Medicine and common sense
In the article I referenced in my last post, the last couple of paragraphs stood out to me, because it highlights something that I've noticed lately: a lack of common sense and a treatment of symptoms rather than the cause. Especially for what are mostly simple problems like headaches, dizziness, and that sort of thing.
Voltaire once said "Common sense is not so common." And he was right.
One of his regulars is a 99-year-old woman he nicknames "Maggie Sweet." One day he noticed her pulling and scratching at the back of her neck.
Diagnoses started running through his head — basal cell skin cancer, for one — as he asked her what was bothering her.
The problem was a itchy tag on the back of her dress. He pulled scissors from his lab coat pocket and cut it off.
While the above probably makes you chuckle — it did me — we see this sort of thing all the time in the pharmacy. People will ask what to do about a headache. The knee-jerk reaction is to suggest Tylenol or an NSAID. But that's not the best thing. Questions like "How long have you had it?" and "how much fluid are you drinking?" and "do you consume a lot of caffeine?" go a long ways towards pin-pointing an underlying cause. Fixing the cause is a lot better than simply covering it up with a pain-killer.
That's obvious to anyone with a brain. But this holistic approach to medicine is something I don't see in some pharmacists, and it bothers me. Yeah, you could reach for the Excedrin, but is it the best way? I've talked to people with headaches and advised them to drink 32oz of water or so over the following 2-3 hours to see how they feel, and they've come back and told me that they felt great. Some have asked me how to drink that much water. Typically I tell them to get four 8oz glasses, fill them with water, line them up in the fridge, and drink one every 30 minutes, or set a goal to drink all four glasses by dinner. Common sense advice like this can be like a revelation from God for some people — and it's not that they're intellectually deficient. They just don't know much about the human body. Drinking 32oz of water can seem like a huge challenge for people not accustomed to drinking water, so you've got to break it down and make it easy for both them and you.
Busy lifestyles mean inadequate nutrition. In the medical field, we often ignore the basics and reach for the pills.
I worked the other night at a pharmacy I don't typically work at, and I listened to one of the pharmacists tell a patient who was experiencing dizziness to take meclizine. He didn't try to get an overall picture of what was going on in this person's life that could cause them to be experiencing dizzyness. (Were they dehydrated? How's their blood pressure? Do they have an ear problem? Etc.) And this was a very smart pharmacist who knows more about pharmacology and drugs than a lot of pharmacists just out of school who haven't had time to forget it all.
While meclizine doesn't hurt, was it really the best remedy under the circumstances?
I was fortunate to learn from someone with a very common sense-oriented approach to medicine, and I'm thankful for it all the time, because I am more effective as a professional. I wish more people had had a mentor like I have, because there'd be less reaching for the pills and more of the making lifestyle changes.
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