The Heroism of Incremental Care

Atul Gwande is an unusually talented observer, thinker, and writer who is a surgeon. I have blogged about his books in the past. If you are interested in health and healthcare, I think that you will find his article on incremental healthcare to be intriguing. Although it is long, I think that it will hold your interest. It can be accessed through Google.

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The Heroism of Incremental Care/ The New Yorker

 

 

 

 

 

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Is It All In Your Head?

 

Suzanne O’Sullivan, MD

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Suzanne O’Sullivan reveals the power of mind-body connections through the enigma of psychosomatic illness. She is a neurologist, and while the treatment of this condition falls under the purview of psychology and psychiatry, the neurologist must first prove that there is not an organic explanation for the illness, have the patient accept the diagnosis, and convince them to engage in cognitive behavioral therapy.  Pharmaceuticals are not effective. The patient has real symptoms which convince them that it is an organic disease. “It can be very difficult for a patient to accept that they suffer from a conversion disorder (a medically unexplained neurological symptom) when that assumption is based entirely on what is missing.” Psychosomatic illness threatens an individual’s image of themselves and they fear that they will be perceived as being weak.

Suzanne O’Sullivan introduces the book with a discussion of blushing. “Blushing is an instantaneous physical change seen on the surface but reflecting a feeling of embarrassment or happiness that is held inside. When it happens, I cannot control it.” This leveler helps us to be more open about psychosomatic illnesses and understand that; they are real; they are no more a weakness than is succumbing to an organic illness; the patient cannot control them; their conscious mind wants to get better; it can happen to any of us. Somatization (a bodily response to a psychological effect) is usually benign, of short duration, and does not become an illness. Examples are trembling hands, perspiration, butterflies, shortness of breath, and laughing. “A psychosomatic illness is the body’s physiological response to stress. They serve a purpose even if that purpose is not always obvious.” The stress is not recognized because the subconscious moves the stress to the body. The person feels that they have handled the stress or may not even have recognized the degree of stress.Image result for blushing

“Illness is not the same as disease. Illness is the human response to disease. It refers to the person’s subjective experience of how they feel but does not assume an underlying pathology. Illness can be either organic or psychological.” “Approximately 70% of the people referred to me with poorly controlled seizures were not responding to epilepsy treatment because they did not have epilepsy. Their seizures were occurring for purely psychosomatic reasons.” “The effect the psyche can have on the physical self has long been observed, but for all that time, scientists and doctors have also been trying and failing to understand how it occurs.”

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We cannot live without stress. Positive stress motivates us (see The Upside of Stress). It is stress that continues and that we are impotent to relieve that causes changes in our brains. To balance the stress in our lives, we must maintain our resilience. One concern that I have is that I see an increasing number of children who are anxious. We went from the extreme of everyone receiving a reward because they participated, to accelerated curricula and the majority of “play” being on organized teams. Children have little free time, supervised from afar, whose importance in development is overlooked. Children need time for unstructured play; to daydream, relax, and decompress; to solve problems of their own or with peers; to imagine; to figure out how to occupy themselves other than an addiction to electronics; to create; and to learn from errors of their own choosing. (see What If Everyone Understood Child Development and How to Raise an Adult)

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Worried Sick

Behavioral and Emotional Problems Associated With Convergence Insufficiency in Children: An Open Trial 

Welcome to Your Child’s Brain

Gut: The Inside Story of Our Body’s Most Underrated Organ

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Giulia Enders

If you are interested in the human body and interested in health, I recommend that you use the following link to watch an interview of Giulia Enders. https://www.youtube.com/watch?v=weskzCKki-s

Giulia Enders is a medical student/researcher whose writing is as careful and clear as are her responses in the interview. The book is easy to read but does not oversimplify. For those of you who have a known gut problem such as celiac disease, you may know much of this information already. I particularly recommend the book for individuals who have an undiagnosed, persistent health issue or just don’t feel as well as you think you should. (This could also be a problem for one of your children.) Gut issues are frequently overlooked, underrated, or misunderstood by the medical profession.

 

 

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