Addiction

“[We] came to believe that a Power greater than ourselves could restore us to sanity.” –(The Twelve Steps of Alcoholics Anonymous, step 2)

by Alan Sanderson, MD

This week I received a letter from Dr. Vivek Murthy, MD, MBA, who is currently the United States Surgeon General. In fact, every doctor in America was sent the same letter, and this is the first time in history that a Surgeon General has reached out individually to every physician in the United States. What public health crisis was so important as to warrant this historic action? Was it the Zika virus? Was it heart disease or cancer, the top two causes of death in the US? It was none of these. His subject was the opioid epidemic, a problem caused largely by our profession’s chronic mismanagement of pain. His letter states:

“It is important to recognize that we arrived at this place on a path paved with good intentions. Nearly two decades ago, we were encouraged to be more aggressive about treating pain, often without enough training and support to do so safely. This coincided with heavy marketing of opioids to doctors. Many of us were even taught – incorrectly – that opioids are not addictive when prescribed for legitimate pain.

“The results have been devastating. Since 1999, opioid overdose deaths have quadrupled and opioid prescriptions have increased markedly – almost enough for every adult in America to have a bottle of pills. Yet the amount of pain reported by Americans has not changed.”

(The full text of the letter can be found here: TurnTheTideRx.org.)

Early in medical school I was taught in a memorable lecture that it is shameful for a doctor to let a patient suffer pain. We were instructed to open the flood gates and bathe our patients in the sweet balm of narcotic goodness they needed. (The lecture was a bit more nuanced, but that was the very clear take-home message.) A year or so later during my clinical rotations I began to see firsthand a much darker side of the picture: drug-seeking addicts with insatiable appetites for controlled substances, manipulating every relationship with the goal of getting more drugs. I have seen how addiction can poison doctor-patient relationships in every specialty I rotated through in medical school and residency, in hospitals, clinics, and emergency rooms, and countless times during my career in neurology. Continue reading

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The Works of God Made Manifest

Disease can be one of God’s most powerful refining tools.

by Alan Sanderson, MD. Adapted from remarks given at the funeral of Stewart C. Sanderson, 30 July 2016.

Near the summit of Mount Timpanogos.

Near the summit of Mount Timpanogos.

Some of my favorite stories about Uncle Stewart involve Mount Timpanogos. The first happened many years before I was born. His little brother Eric was invited to hike Timpanogos with a friend of his, and Stewart prepared him a lunch to eat on the hike. The family Eric hiked with had all sorts of good food to eat at lunch, and trail mix to eat along the way, but when Eric opened his lunch bag he found only one sandwich. It was a slab of raw turnip between two slices of homemade whole wheat bread. Last year in a family discussion about this story Stewart explained, “Maybe some turnip seemed like a good idea to make up for the dryness of bread! Of course, a person could just drink some water for that. I do like turnips, in moderation.” Eric observed that the real lesson of the story was that “an older brother was thoughtful enough to do that kindness – even if the cuisine was unique to him.”

Uncle Stewart gives a botany lesson to young family members, 2012.

Uncle Stewart gives a botany lesson to young family members, 2012.

When I was eight years old I hiked to the summit of Timpanogos for the first time with my dad and siblings. On our way down from the summit we slid down the glacier, and as we approached Emerald Lake we saw a lanky figure hiking toward us. As we got closer we were surprised to find that it was Uncle Stewart. He was wearing an old pair of jeans, an old long-sleeved dress shirt, and his signature hat. He was also holding an old bleach bottle, which was his water bottle. I remember that he let me drink out of his bottle, and the water smelled and tasted like bleach.

When I was 18 years old I took a trip with Uncle Stewart to Mexico to collect plant samples for his botany research. On that trip he bought a loaf of whole wheat bread and a bottle of Catalina dressing at a grocery store, and ate Catalina dressing sandwiches for most of his meals. Ten years later he was still using that same old bleach bottle to carry his water.

I have been asked to say a few words today about Stewart’s experience with the disease which took his life. My goal is to help us understand something about what he suffered, so that we can appreciate how much our thoughts and prayers and service meant to him. Continue reading

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Faith to be Healed

When it comes to healing broken bodies and souls, God is a lot more powerful than any medical doctor.

by Alan B. Sanderson, MD

Many years ago I did something stupid. I climbed Mount Timpanogos (11,752 feet, 3,582 meters) a few days after injuring my left knee. By the time I had reached Emerald Lake at 10,000 feet (3,050 meters) I could tell that my knee was going to be sore, and I considered turning back, but I pushed on because I didn’t want to get so close to the top without getting there. As I approached the summit it became painful to bend my knee, so I hobbled along trying to keep my left leg straight. It became clear to me that I was in trouble when I finally stood at the top of the mountain and gazed down on the valley thousands of feet below me.

While I stood there I worried about a lot of things. My first worry was that I wouldn’t make it down the mountain without help. The thought of having to be rescued because of my own stubborn foolishness was simply mortifying to me (almost literally). I also worried about how much time and money this injury would cost, and I fully expected that I was destined for knee surgery and months of the rehabilitation. Most of all I worried that I had done permanent damage to my knee, and that I could be facing a lifelong disability. Here I was at age 21, active and in excellent physical shape, standing on top of a nearly 12,000 foot mountain, worried that I had just traded my entire future of physical activity for one day of hiking.

As these thoughts and worries reverberated in my mind, I determined to seek help from a higher power. Continue reading

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Science and Religion

We believe in everything which is true, regardless of where the truth may be found.

by Alan B. Sanderson, MD

My father is a geologist. During his career he used the tools of his scientific discipline to answer practical questions about the natural world. “Where do we drill to find petroleum?” “Is it safe to put a building here so close to a fault zone?” “Will this chemical leak get into the ground water?” “Where do we dig to find the most copper in this mine?” When we drove through the beautiful scenery of the American southwest he saw the view differently than other people did. He would often pause on our outings to explain how the canyons and plateaus around us were made. I remember once when I was struggling to understand what he was explaining, he said, “You’re not thinking fourth-dimensionally!” In his mind’s eye all of those sturdy mountain ranges were being simultaneously uplifted and eroded in slow motion over geologic time, following the laws of nature.

My dad is also a man of faith, and is a creationist. That is, he believes that God is literally the creator of the earth. This doctrine is clearly taught in the Bible, and the scriptures revealed in modern times have also confirmed it. (For instance, see the creation stories in the books of Moses and Abraham in the Pearl of Great Price and compare to the account in Genesis.) If the scientific method can teach us about geology, he reasoned, then it must reveal something about God’s methods in creating the earth. Geology, then, is simply the study of how God creates landforms and sedimentary, igneous, and metamorphic rock masses. Believing in science and also in religion is not contradictory in his view.

The sun is the center of our solar system. The Son of God is the center of the Plan of Salvation. The heart pumps blood. God reveals his word through prophets. Consciousness is a function of the brain. We must forgive others in order to be forgiven. Duchenne muscular dystrophy is caused by mutations in the gene which codes for dystrophin. God is our father in heaven, and he loves us. All of these statements are true, but our methods of discovering these truths may be different, and their relative importance in different contexts may also be different. Continue reading

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The Mortal Doctor

Medical doctors have a unique perspective on mortality, but we are just as mortal as our patients are.

by Alan B. Sanderson, MD

I will always remember the first time I saw someone die. I was a medical student working in the emergency room of a small, quiet hospital, and it was late at night. An ambulance pulled up with sirens blaring, and they wheeled an old man into the trauma bay while giving him chest compressions. Continue reading

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Exercise and Physical Activity

Taking good care of your body is one way to glorify and give thanks to God.

by Alan B. Sanderson, MD

One day when I was a medical student I walked into the kitchen of my home and pulled a carton of ice cream out of the freezer. There was only a bit left at the bottom, so I grabbed a spoon and started eating right out of the container. My four year old son was sitting at the table watching me, and apparently thought that I was going to eat an entire half gallon of ice cream by myself. He said, “Dada, if you eat all of that you’re going to get diabetes!

I glanced from him to the almost empty carton of ice cream in my hand, and to the spoon in my other hand, and then I thought, He’s right! With my family history I’m going to get diabetes for sure if I don’t make some serious changes starting now. This experience marked the beginning of a new direction for me in my personal health habits. Continue reading

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Nursing Hands

Nurses are often called to have the heart of a hero. Sometimes this can be a difficult calling to live up to.

by Sandra G. Babb, RN

I often hear people speak very highly of my profession, saying that nurses are “angels” and “heroes”. I would never say that these compliments are undeserving but if I look at myself honestly, I’m not sure I can describe myself that way. I like to think that I care for all my patients with an equal amount of compassion, refraining from harsh judgment, but I must admit that at times I find it a challenge to do so.

Years ago when I was a fairly new nurse I took a call about a patient that was coming to us from the Emergency Department during a night shift. I sighed when I heard the patient’s name. Continue reading

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The Book of Mormon – Alternate Chronology

A reading chart for The Book of Mormon following a different order through the various subplots.

by Alan B. Sanderson, MD

I have always been fascinated by the many stories and subplots within the narrative of The Book of Mormon, where there are often multiple scenes of action happening simultaneously. Learning this chronology when I was young turned out to be a major milestone towards understanding and appreciating the book. Continue reading

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Best Efforts and Highest Priority

A personal memoir about trying to put first things first in my career choices.

by Alan B. Sanderson, MD

In February 1999 the First Presidency of The Church of Jesus Christ of Latter-day Saints issued a letter which was to be read in all congregations around the world. At the time I was living in a small town in England about 100 miles north of London, and was approaching the halfway point of my mission. I remember when the bishop of my ward read this letter, and I have thought about it many times since then. Continue reading

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Weakness and Strength

A personal story about discovering my own weakness and turning to the Lord for strength.

by Alan B. Sanderson, MD

The Lord has given me a “thorn in the flesh” which has been with me more or less for as long as I can remember. It has caused me anxiety and sorrow on many occasions, and has brought me to my knees on many others.

I remember when I learned the name of my weakness. It was in mid-December of my third year in medical school, on a day when I was given a list of patients to call on the phone to recruit for a research study. Continue reading

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