Gotcha
It was a little game we played.My shoes squeaked quietly down the hallway of the nursing home as I approached her room. I knocked gently trying to avoid any particular rhythm or dissonance.Go away!Her voice was at once stern, and then followed by peels of laughter. She only saved such greetings for me. And I tried to trip her up. I varied my visits by time and pattern. Sometimes I knocked, and others I would call out in a distorted voice. She always knew. She was recovering quickly and would be discharged soon. The rest of my visits that day were not as positive. The gentleman next...
Source: In My Humble Opinion - October 20, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Just Be
It all started with the tip of my tongue. Really. I was chewing on dark chocolate chocolate chips with a vigor that was maybe a touch inappropriate for such a snack. I bit down firmly and felt immediate pain sear through my mouth where the tooth overzealously punctured the soft tissue. I bit my tongue.Which wouldn't have seemed so calamitous if it had not been one of many bodily malfunctions that had recently befallen me. A growth the size of a marble called a chalazion has grown under my eye lid. My hairline continues to recede. All of the sudden, out of nowhere, I have acne far surpass...
Source: In My Humble Opinion - October 13, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Insults
It hit me today while on hold with an insurance company to get a preauthorization. The call took thirty minutes. The medication was denied. And I knew that I was going to get an earful from the patient when I delivered the bad news. As I dialed the phone number, a disturbing and yet all to familiar feeling overtook me.Helplessness, powerlessness, impotence.I struggle with these feelings daily. In the beginning of my career, they were spurred by the complexity of disease, the willfulness of bad luck. Battling the human condition was a long, difficult slog fraught with trap doors and misst...
Source: In My Humble Opinion - October 6, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Extraordinary
He squeezed into the elevator just as the door was closing. There was a lightness about him, an excitement. His jacket was newly pressed and uncomfortably free of nicks or stains. He stood at attention with perfect posture. There was no sign that working at this early hour on a Sunday morning, nor even being awake, was something out of the ordinary. Extraordinary.He glanced over at my tattered lab jacket without trying to seem obvious. I'd like to think that is was the gray color (as opposed to his white) that gave me away as an attending physician. More likely it was the telltale...
Source: In My Humble Opinion - September 29, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Home
It was a short trip from the hospital to the nursing home. I luxuriated in the mid-morning sun. Wisps of fresh air snuck through the cracks of my barely opened windows. Although I had just gotten credentials at this particular facility, the path I drove was all to familiar. I turned my head as I passed the elementary school that I had attended as a child.As I stared at the playground, a long buried memory percolated to the forefront of my consciousness. I must have been around 8 years old, a little after my father died. I am playing by myself on the jungle gym, and glance longingly at the stre...
Source: In My Humble Opinion - September 22, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Dystopia
He had been educated at the finest universities. He had graduated cum laude, or whatever the term is they use nowadays to signify distinction. His pedigree was squeaky-clean. But as he haltingly entered the dark building at the end of an otherwise unexceptional suburban street, he felt more like a criminal than a scholar. His office was drab. Each room a glow with the artificial light provided by an incandescent bulb. He often wondered whether the lack of windows was to keep the light from piercing the imperturbable darkness or to trap the terror in. He knew his place. He was the last st...
Source: In My Humble Opinion - September 19, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
If We Fight For It
It occurred to me towards the end of our conversation that there was a large gaping hole. We had talked about physician burnout, career choices, and his current plans. He had drawn a map of his future. It originally shot like a straight arrow towards clinical medicine, but now veered precipitously. I took a moment to first clear my thoughts, and then my throat.Medicine, I explained, is still as noble a profession as ever. Every day I dip my toes tentatively into the current that swirls around me. Often I am pulled violently into the depths. My body bumps and sways in the mass of h...
Source: In My Humble Opinion - August 31, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Being Your Doctor Is...You Pick
Being your doctor is exhilarating. Everyday I wake up to a schedule brimmed with purpose. The door of my office is a portal into the richness of the human experience. I become a thread in the tapestry of other's lives. I bear witness to the joy and pain, laughter and heartache, and mundane daily routine. I spend my days bouncing between art and science. Paid to be the wily detective, my brain stumbles on detail. Some cases are typical, quickly resolved with an adjustment here or there. Others are more enduring, months are spent contemplating the possibilities until answers present ...
Source: In My Humble Opinion - August 21, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Have We Lost Our Heart?
There was once a little boy who loved to draw. He would wake up every morning, pull out his box of colored pencils, and let his hands explore the promise of a pristine sheet of blank paper. For him, the canvas was anything but empty, images and ideas exploded out of his mind and magically appeared on the pages in front of him. His parents and teachers recognized his talent early in childhood. Accordingly, he was afforded the luxury of the finest education. His ability grew with each class and workshop. He graduated college among the most gifted, and found work in one of the finest drawin...
Source: In My Humble Opinion - August 14, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
On The Internet
Of course there are patient archetypes. We all use them. I mean, there is the old lady that is super sensitive to even the smallest dose of just about every medicine. The psychiatric patient whose allergy list runs a mile long. The drug seeking guy that swears his pills were stolen from his suitcase yet again.My favorite is the widowed war hero. His unrequited love for his deceased spouse pervades most visits. He writes poetry and can carry a note to operatic proportions. He is kind and humble. He lives lost in a world of dreams and sweat memories. He is both jovial and...
Source: In My Humble Opinion - August 3, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
The Sh$t You Read In The Newspaper
Jim almost convinced me. The burning in his chest, after all, could have just been gastroesophageal reflux. He assured me that the sensation was nothing new; that he got it from time to time after a large meal and took Tums. I couldn't, however, ignore that it seemed to worsen with activity. The pain was bothersome enough to drag him into my office, without taking the time to make an appointment.Jim and I argued over the EKG. He wanted to take his prescription and go home. No hospitalization, no blood tests, no diagnostic studies. I grabbed his shoulder, and did my best to c...
Source: In My Humble Opinion - July 20, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Are You Proud Of Your Patients?
It was only afterwords that I wondered if I had been condescending. The words had come out so naturally. We were sitting across from each other in the nursing home. It didn't take a doctor to recognize that his leg was visibly less swollen. I had seen him walking down the hallway with the physical therapist. His face a mix of pain, concentration and triumph.Each day had brought improvements. The range of motion was returning. His strength was growing. His body balanced now with only the most minimal of assistive devices. What had once been disability had transformed to ...
Source: In My Humble Opinion - July 12, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Sticking It To The Man
Like two ships passing in the night, we sidled up to each other at the nursing station on the hospital telemetry ward. I had already been home, ate with the kids, and returned, while he hadn't left floors all day. We typed away at our computer stations, and chatted from time to time. After we exchanged common pleasantries, we jumped into local politics. We were hungry for news. Battle worn and weary, we were searching for signs the tide was starting to turn. The gossip was mostly pessimistic, but I saw a glimmer in his eye as he abandoned his screen and turned to face me.I bet you haven't hear...
Source: In My Humble Opinion - July 3, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Utility and Functionality
It is one of the most ancient stories wending it's way through modern history. The hotheads of late have coined the term creative destruction. But this concept of replacing old with new, or innovation upending tradition, is no more novel than the concept of change itself. There is nothing truly original in the world.I ease off the gas pedal of my already outdated hybrid Prius.My job will eventually fall prey to a computer named Watson. My practice will be gobbled up by the nearest Goliath medical center as history scoffs at the arthritic physician bending over a doorbell with leather bag in hand. Th...
Source: In My Humble Opinion - June 29, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Why I Disagree With The Government And Use Antipsychotics Anyway. It's Good Palliative Care!
The outcry over antipsychotics has ranged far and wide. Every one from governmental agencies to senior advocacy organizations have pointed to the abysmal data. Antipsychotics have a negative impact on morbidity and mortality. They say we are chemically restraining those who are too fragile to stick up for themselves. They say we are sedating instead of treating.And I disagree wholeheartedly. I manage a large group of moderately to severely demented nursing home patients. They are agitated and delirious on a regular basis. Often searches for infections, pain, constipation, depression, and...
Source: In My Humble Opinion - June 13, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
