I reached out to Sandra to learn more about how she writes the column and the lessons we can learn from her.
Here is our edited conversation.
Q. How do you choose your ideas?
ONE: It must be something I didn’t write about. It has to be a solved case. I need to know the final diagnosis. Even though it’s a solved case, there has to be a mystery. And there has to be a human story.
Q. Once you choose a case, how do you report it?
ONE: I request a chronology of events and medical records that confirm the diagnosis. The medical records and chronology allow me to see whether, in fact, this is a mystery, whether it unfolded in an interesting way. Is this an interesting case?
So I interview the patient, sometimes the parent, sometimes the spouse. The last step is to talk to the doctor who made the diagnosis or the doctors who treat you. Any step along the way, the process can fail.
Q. Do you write about unsolved cases?
ONE. No, it has to be a settled case. A lot of people write to me and say, “I have this problem, can you help me?” Unfortunately, that’s not what I do. I once wrote about an attorney in Detroit who had participated in the National Institutes of Health’s undiagnosed illness program. He has consulted more than 100 doctors and still doesn’t have an answer. But I found his case so unusual and interesting that I made an exception this time.
Q. What are some of your most memorable medical mysteries?
ONE: I wrote about a family that had recurrent strep throats. They couldn’t figure it out. An enterprising veterinarian got involved. Turns out their cat may have been the vector. When they finally treated the cat, nobody had strep.
One of the strangest – there was a woman who had serious kidney and heart problems. Turns out she was eating too much licorice. That was really weird.
And I still vividly remember a State Department employee who had a terrible itch in her head at night. She had even worked for a type of cancer. She had seen several dermatologists. Turns out she had head lice for a whole year. How did they miss it? That was really impressive.
Q. What did you learn about the medical system by writing about medical mysteries?
ONE. Medical care has become increasingly specialized. Doctors are familiar with a small part of what is going on, but diagnosis is an inherently complex process. I also think the time pressures are getting worse. It’s like, “You have 10 minutes. Go.” That won’t work with a tricky problem.
I also think that sometimes patients are not good at describing problems. People who tend to do better are organized and can describe their symptoms in a way that is intelligible to a doctor.
Q. What is your best advice for patients to get better medical care?
ONE. Primary care physicians can really help a patient. I often see people who go straight to the experts. They may not have a primary care physician or use urgent care when they are sick. This can be troublesome. People really underestimate the role of a good primary care physician.
The 2022 Wellness Gift Guide
Need a gift idea? The Well+Being team shared our favorite finds for cooking, exercise, spending time at home, improving our mental health, gifts for your pets, and more.
Some gifts are practical and affordable; others are outright splurges. I just bought air fryers for my family members because our Eating Lab columnist, Anahad O’Connor, recommended them. Runners will appreciate the perfect running shorts recommended by fitness writer Kelyn Soong. Amanda Morris, who writes about disability, suggested jewelry for hearing aids. Reporter Teddy Amenabar has found the perfect travel coffee mug.
There is so much to choose from, and each item has brought us closer to living a healthy and fulfilling life. We hope they do the same for you and your loved ones this year.
Feeling full? Don’t worry. Your stomach probably won’t explode.
This week, a reader asked: I always feel like my stomach is going to explode after eating on Thanksgiving. Can this really happen?
While theoretically possible, it’s extremely unlikely that your stomach would explode from overeating, said Sophie Balzora, an associate professor of medicine at New York University’s Grossman School of Medicine and a gastroenterologist at NYU Langone Health. She writes:
Your stomach is a tough organ with thick muscular walls and a rich blood supply that can easily withstand even a hearty Thanksgiving meal.
The stomach also has a remarkable ability to stretch from its resting volume without much change in pressure. Even before the first bite of turkey hits your mouth, the anticipation of it—whether through smell or sight—sends a signal to your brain that gets delivered to your stomach, telling it to get ready for the food. As you eat, the stomach stretches, making more and more space.
But the rupture of the stomach happened. A case report involved a 24-year-old female patient who presented to an emergency room in Turkey with sudden abdominal pain, vomiting, and nausea after eating an excessive amount of fruit. Abdominal surgery revealed that her stomach was perforated and contained almost five liters of partially digested food, including grapes and pomegranates – clearly exceeding a volume most human stomachs can tolerate.
To learn more, read Balzora’s full answer at Ask a Doctor: If I Eat Too Much, Will My Stomach Explode?
It’s been another busy week! Check out these team stories.
How Exercise Affects Your Appetite on Thanksgiving: High-intensity exercise can dampen your appetite for a few hours. But regular moderate exercise can make you hungrier.
Inviting pets to holiday party? Know the Foods You Can and Can’t Share: Veterinarians offer guidance for a fun and safe holiday dinner with your furry family members.
9 tips for dealing with grief with kids during the holiday season: Check in with yourself and your kids, show some care, and create new traditions.
My mother’s diet affected me too: My mother’s obsession with weight is not unique. Researchers have studied how a mother’s restricted eating habits can affect her sons, particularly daughters.
What is the difference between RSV, flu and covid-19? Three respiratory viruses are overwhelming families and hospital systems. Here’s advice from infectious disease experts.
The “Most Common Disabling Hand Condition” You’ve Never Heard Of: People with Dupuytren’s contracture often mistakenly assume they have arthritis or tendonitis, or don’t realize a problem until their fingers start to bend.
Why your doctor doesn’t seem to care about you: Many patients define caring as listen, investigate, monitor the results and defend them. This type of care requires time and resources that many doctors are not given, says Dr. Shirlene Obuobi.
Please let us know how we are doing. Email me at [email protected]