The intersection of physical and mental health

“Despair” (public domain art)

A good part of my medical practice at Hennepin Healthcare is in mental health.  Although I’m a general internist, meaning I specialize in chronic diseases of adults, I have a special interest in the intersection of medical and mental illness.  Consequently, I spend a hefty portion of my days on the inpatient psychiatry units.  So when a piece came out in the New York Times this week, I was immediately drawn to it.  Written by Dr. Dhruv Khullar from New York-Presbyterian Hospital, it is entitled The Largest Health Care Disparity We Don’t Talk About.  I strongly encourage you to read it.

This is particularly of interest to me since I have also been part of a group of five medical systems across the country who have recently published our own experience in caring for people with mental illness. You can read our very brief paper at the Annals of Internal Medicine.

In this post I’ll talk a bit about my own experience in caring for patients with mental health conditions.  I’ll end with a few suggestions. Continue reading “The intersection of physical and mental health”

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Do you need an annual physical?

I’m a doctor (duh).  I do annual physicals sometimes (duh, again).  But I recently was put in the position of debating another doctor – on live radio –  about whether or not the annual physical is doing anybody any good.

Of course, physicals help people to, well, stay healthy.  Right?  Not so fast!  This isn’t as simple a question as it may seem.

Do people really need an annual physical?

The big debate occurred about a couple weeks ago when I was asked to be on Southern California Public Radio, KPCC 89.3 FM out of Los Angeles.  I was on the long-running show AirTalk®, hosted by Larry Mantle.  It was set up as a “pro vs. con” debate between me and a physician-researcher from Harvard, Dr. Ateev Mehrotra.  Dr. Mehrotra has done a great bit of research on just such topics.

I invite you to listen to the audio segment from SoCal Public Radio.  It’s about 18 minutes long, and you can access it from their website, KPCC.ORG, under the AirTalk® section.  It ran on Wednesday, January 17, 2018 so go to that date in the archives and scroll to the bottom. Continue reading “Do you need an annual physical?”

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Scenes from a frozen Minnesota lake

On Lake Harriet, Minneapolis

Hey.  This is going to be a weird post.

I went for a run today on a balmy January day near my home in Minneapolis.  Along the way I encountered frozen canoes by a lake shore, ducks swimming in a rare patch of open water, and thousands of people on a frozen lake – walking, swinging on gigantic wooden swing sets, biking, fishing, running, dressing up like butterflies, even standing in a circle while singing old hymns.  I saw guys running in shorts.  OK, that last part is not too weird, after all, it was 39 degrees today.  In Minnesota that qualifies as shorts weather in January.

Of course, I wore headphones playing a mix of Prince songs.  It was a terrific Minnesota kind of day.

I’m going to share a bit of it with you, my Healthy Matters friends.  There’s no medical talk here – no influenza or heart disease or illness or any kind.   To those of you feeling sick today, I hope you feel better soon!  But for now just some thoughts and pictures from a day when I felt really alive.  Surrounded by active, artsy, whimsical people.  Today I’m thankful for nature, for winter days, for my Minnesota neighbors – and I’m going to share a bit of it with you.

So if you wish, I invite you to check out some scenes from a frozen Minnesota lake .  .  .  (with some links to cool stuff) . . .

Continue reading “Scenes from a frozen Minnesota lake”

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In case you missed it: our most popular topics

I have been writing My Healthy Matters for nearly two years, and over that time there have been over 50,000 views to the site.  To all of you who read along with me, THANK YOU!

I took a pause in writing new posts today to look at the statistics on what most of you are reading on the blog.  It is really fascinating to see what strikes your collective fancy, so I thought I’d do a little retrospective post to highlight the most popular posts of the past.  You may wish to go back and read what you missed.

I’ll rank them in order of popularity, based on number of people who viewed them in 2017, and I’ll include links to the posts in case you want to read them.

Continue reading “In case you missed it: our most popular topics”

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Finding the ordinary among the extraordinary

Hi, Healthy Matters friends!

I have been steadily moving toward more writing in my career and specifically I’ve been working in an area called “narrative non-fiction.”  My writings are mostly based on medicine, health and wellness.  Big surprise there – sort of like what I do on this blog. I hope to collect them into a book at some point if I get any good at it.

A venue for publishing narrative non-fiction in the medical field is an online journal called Intima and I had an essay posted there in April.  It was called Don’t worry, at least we will die together!” and it was about my experience with medical students in Jerusalem.  If you missed it, you can access the piece in this blog post below.

The editors encourage writers to interact with other writers on the site, and so I wrote a very short post in response to an essay by Margot Hedlin, a newly minted doctor whom I have never met.  Her essay was called, “There’s a limit to your love” and it was really thought-provoking.  She’s a terrific writer and she masterfully got me thinking about the mundane and the not-so-mundane parts of medicine.

My response to Dr. Hedlin’s piece has now been published in Intima.  It is called Finding the ordinary among the extraordinary.”  It has my musings about the need to sometimes find normalcy even in utterly abnormal situations.  Like medicine.

I encourage you to read Dr. Hedlin’s piece first in the “Field Notes” section, then my short response in the “Crossroads” section.  Maybe as a trio these pieces will pull together some themes that resonate with you.

Here are quick links to these three pieces:

I’d love to foster dialogue, so please feel free to share these pieces on Facebook, e-mail, Twitter, or wherever you spend your social media time.  Or simply share this MyHealthyMatters blog post and let people do their own clicking!  (Buttons to share are at the top and bottom of every post I do).

And the editors at Intima encourage a wider conversation, so maybe you could leave a comment on the site with your reaction to any of these pieces.

For the main Intima site, click the logo here:

Happy reading and happy contemplation!

David

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“Don’t worry, at least we will die together!”

Jerusalem, photo © David Hilden

Hi, friends!

In this post I simply want to invite you to read an essay I wrote which was recently published in a journal I admire.  Called Intima: a journal of narrative medicine, it is a literary place where medicine is explored through story, narrative non-fiction, and art.

My piece is called “Don’t worry, at least we will die together” and is an account of an experience I had back in 2015 while in Jerusalem.

In addition to reading my piece, I hope you will explore Intima and immerse yourself in any of the outstanding works that were submitted.  The journal, which originated at Columbia University in 2010, is a treasure that I hope many of you will come to know.

I haven’t posted much about my interest in Middle East issues, so I’ll give you just a bit of background.  If you do nothing else, please click on the Intima logo above and check out my essay.   For just a little more on my experience, keep reading. Continue reading ““Don’t worry, at least we will die together!””

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Butterflies and bacteria: thoughts on a healthy planet

butterflies-2My family just returned from a pilgrimage of sorts.  Having returned from a journey to witness one of nature’s miracles – and picking up a bit of a health problem myself –  I’m feeling all butterfly-ish.

Please read on for my story and some thoughts about health, both the human, the insect, and the planetary kind.

(Except where noted, all photos are © David Hilden.  Amazing what you can do with a camera phone) Continue reading “Butterflies and bacteria: thoughts on a healthy planet”

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The 36-hour shift

I was reading the paper this morning over my tea and crumpets when this headline caught my attention:

“First-year doctors would be allowed to work 24-hour shifts under new rules”

For web Dave Hilden
An old picture of me

Now there’s a topic near to my heart, so I decided without much forethought to subject you to my ramblings about physician training and the unbelievably long work hours that our society subjects physicians to all the time.  But you may be surprised about what my conclusions are on the topic.

For those of you who read my last post Insomnia Part 1 and are looking for Insomnia Part 2, please bear with me because that second part is coming next week, complete with more insights from Samantha Anders, sleep expert from the Sleep Center at HCMC.  I’m hoping to get some video interviewing done with Dr. Anders about behavioral therapy for insomnia, so stay tuned for that.

Why should you care about work rules for doctors-in-training?

That headline was from a Washington Post article covering the a proposed relaxation of work-hour restrictions for interns in hospitals.  So here are some stories from my own experience about the rigors of medical training.  Hopefully you’ll find something in here to get you thinking.   Continue reading “The 36-hour shift”

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Reflections (but no pictures) from 9/11 and this week’s Emergency Preparedness topic

nycA remembrance:

Fifteen years ago today at around 8:00 Minneapolis time, I was in the Intensive Care Unit at HCMC.  I was a medical resident on that day doing my rotation in Nephrology and was visiting a critically-ill patient in the ICU with really bad kidney problems.  My attending physician on that day was my med school adviser and my residency program director, Dr. Morris Davidman.  Though no longer practicing, he’s still a mentor, role model and friend.  He was the first person I talked to about what was certain to be a much-changed world  that day.

I remember that day well, and today marks its 15th anniversary.  That is long enough that my own kids were too young to remember and a whole generation is growing up not having been born yet in 2001.  To me that’s a strangely weird thought.  I’m not going to write about those events per se, as enough is already written and said about it and I have no insight whatsoever that each of you reading this doesn’t already have.  And I’m not posting pictures of the tragedy after reading a provocative blog post from a New Yorker basically saying that the none of that is helpful  . . . we all know what it looked like.  Instead, I’m showing the NYC skyline as it looks now from my recent ride on the Staten Island Ferry.  I do love New York.

That being said, I think it therapeutic and natural for us to remember where we were, what we were doing, and then stop and remember those who were impacted so directly – people in New York City and Washington, people on those planes, their loved ones, the firefighters and cops and first responders.  Perhaps take a few deep breaths and remember that though we cannot prevent bad things from happening, we can still dedicate ourselves to doing good in the world and remember the terrific and loving people in our lives.

So I remember standing next to Dr. Davidman watching the TV above the head of a critically-ill and comatose patient.

Do you remember where you were?


National Preparedness month

Regional 2016 National Preparedness Month Logo

“Americans have been tested by trial and tragedy since our earliest days — but year after year, no matter the hardship, we pull through and forge ahead.”

                                   President Barack Obama

September is National Preparedness month so that was the topic today on our Healthy Matters radio broadcast.  I guess it was apropos given that today is September 11.  To help me, I invited Mark Lappe, the Director of Emergency Management here at my hospital.  Did you know most hospitals have a Department of Emergency Management?  I knew my hospital does, given that it is a major Level I trauma center, but I guess I didn’t know that most other hospitals do as well.

We talked about community-wide preparedness as well as the steps hospitals take to stay prepared for bad situations.  Like the generators that kick in at HCMC (my hospital) within 2 seconds of a power outage across a campus spanning 6 downtown city blocks.  Wow.  Then we moved to emergency preparedness in your own homes, so as promised, I’m going to put some links here for more information.  You’ll find them in a bit.  In the meantime, listen to Mark on the podcast if you wish.

To read President Obama’s full proclamation, click here.

Why worry?

When I think about 9/11 and about the other disasters that we hear about just about every week in the news, I often wonder if it makes any difference whether we plan for them or not.  Have you ever felt that way?  After all, between flooding in Louisiana and shootings in Orlando and terrorism on the French Riviera, it’s easy to feel like we live in a whole new world in which we are powerless to defend ourselves.

But I resist that thought whenever it hits.

Certainly, there are loads of events that we are powerless to either predict or prevent.  That being the case, I think I find myself drawing two conclusions:

  1.  I am not deterred by awful events in living my life.  I will continue to travel, attend big celebratory events, meet new people, welcome the immigrant to our community, learn about new cultures, enjoy fine art, and most of all see new places in the world.
  2. But I think it wise to listen to those among us who have expertise in keeping us safe, like Mark Lappe on my radio show today

The first point reflects my belief that we need to keep on living boldly and not let scary things paralyze us.

I know terrorism is real but the terrorists score a victory when we demonize immigrants, pre-judge people in the name of safety, allow the government to invade our privacy and scale back our liberties  . . .  all out of fear.  Benjamin Franklin was right when he said:

“Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety”

And the Zika virus is also real and scary.  But we have the knowledge, if perhaps not the willpower, to do something about it, so let’s do it!  See below for one suggestion on how you can act.

And earthquakes and tornadoes and flooding are real as well.  But we can do something about climate change and when natural disasters do occur, we can do like we always do and help each other out.

Which leads me to the 2nd point above, now that I’ve been on my soapbox a little bit (sorry!) and that is that a bit of advance planning seems to make some sense.  So now onto some resources you may wish to check out in keeping your family safe and secure during emergency situations.

Great resources and a call for action

A good place to start is ready.gov which is a comprehensive site from the US Department of Homeland Security.   Click around the site for a while; it is really comprehensive with information on a variety of topics for you and your family.

One of the recommendations from the experts to prepare your own family for emergencies is to make an Emergency Plan.   Get help with making a plan for your family here from FEMA.  There are printable checklists of supplies you should have in an Emergency Kit.  (One aside . . . those of you who watch The Big Bang Theory may know that Sheldon has not one, but two, emergency kits in his apartment.  And he’s a genuine genius.)

We learned on the show that texting is preferable to calling on the phone if you or a loved one is caught in a disaster situation.  Teach your kids to text you “I’m OK and I am currently at location here” if you ever find yourself separated.  Phone lines, even cellular lines, often don’t work in disasters!  It’s also a great idea to write down all your contact information.  The FEMA site has some downloadable sheets to help with as well.

A call for action

I encourage you to contact your member of Congress and US Senator and urge funding for overcoming the Zika virus.  We have the medical knowledge and the public health knowledge to solve the spread of Zika.  We just need our leaders to act!  Or if you don’t favor such an approach (hey, people have different views on how best to act and that’s OK) then tell your elected officials your own view.  It’s no longer just in other countries (though we should have acted to help other countries long before this), it is our neighbors in Florida and Puerto Rico we are talking about with Zika.

Public enemy #1
Public enemy #1, Aedes aeygptii

 

So some thoughts on risk and planning, disasters and planning for disasters.  I admit you probably have as much insight into these issues as I do, which I’d love to hear!  Next post will be about something medical.  Since this is a medical blog and all.

Thanks for stopping by!

David

 

 

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The finer things: Beethoven’s 5th, Dutch bicycles, and naked saunas

Concergebouw interior emptyBeethoven, bicycles in Holland, and naked saunas.  Now if anything screams “get your in-depth medical information here” . . . well let’s just say you’ve come to the wrong place.

But among other things, my life the past two weeks has involved, yes, numerous encounters with my man Beethoven, dodging bicycles in Amsterdam, and naked saunas in Finland.

I’ve had an interesting two weeks.  I’ve been away from the Mother Ship (aka Hennepin County Medical Center) for a while so haven’t had a chance to write or post anything medically relevant.  Instead I’m going to subject you, dear reader, to some musings from my recent travel experiences when I was fortunate to serve as the tour physician for the Minnesota Orchestra as it played incredible concerts to sold-out European audiences.  I’ll try to weave a bit of medical perspective into this post but mostly get ready for my ramblings about things that make me happy  – which when you think about it is a cornerstone to a healthy life.

And if you want to know what Beethoven has in common with either Dutch bicycles or with naked people in Finnish saunas, well you’ll just have to read on at your own peril. Continue reading “The finer things: Beethoven’s 5th, Dutch bicycles, and naked saunas”

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