A Little Book of Doctors' Rules III
"All cultures have their sages. The job of the sage is to codify and pass on nuggets of wisdom gained through experience, observation, and reflection. Dr. Meador is our sage and this little book of rules for clinical practice is just so: a collection of proverbs carefully rendered and trustworthy, offered as guidance for the clinical encounter that we may avoid folly, proceed expeditiously, render comfort, and see our patients safely through. My advice: read the entire volume over a week-end, then begin again, reading a few at a time over coffee before work, or at the end of the day – to great profit for yourself and your patients!"
John Leonard, MD
Professor of Medicine Emeritus,
Department of Medicine, Vanderbilt University
Former Residency Program Director, Internal Medicine
"This book is so valuable because Meador reminds doctors that they are treating a person, not a disease. With that in mind, he stresses the importance of listening to the patient, observing him, and even touching him.
First, listen for clues: "Most patients can tell you why they got sick. . . Let a patient ramble for least 5 minutes when you first see them. You will learn a lot."
Then, be sure you are facing the patient. "Learn to watch people's faces and eyes. Learn to watch their lower lip and then the upper lip."
Finally, "Always examine the part that hurts. Put your hand on the area."
Then, based on what he has heard, seen and felt, the doctor is in a position to begin ordering tests-- but not a battery of tests: "Use laboratory tests like a rifle, not a shotgun." Over-testing can lead to over-treating."
author of Money-Driven Medicine: The Real Reason HealthCare Costs So Much.
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Fascinomas - Fascinating Medical Mysteries
“Meador offers a pleasant set of anecdotes about puzzling symptoms and the work of the ‘physician detective.’ A quick and enjoyable book of health-related who- and whodunits.”
“Fellow Physicians will find both hilarious entertainment along with some ‘aHa!’ moments that will sharpen their diagnostic acumen. For the general reader this book is not only entertaining but very informative about many aspects of the practice of medicine that should prove fascinating in the realm of Ripley’s Believe it or Not!
Some of the cases (and each is so short that giving away too many examples would hamper the joy of reading this book for those who wish to purchase it) include a strange case of ascending paralysis in a young girl that could have proven fatal had not a curious nurse in ICU no found the bulbar tick bite in the girl’s long hair, the removal of which immediately reversed the life threatening neurologic disorder that had puzzled all physicians involved, a case of an obese couple placed on a diet to reduce - not knowing that the woman would chew exorbitant amounts of sugarless gum (containing the culprit sorbital) that resulted is serious diarrhea, cases of Munchausen Syndrome (patients who inflict harm on themselves for secondary gain), a tale of the helpful aspects of rat eating snakes, a bizarre diagnosis of carbon monoxide poisoning that is a ‘true detective mystery’ sort, a case of dose and generic pill color resulting in adverse reactions easily altered by a bright observing physician’s thoughtful input, some old wive’s tales intervening in diagnostic dilemmas that prove to be not elegant possible surgical diagnoses but chicken pox!. The lost goes on and on.
Meador’s quite the gifted writer in discussing these cases and keeps just the right amount of mirth along side pertinent learning information to make these stories appeal to both medical and non medical readers: he has been writing satiric medical articles in the best of journals for many years now! Highly recommended.”
Grady Harp, November 2013
“A 5 star fascinating journey through the mind and bodies of humans. We are such complex systems filled with amazing interlinking processes. I was fortunate to hear a radio talk show with Dr Meador and couldn't wait to read his books. His writing is both tongue in cheek and scientifically accurate. Truly enjoyable reading. ”
D. Hanavan, February 2014
“It was short and sweet and to the point. Personally, I would have liked more substance in the stories, but all in all, a good read. ”
William R. Jones, January 2014
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True Medical Detective Stories
“An intriguing account of 19 medical mysteries and the true–life medical detectives who solved them. Over his 50-plus years of practicing medicine, Meador (Puzzling Symptoms, 2010, etc.) has seen many unusual illnesses that defied traditional diagnosis. In his latest book, he recounts the most fascinating–and downright bizarre–of these cases, in which patients experienced troubling medical symptoms with no apparent cause. The cases involve both Meador’s and others doctors’ patients. All, however, are solved using the same method: medical deduction rooted in careful listening.
The book begins with a dedication to the late Berton Roueché, who popularized the medical-detective genre as a staff writer for the New Yorker. The first chapter, “Dr. Jim’s Breasts,” revisits an interesting case involving a 76–year–old man who suffers from the ailment of the title. Without giving away the ending, through much inquiry, the cause of the man’s breast enlargement is discovered–and it is a curious cause indeed. This and other cases illuminate a consistent theme, which is that patients, with a doctor’s guidance, are often their own best medical detectives. In the chapter “Two Cases of Pneumonia: Two Different Causes,” two unexplained incidents of chronic pneumonia are solved by an infectious disease specialist who teases out patient histories with careful listening and questioning and by “involving a family member in the search for clues.” Other chapters, such as “A Paradoxical Suicide Attempt” and “A Near Death from Hexing,” provide striking examples of the mind’s ability to create profound physiological responses and the need for physicians to take this into account.
The author’s suspenseful, Sherlock Holmes–esque retelling of each case will keep the pages turning. But this is more than just a collection of entertaining anecdotes. In an age of technology-driven, impersonal medical care, Meador provides a powerful reminder of the need for meaningful dialogue between doctors and patients.
In a world of high-tech medical care, Meador makes a compelling argument for the simplest of diagnostic tools—listening to a patient.”
“Dr. Meador is offering up much more than an entertaining series of medical anecdotes. He is offering an object lesson on the importance of the "clinical interview", the dialogue between patient and physician that is prerequisite to any meaningful outcome. This is a lesson that should never be lost in the debates over reforming the “health care system”. And Dr. Meador offers it up in a masterly fashion.”
“After retiring from 32 years as a surgical RN, there is not much that can surprise me. This writer artfully points out how being a thorough listener can glean amazing relevant facts from their patients and families. So often we in the medical profession give our brief spiel to patients, being pressed for time...Unfortunately, our allotted time with patients is very limited. One of our orthopedic surgeons had created a solo practice in order to practice a more humanistic approach. He told the story of an elderly lady who had lost her husband and presented with chronic wrist/hand pain. Nothing appeared to be abnormal. Upon listening to the patient state repeatedly that she literally could not handle it any more...the MD chatted with her and found that she felt overwhelmed by the tasks presented since her husbands demise. With encouragement from the MD, she agreed to allow her family and friends to become an active part of her support system, and her pain disappeared upon leaving the office!
Wonderfully written book with an interesting review of how young MDs also have their journey through their own belief systems. We all have them. Hopefully no lizards are involved! Delightfully written.”
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Symptoms of Unknown Origin
“This book is about thinking outside of the box when confronting human illness. It consists of a collection of very entertaining medical enigmas from Dr. Meador's career that serve as parables to illustrate the inadequacies of the prevailing "biomolecular" approach to understanding and treating illness.
Although the biomolecular model of Dr. Meador's day has since been supplanted by the biopsychosocial model in academic circles, in actual clinical practice this transition has yet to occur. Instead of searching for root causes, we learn to blame our patients for their refractory illnesses by characterizing them as "problem patients", "difficult", or "noncompliant". Those labels are often true, but they don't encourage or help us to address the underlying problems. Dr. Meador's book does.
Whether you're a dedicated "never-give-up" doctor who wants to help even your most trying patients, a frustrated clinician who is sick of losing battles with chronic disease day in and day out, or simply a perceptive soul who snickers at the thought of trying to reduce a whole patient into a set of ICD-9 codes, I think you will find this instructive and compassionate little book to be full of insights that will make it worth reading and re-reading on a regular basis.”
“This book, Symptoms of Unknown Origin, was fascinating. The author, Dr. Meador, tells about his working with and learning over time with patients who seem to have no origin for their diagnosis. Using the skills of a neurolinquist he sharpens his ability to find causes where none seem to exist, and such causes are often outside of the medical field. It was a "can't put it down" book.”
“Dr. Meader uses case studies to consider how physicians can recognize and treat patients with symptoms hitherto deemed 'imaginary' or unconnected to disease. These case histories are bizarre and unique, but go a long way in illustrating how diagnoses can easily be wrong, and how the methods Dr. Meador developed to diagnose 'nonexistent' diseases can help physicians consider diagnosis more fully. Dr. Meader urges subsequent studies to test his observations, but the real meat here lies in case history examples which are eye-opening surveys of uncommon medical health and disease indicators. ”
Midwest Book Review
“I am proud to claim Cliff Meador as a friend and mentor throughout my medical career, and this book will show you why. It's funny, brilliant, and gets at the heart of the practice of medicine: the intimate, important interactions between doctor and patient, science and humanity, suffering and healing. More than anecdotal, this ought to be required reading for every medical student, and for anyone who's ever been a patient. ”
Mary A. Harbison
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“In reading this enthralling book, one is taken step by step through the education and life of a medical student and young doctor. You will laugh and you will cry. This is an exciting and entertaining memoir. It is filled with true stories, vignettes and experiences that will make you understand how doctors are created and why they are like they are. He pays tribute to his patients, as well as, his professors as eminent teachers. Dr. Meador's compassion and extraordinary sense of humor combine to give him an inimitable voice...one that leads you rapidly through the book... When you finish you wish it had not ended so soon.....”
Betty Ruth Speir
“I love this little book. Of course the fact that I was in med school in Birmingham, AL about the same time author Meador was in med school in Nashville, TN, probably has a lot to do with that. Although some of the content is historical, and some frankly hysterically funny, this is how the American doctors of the past 50 years were trained. It behooves patients to try to understand this as they work on their own patient-physician relationships. Yes, medicine has changed a lot, but Meador's tales suggest that med school, in essence, may not have changed much. We have published an excerpt chapter of Med School at [...] if the Amazon reader wants to taste before buying. ”
George D. Lundberg
“If medicine is your avocation as well as your vocation, you read books like this. And his are always pleasant. ”
Susan W. Hawn
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A Little Book of Nurses' Rules
“I discovered this little book many years ago at an education seminar and fell in love with it. There's truly something for every nurse in the book, new nurses get the benefit of more seasoned practitioners, older nurses can be reminded of why we really got into this field. It's perfect for hospital nurses, specialists, office nurses, school nurses, too. It makes a perfect "little gift" for the nurse who was so good to you in the hospital (you can gift all the nurses with just one package!), or the one in your doctor's office who takes extra time with you. Trust me, you can make lots of people smile with this!”
“I enjoy this book as a quick reminder of some of the things I tend to forget when things get busy. Some of the stuff is silly and some stuff I disagree with & it is occasionaly preachy but on the whole it hits the mark. I love "signs of a bad shift..." & live by "there are only 3 ways to answer a question..."
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A Little Book of Doctors' Rules
“There is nothing new in this book but there is nowhere you can get all this wisdom in one place that is still in print. This book has REALLY essential information for anyone who wants to be a "complete physician." This is not a book about how to read a blood gas or treat high blood pressure. It is a book of strategies, tips and observations on dealing with the people called patients and their families. It is in an easy to take format sans heavy analysis. The book will help you help people but it also helps me to remember that everybody has problems with patients and they can't always be solved.”
Susan W. Hawn
“I've been in the practice of medicine for nearly 30 years, and, over those years, have continued to love caring for, and about, patients. I don't know if my medical school was especially prescient, but many of the rules in the book were passed on to me as part of good medical practice, and I continue to hold to them as a practical ideal. In fact, I now give copies of the book to graduating medical students, nurse practitioners, and physician's assistants who train under me. They know that these "rules" govern my practice, and I emphasize to them the need to practice similarly as their careers proceed. Unfortunately, I know all too many colleagues who scoff at any suggestion that their practices might be improved by assimilating many of these ideals, not to mention improving the satisfaction level in their practice of medicine. These days, it all too often seems that people who go into medicine do so for all of the wrong reasons, predominantly surrounding greed and the pursuit of the almighty buck, and their satisfaction levels plummet. I wish I could get through to these people, to tell them that there is a better way, but, by that point, they won't hear of it. They're too busy making all the money they can, and don't realize that gold doesn't buy happiness. My advice: to doctors, buy it now, and read it before you become disillusioned and jaded; for those who have friends or loved ones entering the medical field, buy the book and give it to them. It just might make them better doctors, and better people.”
C. J. Fara