News of Robin Williams’ suicide was a shock. How could a man devoted to making others laugh take his own life? His death brought the disorder of clinical depression to the forefront.
Depression is a common mental illness that is manifested by prolonged sense of sadness, and other symptoms such as loss of desire to do pleasurable activities, irritability, insomnia or oversleeping, change in appetite, loss of energy, fatigue, difficulty concentrating, and sometimes thoughts of death or suicide. Depression affects 1 in 11 adults, and nearly twice as many women as men. Sadness and depression are different. Many people feel sad after losing a loved one, or losing a job, or ending a relationship. People who are depressed, however, can usually differentiate normal grief from the disabling continued weight of clinical depression. Although there is excellent treatment for depression, many people do not seek help because they mistakenly construe it as a personal weakness rather than a legitimate illness. Many celebrities have publically acknowledged their own battles with depression in hopes that others Continue reading →
“But I have promises to keep, and miles to go before I sleep, and miles to go before I sleep.” Robert Frost
A relative of mine, Stewart, (not his real name) was driving home from LA, and fell asleep at the wheel. Stewart was 18 years old at the time, and on winter break from college. He drove to LA in the morning, and then, after spending the day there, drove home that night. Although he knew he was drowsy, he made the decision to drive home. The last thing he remembered was listening to a 49er Monday night football game before he dozed off without warning. His new 1996 Toyota Corolla was totaled when the car crashed into a barrier on the side of the highway Continue reading →
I recall my Great Uncle Sidney. He loved to devour a delicious steak for dinner. Eventually he had to undergo coronary bypass surgery for cholesterol-clogged arteries of his heart. Within a decade he died! His heart did not kill him. He died of cirrhosis of the liver because of a blood transfusion contaminated with hepatitis C virus which he received during his bypass surgery.
Hepatitis C (HCV) is one of those conditions one hardly hears about because most people who have it don’t know they do. Of the 3.2 million Americans who have hepatitis C, only 5-6% of them have been successfully treated. It is 3 times more common than HIV in this country, and it is the leading cause of liver transplantation and liver cancer. The mortality from HCV has Continue reading →
As we approach the High Holidays of Rosh Hashanah and Yom Kippur this month, I find myself becoming more reflective, particularly about what’s important in my life. Twenty years ago I was asked to complete a biographical survey for a physician newsletter about my personal interests, which included questions such as the latest book I read, my favorite movie, etc. There was one question that stood out, “What is the meaning of life?” My response, “God knows.” It occurred to me a few years later that I could delve into a better understanding of this existential question by probing my patients for their stories about what has been meaningful in their lives. You may wonder how during a 15-20 minute visit with patients I could have time for such a discussion. One cannot come out and say, “Tell me the meaning of your life,” but I felt I could approach the Continue reading →
On April 12, 1945, President Franklin D. Roosevelt was sitting in his living room having his portrait painted by artist Elizabeth Shoumatoff, who later became most renowned for “Unfinished Portrait” of FDR. Also present was Lucy Mercer, Eleanor’s social secretary, but most notorious because of her affair with the president. His dog, Fala, and two cousins were in the room as well according to biographer Doris Kearns Goodwin. At 1:00 pm, FDR complained of “traffic pain at the back of my head,” and collapsed, unconscious. His cardiologist quickly arrived and recognized the signs of a cerebral hemorrhage, a type of stroke. One could argue that one of FDR’s visitors that day triggered his stroke, but it is much more likely that years of untreated high blood pressure led to FDR’s demise at the age of 63.
High blood pressure or hypertension still remains a hidden killer at large. It is estimated that high blood pressure kills approximately 1000 Americans each day due to its effects on Continue reading →
My 2-year-old granddaughter seemed to welcome her newborn baby sister with bland indifference. I observed her as she played with her blocks and other toys and did not appear to be perturbed by the presence of a new member in her family. After she had dinner, I was surprised when she set out deliberately for the couch, wrapped her mother’s pillow around her lap, lifted her shirt, and clutched her bear to her chest. It was dinner time for her bear! While it was fun to watch her precise imitation of breast feeding, it made me stop and wonder how we as adults subconsciously follow patterns of behavior that may not reach our cognitive awareness. Continue reading →
My twin daughters were born in August of 1981, just two months after a publication from the CDC reported the first cases of a rare lung infection that eventually led to what became known as the AIDS epidemic. Because they were very premature, my newborn daughters required numerous blood transfusions from Irwin Memorial Blood Bank in San Francisco. One daughter received over 40 different transfusions. In 1985, the FDA approved the first blood test to detect HIV antibodies in the blood, and blood banks began their first screening of their blood supply. It was shortly thereafter that my wife and I received a letter from the Continue reading →
“Ahh choo, bless you, ahh choo, gesundheit “ are the expressions one hears this time of year from allergy sufferers and their companions. People who have migrated to California from other parts of the country are surprised to experience allergy symptoms they never had previously. Allergy victims march into doctor offices and pharmacies every spring because of the combination of the long growing season here, habitat for many species of plants in California, and windy days. The “bless- yous” and “gesundheits” exclaimed by empathetic bystanders are exclamations based on an ancient superstition to forestall evil spirits from entering the body after one sneezes, but now it seems impolite not to offer consolation. Sneezing usually heralds the onset of a cold, but can also be triggered by exposure to sunlight or strong odors. This time of year, sneezing portends hay fever or seasonal allergic rhinitis. You may be one of the estimated 20% of Americans who have this condition and if so, keep reading.
February is American Heart month. It represents an opportunity to think of hearts other than in the context of Valentine’s Day.
During the course of my career as an internist, I have cared for hundreds of patients with heart disease. Believe me, it is better to make some simple interventions in your life now than to wait until you have severe problems. Let me give you one example of a patient of mine I cared for about 20 years ago. Roger (not his real name) was in his late 50’s when he sustained his second heart attack. He was an ex-smoker, worked hard every day in his stressful job to support his family, and had little time to exercise or to take the time to eat healthy. After his second heart attack, he could not walk even half a block before he developed chest discomfort. I sent him for various cardiac tests with the hope that the obstructions in his coronary arteries could be Continue reading →