headaches and high fevers, and visited 3 different doctors in 2 different states. Only until she visited the last doctor, did she finally get diagnosed with the correct condition she had: malaria. The first two doctors failed to ask her, "have you traveled out of the country recently?" In pharmacy school, they stress so much about asking open ended questions, and I have learned from this book (and from my life) that it really is important!! It is something that I will always keep in mind when interacting with a patient.
ReplyDeleteHey Will, to comment on Maxine Carlson, that would have changed my perception, or at least where I would have expected the story to go. If you added the vicodin, percocet, etc to story a large number of patients (unfortunately) come to mind. I try to remind myself that the one time I don't give someone the benefit of the doubt is when it is deserved. I actually had a patient come to pick up something earlier than she should have needed, she had a prescription, and I was too new to pharmacy to really start to pick up on any "seeker" stuff. Turns out, she had a child die that week as a result of an accident. That was probably a good lesson for me to learn early.
ReplyDeleteLooks like my old post got deleted somehow. Anyway, these "failure to crrectly diagnose" stories are quite unbelievable until they happen to someone you know. Someone in our extended family was not diagnosed with diabetes type I for most of his adult life. It boggles my mind that from age ten (when he started having some symtoms) to age 40 when he died, he was not correctly diagnosed. What a waste of a life especially when treatment is so easily available.
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