17 years ago. My wife was almost 3 months pregnant, we hadn’t told anyone yet. In my office when she called to tell me about the attack. Riding in a police car across NYC with a machine gun mounted vehicle at each intersection. To the medical staging area at Chelsea Piers. The line of ambulances that never brought anyone – the first wave of victims went directly to the hospitals. The next wave of survivors walked out. Walking home from Chelsea Piers because it was the only way to get there. Remembering the people, the sights, the sounds and the smells. Mostly remembering my City coming together, figuring out how to get through a terrible day and find tomorrow.
The end of 2016 – and every year – brings out the numbers – 10 best events, top news stories, greatest moments in sports, etc. People have a natural need to quantify and rank things. It gives us a sense of control over our lives – very important in a year that so much seemed beyond our control. I am no different – living my life by the numbers. I track my activity and sleep with a Fitbit, my runs with Runkeeper, occasionally track my calorie intake with Lose It! I track the number of patients I see every day, the articles I post on TheDiagnosisMD, number of hits it gets. While the numbers are not the sum of all that is important in my life, it is an interesting lens with which to view it through!
- 11 posts – missed my goal of 2 per month
- Wrote 4/11 in January – meaning I went months without updating TheDiagnosisMD, other than via observations on Twitter and Facebook.
- 824 people visited this blog in 2016 – less than in 2015 – perhaps an indicator of the lack of consistency last year!
- In 2017, not only do I want to write more – I want to write consistently.
- Tracked 4,463,882 steps – over 700,000 more than 2015 – NYC is a walking town for sure!
- Ran 375 miles – 25 more than last year
- Average distance per run 5.4 miles
- Average pace of 8:56 per mile – 32 seconds per mile faster
- I sleep an average of 6.5 hours per night – 12 minutes more per night than 2015
- Not going to attempt to count hours!
- Became more involved in a leadership role in our practice and the Department of Medicine
- Was co-investigator on a grant submission (decision pending) to develop a clinical research project and education program
- Taught medical students and residents
- 2940 face to face visits with patients
This last number strikes me as incredible – not for its absolute value, but the opportunity it represents. 2940 chances to make a difference in someone’s life. 2940 shared moments of success, failure, hope and fear as people cross my path. My goal in 2017 is to make the most of these moments – for myself and my patients!
What are your goals for 2017?
The path to wellness begins with a proper diagnosis
It was a typical Monday for an Internist – lots of phone calls, catching up on results that came in over the weekend, a full office schedule. I was about to go see my next patient when my assistant said that Dr. X was on the phone about a patient, could I take the call. I popped into my next patient’s room and told them I’d be 2 minutes – they said no problem and I went to my office to take the call.
The call was from a sports medicine fellow working with a specialist that I’d sent Mr. Smith to (name changed). I met Mr. Smith about 2 months ago, he had new onset high blood pressure and complained of back pain. We’d started some blood pressure medication and he was seeing the sports medicine specialist to design an exercise program for his back. He’d gotten an MRI as part of his evaluation, and instead of showing the expected herniated disc, it showed metastatic cancer – from where, we did not know. We called Mr. Smith and had him come in the next day to review his scan.
I met with Mr. Smith and his wife the next day. I took them through the scan findings, explaining what we could and couldn’t tell. He told me his back wasn’t too painful, and the specialist was helping manage it. We talked about a plan – blood tests and CT scans to find the source of the cancer. I told them I’d speak to an oncologist – and arranged his appointment with him.
Two days later, I had the blood work and his CT results, and we met again. The news was not good – there were extensive metastases in his spine and it looked like lung cancer – though we still couldn’t be sure. I sat with the Smiths, and we discussed a plan. They’d be seeing the oncologist in a couple of days, I’d already sent there results over. We discussed the next steps, what the oncologist would likely do next. We talked about how he hadn’t been sleeping well, and that I could help with that.
The Smiths left – and I was drained. It was very emotional telling someone who felt fine they have metastatic cancer. Yet we both left the encounter optimistic. The Smiths understood they have an uphill battle, but together they felt informed, guided and supported.
How Mr. Smith does is mostly out of my hands – yet I know I played a huge roll in getting them ready. I did all the things I love about medicine – bonded with a patient, made a diagnosis, educated them and got them ready for the next steps. This is Internal Medicine, and why I do what I do.