Doctor David Fisher's Blog

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David Fisher, MD, MPH: May 2009

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Wednesday, May 27, 2009

Lessons from a Broken Hand

So I broke my hand 2 weeks ago. The big blue cast that runs from my pinky halfway up my forearm invites the inevitable question, "What happened to you?"
My stock answer: "Bar fight. But you should see the other guy!"

No one believes me. I'm not sure what to think about that.

In truth, my electric power drill got stuck, torqued backward, and before I could let go, my fourth metacarpal bone had sustained a spiral fracture. I am wearing a cast for four weeks, and I'm learning a lot of lessons. Here are three.

1) Losing the full function of my right hand renews my awe at the design of the human hand. Look at your hand for a moment. With it you can grasp and carry heavy objects, and discriminate between the finest of textures. Our hands communicate, measure, transport, open, close, applaud, curse, direct, dissuade, strike, squeeze, throw, catch, push, pull, hold and release. They can be trained to perform the most complicated task to the point that it becomes automatic. Remarkable.

2) It's no fun being a patient. It's good for doctors to remember this. Just waiting to register for my X-ray and then waiting to go into the radiology suite and then waiting for the X-ray tech to come in and then waiting for her to check the views and then waiting for her to repeat the X-rays at a better angle was enough to drive me crazy. I asked for a copy of the films, took them to the car, held them up to the sunlight and diagnosed myself. How much harder it would have been to wait for the radiologist to read the films and then wait for her/him to call my doctor and then wait for my doctor to call me to tell me what to do next. I have new appreciation for my patients and their patience.

3) The fourth and fifth digits (in layman's terms, the ring and pinky fingers) are the unsung heroes of the hand. Mine are locked into a cast and currently unable to assist the "Big Three"- the thumb, index and middle fingers. Temporarily losing the function of a body part always makes one appreciate its simple utility, in things as mundane as tying one's shoes. I never noticed that I hold my shoelaces down with my pinky while completing the knot so it is tight across my instep (a quirky need of mine). My cast makes this impossible. Thank God for slip-on shoes. My handwriting looks like my 4-year-old's, not because I cannot grip a pen, but because I cannot balance my hand on the paper with fingers 4 and 5. Once again I am reminded that every member of a team is important. The apostle Paul states it beautifully in his first letter to the Corinthian church, chapter 12:

"The eye cannot say to the hand, 'I have no need of you,' nor the head to the feet, 'I have no need of you.' On the contrary, the parts of the body that seem to be weaker are indispensable, and on those parts of the body that we think less honorable we bestow the greater honor . . . God has so composed the body, giving greater honor to the part that lacked it, that there may be no division in the body, but that the members may have the same care for one another." I Corinthians 12:21-25

I am often humbled by the faithful work of the nurses' aides in the nursing homes where I round. They change adult diapers, clean wounds, and feed those who don't have enough capacity to even say 'thank you.' Their job is much harder than mine, and I am convinced their reward will be greater. Maybe you feel like the "less honorable" member of a team. Perhaps your daily grind doesn't seem to be accomplishing much, and you wonder why others seem to get all the glory. Take heart- if you feel like the "weaker part," it confirms that you are indispensable. Just ask my pinky finger.
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Sunday, May 24, 2009

Love somebody? Check out their Checklist

Two dozen roses met my bride as she walked in the house one afternoon last week. "What are these for?" she asked.
"From now on," I announced, "every time you do what you just did, it's an automatic two dozen roses."
She had just returned from her annual checkup, and it was time again for that test that every woman dreads- the Pap smear.
"Do I really have to keep going through that?" she asked.
"I've watched women die of cervical cancer, honey. Please keep getting tested- I want you to stick around for a while."

It was then that I realized I was behind on my own preventive screening. It was time for my cholesterol test. Why does it seem so much easier to tell others what to do than to do it yourself? It's particularly easy to put off something like an uncomfortable test or procedure, especially when the benefit of going through the hassle is not always clear.

Thankfully, the US Preventive Services Task Force (USPSTF) has put tremendous effort into identifying which screening tests are the most important. Their recommendations are based on decades of research, and the only tests that make the cut are the ones with strong evidence that they save lives.

The USPSTF has published a checklist that summarizes their recommendations.
Your Checklist for Health (Men)
Your Checklist for Health (Women)

So, I'll take the timeless words of Sting and alter them a bit: "If you love someone . . . check their list." Make sure the person or people you love are keeping up. When they do, let them know how much you appreciate it. And while you're at it, make sure you are up to date, too.
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Health Headlines

One-third of Americans do not use sunscreen
Vitamin D may help preserve mental agility
Cholesterol drug lowers amputation risk in diabetics
Large study confirms that physical fitness leads to longer life
US sets aside $1 billion for H1N1 flu vaccine
CDC to swimmers: Don't pee in the pool!
Read more....