Lisa Sanders > Quotes

“..I don't count Jennifer among my mistakes. She had a severe infection and precious little reserve. Nevertheless, I think of her often. Those minutes of terror and confusion I felt standing powerless in her room served as a visceral reminder throughout my training... that the big picture isn't enough in medicine...”
― Lisa Sanders, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

“The basic sciences of anatomy, physiology, biology, and chemistry are linked to a patient at the bedside through very specific stories that doctors learn and eventually create. These stories, what researchers now call illness scripts, contain key characteristics of a disease to form an iconic version, an idealized model of that particular disease. … It is the story that every doctor puts together for herself with the knowledge she gains from books and patients. The more experience a doctor has with any of these illnesses, the richer and more detailed the illness script she has of the disease becomes.”
― Lisa Sanders, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

“A lot of the appeal of internal medicine is Sherlockian—solving the case from the clues. We are detectives; we revel in the process of figuring it all out. It’s what doctors most love to do.”
― Lisa Sanders, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

“Much of the education doctors get in their four years of medical school and subsequent years of apprenticeship training is focused on teaching this skill of identifying and shaping those aspects of a patient’s life and symptoms, exams and investigations that contribute to the creation of a version of the patient’s story that makes a diagnosis possible. Indeed, the ability to create this spare and impersonal version of the patient’s story is THE essential skill in diagnosis.

It’s also one of the aspects of medicine that can seem the most dehumanizing.”
― Lisa Sanders, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

“The experience of being ill can be like waking up in a foreign country. Life, as you formerly knew it, is on hold while you travel through this other world as unknown as it is unexpected. When I see patient in the hospital or in my office who are suddenly, surprisingly ill, what they really want to know is, "what is wrong with me?" They want a road map that will help them manage their new surroundings. The ability to give this unnerving and unfamiliar a place a name, to know it - on some level - restores a measure of control, independent of whether or not that diagnosis comes attached to a cure.”
― Lisa Sanders, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

“In medicine, uncertainty is the water we swim in.”
― Lisa Sanders, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

“But then there are other cases… Cases in which the narrative of disease strays off the expected path, where the usual suspects all seem to have alibis, and the diagnosis is elusive. For these, the doctor must don her deerstalker cap and unravel the mystery. It is in these instances where medicine can rise once again to the level of an art and the doctor-detective must pick apart the tangled strands of illness, understand which questions to ask, recognize the subtle physical findings, and identify which tests might lead, finally, to the right diagnosis.”
― Lisa Sanders, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

“If a doctor has worked through the problem well, there’s a very good chance that one of these possible diagnoses will be right. The rest though, by definition, will be wrong. We are regularly wrong in the pursuit of being right. … The question we are taught to ask ourselves is, if it isn’t that, what else could it be?”
― Lisa Sanders, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

“It is much more important to know what kind of patient has the disease than what sort of disease the person has,” Osler instructed his trainees at the turn of the twentieth century.”
― Lisa Sanders, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

“a stroke is only a stroke after 50 of D50—a”
― Lisa Sanders, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

“results”
― Lisa Sanders, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

“One of the human limitations in medicine is that no one can know everything.”
― Lisa Sanders, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

“Medicine—to the extent that it can be called a science—is a sensual science, one in which we collect data about a patient through touch and the other senses according to a systematic method in order to make a diagnosis.”
― Lisa Sanders, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

“This was stress cardiomyopathy, also called “broken heart syndrome.” First described by the Japanese in 1990, this disease occurs when an emotional trauma causes the brain to release high doses of stress hormones. This hormonal blast paralyzes the muscle cells of the heart, preventing them from working to pump the blood. Typically only one section of the heart is spared this devastating paralysis—the part closest to the aorta so that with each heartbeat only the upper portion contracts and the heart looks like a narrow-necked vase. The Japanese called it takotsubo, after a type of trap that is used to capture octopus and has the same vase-like shape. For reasons that no one understands, this mostly affects postmenopausal women. There is no cure. There is no clot to bust, no bugs to kill. Like its metaphorical counterpart, the only treatment is support and the passage of time. The initial burst of hormones subsides and the patient must be kept alive until the heart recovers. For those who survive long enough to reach the hospital, the prognosis is good.”
― Lisa Sanders, Diagnosis: Solving the Most Baffling Medical Mysteries

“In medicine, it is essential to rule out diseases that can kill, and then move on to those that may only make you wish you were dead.”
― Lisa Sanders, Diagnosis: Solving the Most Baffling Medical Mysteries

“While you may be able to say with precision what the average man will do, "you can never foretell what any one man will do.”
― Lisa Sanders, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis

“Hemicrania continua is a type of daily headache characterized by persistent pain on one side of the head punctuated by episodes of sharp pain. The painful flare-ups are often accompanied by other symptoms, including watery eyes, runny nose, eyelid swelling, or constriction of the pupils. Remarkably, most patients with this type of headache get better when treated with an inexpensive medication that has been around for years: indomethacin.”
― Lisa Sanders, Diagnosis: Solving the Most Baffling Medical Mysteries

“Despite all the available technology, the tools doctors often rely on most are the most old-fashioned—a phone, a respected colleague, a mentor or friend.”
― Lisa Sanders, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis