I’ve been thinking a lot lately about perspective.  Why is it that some people seem to be very good at seeing the forest and others the trees but few can skillfully do both?  I’ll give you an example of what I mean and you’ll understand why I think this is important.

I’ve had wacky blood test results for over a year.  I have a team of four crack physicians, an internist and three specialists, and none of them have been able to figure out what’s wrong with me.  I was relieved when the hematologist/oncologist declared that I did not have leukemia but was less enthusiastic when he followed that with, “there’s definitely something infectious or inflammatory happening but I have no idea what.”  I wanted to reply, “well, isn’t it your JOB to have SOME IDEA what, Mr. Top Doc?”  Instead, I sighed and hoped that when I returned in six months my test results would be closer to normal.

I should preface this with one more piece of information: the week before this office visit I landed in the ER in tremendous pain and barely able to take a breath.  Two docs (I caught one on the last leg of his shift and the other on his first) ruled out a pulmonary embolism, told me it must be muscular, patted me on the head and sent me on my way.  I told Top Doc this as soon as he saw me and then after reviewing my test results he confessed to the absence of all ideas.


I work in a nursing school.  A friend and colleague who was an Emergency Department nurse stopped by my office soon after my ER and Top Doc encounters, asked me to describe the pain, had me point out where (on her back – so she wouldn’t hurt me by pushing on mine) I was experiencing pain and told me that it sounded like my gallbladder.  I told her about my test results and she said that they were consistent with gallstones.  I’m white, a woman and in my forties – a prime candidate.  She advised me to get an ultrasound.  Not wanting to return to any docs immediately, and just being a generally stubborn person, I waited six months until my next appointment with Top Doc and grimaced through intermittent periods of stabbing pain and prolonged dull ache.  I also did some basic research on the gallbladder and gallstones; my friend’s five-minute diagnosis made absolute sense.

When I returned to Top Doc six months later my test results were as screwy as ever.  He was still without ideas.  I reminded him of my ER experience, listed all of the irregularities that the last year of tests had revealed, and asked if maybe it just might possibly perchance be my gallbladder.  I actually saw the giant light bulb over his head switch on – POP! – like when a stadium is being prepared for a night game.  When he recovered his powers of speech, Top Doc stammered something about gallstones being one of the most overlooked blah blah blah … and he wrote me the ultrasound order.

Gallstones.  I have my consult with a surgeon in two days.  After almost eight months of nonsense I’m really looking forward to getting rid of my gallbladder.  If they didn’t suck it out in pieces, I would have my gallbladder bronzed and present it to Top Doc as a reminder that perspective matters and the ability to see both the forest and trees should be required of anyone who holds people’s lives in his hands.  A physician who is out of ideas should be out of practice.  Thank goodness for nurses!  8)