In medical school, the weirdest most esoteric diseases and ailments were always referred to as “interesting cases”.  We soon discovered that this was code for “You best kiss your behind goodbye if you have any of these because you’re a goner.” I vowed then and there that if I could go through life and never be an “interesting case” I would be a happy camper.

That being said, I have come across some rather fascinating medical issues that most of you will think I made up, but I assure they are real. And yes, you don’t want any of them. Trichophagia, or Rapunzel syndrome, is where a person (mostly women) compulsively eat their hair.  We all remember the weird girl in middle school who constantly chewed on her pigtail.  This is not her.  Someone with trichophagia actually pulls the hair out and makes the equivalent of a BLT and chows down.  If they do it a lot, and who wouldn’t, they can actually get a bezoar.  This is better known as a hairball, most commonly found in the family cat.  A horrible result of a bezoar can be an infection, intestinal blockage, and even death.  Needless to say, this is primarily a psychiatric diagnosis and requires aggressive treatment.

Hirschsprung’s disease, or toxic megacolon, is a largely a childhood disease where the colon’s ability to empty is severely limited.  As you might imagine this results in a blockage even the Barbary Pirates couldn’t breach.  This is more common in males (finally, something nasty more common in males!) and can manifest with a swollen belly, vomiting, including vomiting a green or brown substance(am I painting enough of a picture here?)  constipation, gas, or diarrhea.  Basically, anything horrible related to the bowels is generated by this problem.  

Witness a report out of China that tells of a man who had part of his colon resected which contained 30 pounds of poop. That’s more poop than a cadre of revelers at a Miralax convention.   While not a disease, there are numerous examples of medical wrongdoing that just hurts to think about.  While operating on the wrong leg or taking out a left kidney when the right kidney was the problem sounds horrible, it’s not as horrible as what happened to a man in Pennsylvania recently.  He went into surgery to have his left testicle removed and the surgeon instead removed the right testicle. Oops!  

All’s well that ends well as the injured party received a hefty settlement and tickets to La Cage aux Folles. Hematohidrosis is a rare disease steeped in history.  Those familiar with the Bible know the story of Jesus in the Garden of Gethsemane.  He was in such anguish that, according to the Gospel of Luke,  he “being in anguish he prayed more earnestly and his sweat was like drops of blood falling to the ground.” Since this, many who experienced “sweating blood” were labeled as stigmata, with religious as well as medical interest.

A recent article lists almost 300 cases documented in the literature.  As for me, I just prefer to sweat bullets! As an aside, not only do I never want to be an interesting case, I never want a disease named after me.  Imagine how Dr. Alzheimer feels.  Think of the horror when Dr. Bardet–Biedl’s grandkids see picture of the poor children with the syndrome named after him (webbed toes, obesity, tiny scrotum, multiple digits).  

Sometimes being anonymous has its place. 



I haven’t been sleeping well lately. In some cultures, insomnia is a result of a jumbled conscience. Maybe I have a constipated consciousness right now. As I was lying awake this morning I started thinking about…kindness. Again, maybe I was unconsciously trying to piece together my lack of kindness by ruminating on it at 5 AM. Who knows.

We don’t have enough kindness today. It’s not the purview of Democrats or Republicans, Christians or Muslims, it’s a human trait that we just don’t practice enough. I really believe it is one of the things that makes us human. You don’t see Giraffes opening the door for each other or orangutans helping each other down the stairs. Sure, some animals care for their young in what appears to be a kindly fashion, but I think most of that is instinctual. Humans can choose to be kind. We need to choose that more often.

It can be so simple. A smile, a touch, some reassuring words. Kindness doesn’t really take a lot of effort. Being mean or thoughtless actually burns way more mental energy.

I remember hearing a scientist tell a story of how a butterfly flapping its wings in Malaysia could influence, through a series of escalating events, the formation of a massive storm on our west coast. I suspect that like that, a single act of kindness could change the world. Who is to say. Literature is filled with stories of kindness that changed lives and in turn, changed history.

The smile you give today may be the trigger that changes tomorrow…for all of us…and for the better.

Happy Thanksgiving!




Some say WWII would have been lost if it wasn’t for SPAM.  I suspect the grunts who stormed Normandy would have a thing or two to say about that, but the point is a quick, easy, preservable protein source was needed to feed all the soldiers and as, Caesar was fond of saying, an army runs on their stomachs.

Unfortunately, SPAM (short for Spiced Ham, or Smelly Putrid Appetizing Meat, whichever you prefer) was introduced with a noble purpose in mind, but beware of unintended consequences.  SPAM, like all processed meats, has been shown to be less than collegial with your arteries and gut.  In fact, many processed meats have been shown to be linked to various forms of cancer. So what exactly is a processed meat? 

It is any meat product that has been Frankensteined into something that stays on the shelf longer or tastes better.  If you open a can of SPAM or bologna, it may stay sitting there for a millennium before it becomes rancid or full of little fungi.  I wouldn’t suggest testing this hypothesis however, simply take my word for it on this one.  The whole taste better bit is certainly individualized, but usually it involves sugar, salt, and more sugar.  Common processed meats are sausage, hot dogs, bacon, salami, and Alpo.

 In 2015, the World Health Organization (WHO are you?  WHO, WHO, WHO,WHO) confirmed that processed meats increase the risk of colorectal cancer, while red meats were deemed "probably carcinogenic" to humans. This conclusion came from a review of more than 800 studies.  I love the definite nature of their pronouncement. 

 Well, we can’t really say they cause cancer (because Big Food gives us bunches of money) but it might be the case, wink, wink. A new study takes it even a bit further.  Published in The European Journal of Cancer, Dr. Jill Pell and colleagues concluded, “Compared with women who had the lowest intake of processed meats, those who consumed at least 9 grams of processed meats per day were found to have a 21 percent greater risk of breast cancer.”  That comes out to about 2 hot dogs a week.  I have no idea if this is limited to beef dogs as no mention in the study was made of a difference with chicken dogs, pork dogs, tofu dogs, or reindeer dogs.

Another analysis of 10 different studies concluded, “a 9 percent increased risk of postmenopausal breast cancer with processed meat intake.”   What are these food Nazis going to tell us next, that kale causes hair to grow on the bottom of your feet?  Actually, I am glad that this information is coming to light.  There is an old saying that you should never see how sausage and laws are made, and I think that is steeped in reality.  

I remember reading Upton Sinclair’s landmark book, “The Jungle” in high school and vowing never to eat meat again.  After a few years, I promptly forgot that vow until I saw the documentary “What The Health” and remembered.  Granted there is always some bias in these types of productions, but it is sobering, and the data seems to be piling up that SPAM and its cousins are not exactly health foods.   
 


Have you ever heard the old saying, “A douche a day keeps the doctor away”? No.  Neither have we because that was uttered by no-one , ever.

As part of my ongoing attempt to inform and entertain, what better topic to tackle than the All- American douche. In fact, douching is not a western construct as it has been around for a very long time. Ancient women across many cultures douched with honey, olive oil, or even wine in an effort to prevent pregnancy. It was common for medieval prostitutes to douche between clients, as venereal diseases were rampant.  The only problem was that the water up the hoohoo trick  didn’t accomplish either.  In some respects, it seems logical that flushing out evil spirits would have a healthy outcome, but as we will see, logic never applies when there is a vagina involved.

Some researchers estimate that 20% of the female population uses a douche periodically.  I think stipulating that it is the female population that this applies to is a bit overkill as any males trying to use this contraption may run into some technical problems.  Today the douche is primarily a tool for “freshness”, kind of like Fabreeze, but historically it was thought of as primarily a contraceptive.  Unfortunately, as we have stated, it was about as effective in this realm as squeezing a penny between your knees. Leave it to the French to design a beautiful apparatus (porcelain even) that allowed a vagina owner to pump fluid into the chasm in an ever so delicate manner.  It was so popular that the Éguisier irrigator remained the staple of cultured women for 70 years.

This next part you may not believe, but it was on the Internet, so it has to be true.  In the early 1900’s Lysol was popularized as the douche of choice.  I don’t know who their marketing director was, but kudos for coming up with another magical use for the disinfectant.  Unfortunately doctors reported 193 poisonings and 5 deaths from Lysol douching before 1911. Women routinely complained of vaginal burning and blisters, though lawsuits were overturned and reports covered up. 

Never admitting fault, Lysol nonetheless changed its formula in 1952 to become a quarter as toxic as before. I can only imagine the late night lawyer infomercials.  “Is your wawa on fire? Call me and get a check!”  I also find it somewhat alarming that the corporate execs didn’t change the formula until the 1950’s.  I’ll bet June Cleaver was a regular Lysol doucher.

So what’s a girl to do?  The medically accepted view of douching (and mine as well) is just say no.  Douching can alter the natural, healthy balance of bacteria and acidity in the vagina, which helps protect the body from infection. The vagina is self-cleaning, like your oven, so let it be free to do its thing.  

If you are compelled to douche by some evil flushing demon, for goodness sakes don’t use a can of Lysol, but get a simple premixed solution of vinegar and water, but know that eating a cup of yogurt may actually do more good. 
 
I normally don’t like to pull back the curtain, but sometimes, in the auspices of full disclosure, I feel compelled to take a closer look at myself.  

This is not one of those times; however, I do want to tackle a touchy subject, that of medical mistakes.  I realize that a doctor discussing this is like a mafioso talking about their bungled hit list, but since I would never dream of doing any of these things, I feel justified.  Just realize that, like making sausage, sometimes it may be better off not knowing some things.  Read on at your own risk and don’t, under any circumstances, forward this to any lawyers. Some might say that the whole topic of medical errors is a tempest in a teapot.  I don’t really know what that means, but it actually is a significant problem.  One recent study stated that 10% of deaths in the US are due to medical errors.  That’s more than diabetes, smoking, or elevator music.  Now I realize that all statistics are subject to bias and need to be contextual to be meaningful, but even if these numbers are wrong, it illustrates that there is something significant going on.

So what actually constitutes a medical error?  Is using the wrong end of a stethoscope considered an error or is it more serious things like substituting Viagra for hair loss meds and having your hair stand on its end?  

As you can imagine, the definition of error is about as clear as a politician’s conscience, so this immediately raises some red flags about how the data is collected.  Obviously, there are some “errors” that have little consequence, such as taking a rectal temperature instead of an oral temperature, but others may be more impactful.  

One of the biggest areas for mistakes is with medications.  Probably the number one major error in hospitals are related to the timing or dosage of medications.  This can arise from a variety of sources: poor communication, sloppy handwriting, stupid computer programs, or inexperienced personnel.  It behooves you, if you are hospitalized, to ask each time you are given a medication what it is, what it does, and how often you are getting it.  Don’t ask how much it costs or you may experience immediate heart failure.  If you are unable to ask or unaware of your medications, simply inform the nurses that both your kids are attorneys and I promise they will take extra care in what they do.

One of the most innocent but frightening medical areas is in misdiagnosis.  Every doctor, if they have been in practice for more than 6 mo has misdiagnosed an illness.  It is just the nature of medical care that nothing is guaranteed or exact, as many illnesses initially mimic each other in their presentation.  A cold, allergy, flu, bronchitis, pneumonia, or asthma may all look exactly the same in their initial symptoms.  If I ordered a CT scan for every patient who had a headache, not only would I be practicing poor medicine but I would be paying for a radiologist's kid’s college. I hate like the devil to admit it, but doctors are human, sometimes, and mistakes will be made.  Luckily most are very minor and of no consequence, and virtually all are unintentional. What can you as a patient do to help prevent medical errors?  Here is a list to peruse:

1. Make sure that all of your doctors know about every medicine you are taking.This includes prescription and over-the-counter medicines and dietary supplements, such as vitamins and herbs. 

2. Make sure your doctor knows about any allergies and adverse reactions you have had to medicines. 

3. When your doctor writes a prescription for you, make sure you can read it.If you cannot read your doctor's handwriting, your pharmacist might not be able to either. 

4. When you pick up your medicine from the pharmacy, ask: Is this the medicine that my doctor prescribed?

5. If you are in a hospital, consider asking all health care workers who will touch you whether they have washed their hands. 

6. If you are having surgery, make sure that you, your doctor, and your surgeon all agree on exactly what will be done.

7. If you have a choice, choose a hospital where many patients have had the procedure or surgery you need. 

8. Ask a family member or friend to go to appointments with you.Even if you do not need help now, you might need it later. 

9. If you have a test, do not assume that no news is good news.Ask how and when you will get the results. 

10. Learn about your condition and treatments by asking your doctor and nurse and by using other reliable sources.

For additional suggestions go to https://www.ahrq.gov/patients-consumers/care-planning/errors/20tips/index.html


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