Patient Presentations

The wonderful thing about BMB is the numerous patient presentations. It is incredibly valuable to see patients, hear them talk about their disorders, and ask them how it has affected their lives. It's not hard to learn about chest pain or difficulty breathing or yellow jaundiced eyes; these are symptoms and signs that we've experienced or we can imagine. But what about someone with bipolar disease? Suicidality? Who hears voices? These disorders in the realm of psychiatry justify their intrigue because we simply don't know what it's like to have that condition. The textbook criteria tell us very little about how these illnesses affect their family, their goals, even their everyday activities. Patient presentations in this block add a whole new dimension to my understanding of the mind.

We've had a few patients come in to talk about their experience with different neurologic diseases. A woman with a congenital dystrophy talked about how she was unable to run her entire life and is now nearly bound to a wheelchair. A man discussed how he is able to be a high-functioning lawyer despite multiple sclerosis. Two great old men who had experienced strokes entertained us with humor and hope as they described how they became best friends at the stroke rehabilitation facility. They bantered, joked around, and really got us to laugh.

We've also seen several patients struggling with psychiatric disorders. A woman with "double depression" (dysthymia plus major depressive disorder), a patient with bipolar disease, a man who jumped off Golden Gate Bridge in a suicide attempt. Only about 20 of the 1500+ people who've attempted suicide off the bridge have survived, and he was one of them. Just today, we had a patient with a borderline personality disorder and another with Huntington's disease.

Honoring patient privacy, I won't elaborate on any individual stories. But I've learned an incredible amount from these brave and fantastic people. Illnesses don't characterize them. They are characterized by an indomitable spirit facing adversity we cannot even imagine. They stride into the classroom, enrapture us with their tale of ongoing struggle with a chronic disease. They teach us, they cry with us, they laugh with us, and they remind us why we chose to become physicians.