What is Pain?

The emotion of guilt is very similar to the sensation of physical pain, and serves a similar purpose.

by Alan B. Sanderson, MD

Pain is a subject that pretty much everyone has some experience with. We have been experiencing pain since before our earliest memories. It is also a subject familiar to medical doctors, most of whom spend a significant portion of their time trying to manage pain in their patients. The current epidemic of opioid addiction is a tragedy for many people and their loved ones, and a hardship for countless more. This post will begin by discussing physical pain, and then move into a discussion about the analogous subject of emotional guilt.

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Where is the Office for EGO Processing?

A humble doctor can be just as capable and skilled as a proud doctor, and can have just as much confidence in his own ability, but his meekness makes him able to accept correction and acknowledge his own mistakes, and gives him a greater advantage in leading his team.

by Alan Sanderson

ID Processing

Some years ago as I walked the halls of the massive sprawling medical campus where I did my residency training, I came upon a sign that caught my attention because of its potential double meaning. The sign said, “ID Processing,” which is the office where ID badges are made. But I thought to myself, “Where’s the office for EGO Processing? That’s what we really need around here.”

(If you don’t get the joke, then look up Sigmund Freud’s structural model of the psyche. I remember my parents told me when I was a kid that if you have to explain a joke, then it wasn’t funny.)

Anyone familiar with healthcare team dynamics will know that the doctor is the most likely person on the team to have a big ego. This seems to be particularly true for surgeons and other proceduralists, but I have met doctors from many specialties who seem to have an inflated view of themselves. (For the record, I have also known many surgeons who are kind and humble people.)

There are many reasons for doctors to have inflated egos, and much has been written on the subject. The proposed causes include baseline personality characteristics, the conditioning of medical training, and the lack of effective leadership skills training. Also, having a specialized knowledge base and skill set changes the way people treat you and the way you think about yourself, especially when that skill set is in high demand.

But there is a difference between having confidence in yourself and in your skills (which is generally a good thing), and having an inflated ego (which is considered to be a bad thing). Is the difference simply a matter of degree, or is there some qualitative difference? And what is actually bad about having a big ego?

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Going Off Course

We don’t want to reach the finish line and then discover that we have skipped part of the trail.

by Alan B. Sanderson, MD

Recently I ran a trail half marathon near Bryce Canyon, and I have been thinking about an incident during the race ever since. At about mile 7.5 I was coming down a dirt road at a fast pace, with tall pine trees all around and hoodoos in the cliffs above me to my right. At a small clearing in the woods the course suddenly veered off of the road in a sharp angle onto a single-track side trail to the right. The turn was marked with signs and pink ribbons tied to a tree branch at the turn. I was watching for this turnoff because I had run on these trails before and I had studied the course before race day.

Going Off Course - map-arrows

Satellite view of the tight turn onto the side trail to the right. The dashed path shows where the runner went off course.

But a runner who was a few hundred feet in front of me blew right past the signs and kept running down the road. This surprised and confused me, and I didn’t know how to react in the moment. My first thought was actually, “Oh, maybe she’s not running in the race after all.” I like to go trail running by myself, and occasionally I will happen upon a trail race which is underway. (That actually happened to me just two weeks before the race.) Also there were multiple race distances on the same day, with runners doing 50 kilometers, 50 miles, and 100 miles on overlapping courses. Maybe she was racing one of the other distances?

A few minutes after turning up the side trail it finally occurred to me that I should have asked her. I should have called out, “Hey! You’re going off course!” or “You missed the turn!” But she looked so confident, running right past the signs, that I didn’t even think to question her at first. Obviously she knew where she was going.

Or maybe not.
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Simultaneously on Both Sides of the Veil

I wrote a guest blog post at my brother’s website, which went live this morning. It is a discussion of the use of chiasmus in Elder Dale G. Renlund’s April 2018 General Conference talk. Elder Renlund told a remarkable story about a heart transplant recipient who became an important figure in the life of his donor’s family. The recipient acted as proxy for his donor as he was sealed to his family in the temple. It is a powerful story, and Elder Renlund used a subtle but very effective literary device to tell it, as I explain in the post: Simultaneously on Both Sides of the Veil: Chiasmus in Elder Renlund’s “Family History and Temple Work: Sealing and Healing.”

Enjoy!


Alan B. Sanderson, MD is a member of The Church of Jesus Christ of Latter-day Saints and is a practicing neurologist.

Do you know someone who needs to hear this message? Please share it with them.

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Ministering for Sociophobes: A Practical Guide

If you have social phobia, please know that there are positive things you can do about it.

by Alan B. Sanderson, MD

One of my earliest memories of social anxiety was when I delivered an invitation to the next-door neighbors to attend my baptismal service when I was 8 years old. This simple errand absolutely terrified me, and I found myself unable to ring their doorbell. After a brief and panicked deliberation I left the invitation on their doorstep and ran for home. It would be nearly two decades before I learned the name of this disorder and started making positive changes to address it, but by then my social anxiety had already exacted a significant toll on my life. This toll was particularly heavy on my Church service as a missionary, as a home teacher, and in other callings. In this post I will describe the symptoms and management of social anxiety disorder and will provide some insights from my own experience about how to work through these limitations to get your Church callings done. Continue reading

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Dr. Sanderson’s Miracle Insomnia CURE!

Learn about the groundbreaking new method that has helped ONE PERSON overcome sleep-onset insomnia!

by Alan B. Sanderson, MD

DSC06932

One of our kids fell asleep with a plastic fish toy in his mouth.

Sleep is a fascinating topic for geeks like me. It turns out that scientists don’t have a satisfactory answer to the first question about sleep: why do we need to do it? It is very clear that we do need to sleep, as all sorts of bad things happen when sleep is disrupted, but its ultimate physiologic purpose remains a mystery.

During my residency I developed an effective way to shut off my mind and go to sleep when I was on overnight call assignments in the hospital. Those were sometimes incredibly stressful nights, and opportunities to sleep were precious and fleeting. There was no time to waste with insomnia. You never knew when that pager was going to go off, so you had to get your sleep while the getting was good.

Please note that this method has not been studied in clinical trials, and that I cannot guarantee its success in your particular situation (and that this post does not constitute medical advice, etc.). But it worked well in the crucible of my residency call nights, and I still apply it with good results today. Consider this post as a personal testimonial. Continue reading

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Confidence in Our Special Knowledge

Just as a physician develops special skills and knowledge through years of apprenticeship, all of us can become disciples of the Savior and be recipients of special light and knowledge.

by Rand Colbert, MD

A few days before graduation, my medical school arranged for a first year internal medicine resident to come and speak to our graduating class about the transition between medical school and residency. Of all of the bits of advice he offered us, one thing he said stood out above all others. He told us to “never let your patients discover that you are the fraud that you know you are.” Of course, this was supposed to be funny, but behind the humor there was a tongue-in-cheek reality that became very real over the next year for me and for every student in my graduating class.

One minute I was a student with a short white coat and the next minute, I wore a longer white coat with “Rand Colbert MD” embroidered above the pocket. It felt strange to actually be a doctor, and I felt like an imposter wearing the longer coat. I spent my one year general internship at the largest private hospital in Wisconsin, with over 700 beds at the time. I can remember my first night on call. There were only two of us interns in the hospital that night, covering all of the patients on our service. Our supervising physician was a brand new second year resident from Pakistan, who had completed her internship two years earlier, spoke English with a thick accent, and was more scared than we were. We didn’t see her all night (she hid in her call room).

I remember the first “code blue” that was called over the loud speakers that night. My pager went off simultaneously since I was designated to cover all emergency situations whenever a patient went into cardiopulmonary arrest. As I ran toward the room where the patient was dying, I wished I could go and hide with my senior resident. The advice given to us just prior to graduation by that wise internal medicine resident rang in my ears louder than the alarm sounding in the halls of the hospital.

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