UNC School of Medicine - Tarhealer Yearbook (Chapel Hill, NC)

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William Blythe, M.D. Something that we are not aware of or that we tend to forget is that patients answer the questions that they think that we ask them and not the ones that we think that we ask them. Shelley Earp, M.D. What non-disease in its mildest forms effect 27% of our hos- pitalized patients? 11% of our admissions have the full blown syndrome? And in some large studies of ICU pa- tients 70% of those with the most severe form of this pre- valent nonentity — die. It’s name after the place we see it the most, the surgical inten- sive care unit, The Sic U Thyroid syndrome. The pa- tient is euthyroid clinically but this TFT’s look distinctly hypo- thyroid. Use Earp Dis- criminate Analysis. THINK TSH ... It will be normal in Sic U Thyroid Syndrome. Fred Dalldorf, M.D. An eco- nomical pearl. In these days of cost containment we should all be looking for economies in diagnostic medicine. We diag- nose various liver ailments in my clinic on the 11th floor without the need of elaborate, expensive laboratory tests recommended to you by many hepatologists such as Dr. Lesesne. The Dalldorf Liver Tests: normal liver — resilient texture; hepatitis — soft and mushy texture; fatty liver — yellow, greasy, and stiff; cir- rhosis — no amount of pres- sure will fracture it. Mark Williams, M.D. People become increasingly unique and differentiated with the passage of time. Physicians must be aware of this and pro- vide more individualized care to older people . . . Re- member the three rope trick. Steven Burnham, M.D Omission of a rectal exam fc the daughter of a doctc caused prolongation of th hospital course when she ha salmonella. Cutting corner for “special” people results i inferior care. Newton D. Fischer, M.D. am supposed to share wit you a bit of information whic will endure. What about vignette on endurance itself The endurance of a commf ment to serve society throug medicine. I suggest that if doctor in the ardor of yout takes on the yoke of leadin others from suffering, h should plan to endure Ion enough to see the missio well on its way. Enduranc could also mean practicin ' medicine long enough to fee natural about it ... in this stat we can identify the probler and work out a logical solutio — not indulge in juggling c conflicting bits of data or sue cumb to impersonal triage. 54

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aul Biggers, M.D. The most nportant common retro- ochlear problem is acoustic euroma. This tumor is said to xist in 3% of the population hen autopsied specimens re studied carefully. Early etection is important in order ) preserve critical neurologi- al function. “Unilateral loss in earing and tinnitus should ng our diagnostic bell.” ames Bryan, M.D. How to urvive as a clinician? Take are of yourself so you can are for your patients. Have a ack door to the clinic. Have a sanctuary” in time or place ' ithout a beeper. Keep your atients moving. Be able to all for help. Enlist the family, urse and patient in the care, ay particular attention to the ubjective, and give relief, eep medications simple, eneric and remember, your ovenant is with the patient, ight, fight, fight. Robert Berger, M.D. The next time you see an athlete, musician, or ballerina do something requiring super- human contortions of their musculoskeletal system, re- member that they are able to do these things because they most likely have collagen vascular disease: Ehlers- Danlos or Marfan’s Syn- dromes. Jeffry J. Andresen, M.D. Reading to one another can unite us in unfettered reverie. The intimacy of shared im- aginative freedom transforms in valuable ways our senses of worth, of safety, and of being understood. Don’t im- poverish your life by failing to have someone you hold dear read to you. Sweet dreams! 53

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FEBRUARY 12, 1988 iarold C. Pillsbury, M.D. BREAT LIES IN MEDICINE. Statement: “JUST’’ a) a little shot b) a little while c) a little pain. ' ranslation: This will be a lot Yorse than I’m letting on. Statement: Our experience ith your problem has been . . . ' ranslation: I’m not sure you ill do very well with this: a) disease b) procedure c) treatment Itatement: We use a multi- lisciplinary approach, ' ranslation: None of us has a olution to your problem so e ll all share the blame for ne result. itatement: I’ll call you with ne results. ranslation: Don’t call me, I’ll all you. itatement: Consistent with, ut not diagnostic of . . . ranslation: I don’t know ' hat’s going on, just pay the ill. itatement: When I was a . . . a) medical student b) resident c) fellow ranslation: YOU’RE BOUT TO GET SCREWED! James Scatliff, M.D. T-, AND t 2 mri weighted images. In general, when a spin echo technique is used and gray scale assigned to perceived proton energies, T-i weighted images bring out anatomy; T 2 pathology. In T-i weighted im- ages, H 2 0 (i.e. CSF) is black and so is fat and bone marrow in T 2 weighted images, be- cause of increased water con- tent, infarcts, tumors, in- flammation and stuffy turbin- ates are white. Under invest- igation is the possibility that MRI radio waves stimulate en- largement of the anterior lobe of the pituitary. Watson A. Bowes, Jr., M.D. The most important days of our lives — days 1 7 to 56 after conception — are the days during which every major organ system is developed and is vulnerable to damage. During this time the symptoms of pregnancy are non- specific, and the physical find- ings are obscure. “He’s like a kid again — Mrs. Irene Scatliff 55