confused doctor


Many people have questions about their bodies that seem so silly, they never bring them up with their doctors. While the answers are sometimes humorous, often they are more complicated and important than we imagine. An expert physician/writer discusses.

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  • Dr. James Hamblin, Senior Editor, Atlantic Magazine and author, If Our Bodies Could Talk: A Guide to Operating and Maintaining A Human Body

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Misconstrued Body Basics

Nancy Benson: A lot of people have questions about their bodies that they never bring up to their doctors – they just seem too silly. Things like, “can I lose a contact lens behind my eye?” “Why do people have dimples?” and one of Dr. James Hamblin’s favorites, “why do people experience itching?”

Dr. James Hamblin: I wanted to start with some of these seemingly trivial questions and the point of the answer is to show that something that seems like it should have an easy explanation just doesn’t, we don’t understand it and historically its often been chalked up to mental illness in a lot of people who keep coming back to their doctors saying they’re itching and the doctor can’t find anything quote/unquote wrong with the person, can’t diagnose and particular condition.

Benson: Hamblin is a Senior Editor at the Atlantic Magazine and author of “If Our Bodies Could Talk: A Guide to Operating and Maintaining A Human Body.”

Hamblin: In recent years you’ve seen a springing up of different academic centers which are meant to be referral centers for people just suffering from itch of an unknown cause. And it’s a great example of medicine being organized around, what we used to think of as a symptom, but the main complaint of a person and trying to solve it that way. To bring it together a neurologists, dermatologists, sometimes psychiatrists, people who study human physiology at a biochemical level and trying to figure out this problem as opposed to taking a patient and having them jump around from, “go see the neurologists and go see the dermatologist” and no one is really tackling the problem itself.

Benson: Hamblin says that problems like itching often get dismissed by doctors and loved ones but if an itch is driving you crazy, it’s serious to you – maybe more serious than anybody thinks.

Hamblin: There’s a story of someone who had chronic itch for a long time, no one could figure it out, ended up coming to one of these itch centers and had a tumor that was causing this imbalance that was causing them to chronically itch. It was actually the sort of cultural bias toward itch as a non serious thing that everyone experiences and that’s what the experts I spoke to said, “might’ve caused people to overlook it and not take it seriously.” And I don’t want listeners to think that just because they’re itching that means that they might have cancer – it doesn’t, but it’s a reminder that for a lot of people it’s a serious thing.

Benson: Hamblin says sleep is another issue that people don’t take seriously. Young doctors for example, are forced to discount sleep during their residencies, working shifts that are 28 hours straight. You’d think that they’d admit that they’re impaired by the end of those long days, but Hamblin says denial is common. We all do it, we may be walking around like zombies, but we think we’re just fine.

Hamblin: Its sort of a blindness to our own impairment and for me it took extreme sleep deprivation which I went through in medical training and all doctors do go through, after you’ve stayed awake for a 30 hour shift you experience some really eerie forgetfulness, some swings of mood and some possible bouts of feeling giddy or even delirious and then you can really feel those effects. And, when they’re subtler, when you have gone consistently with only 5 or 6 hours of sleep and you should’ve been getting 7 a lot of people say, “oh maybe I’m a little tired but I’m functioning fine,” when in fact they’re forgetful, their reaction times are impaired and we may be so used to not getting enough sleep that we don’t even feel impaired at all.

Benson: However you may be surprised to learn how long some people have gone completely without sleep. Hamblin says the record as far as he knows is 11 days.

Hamblin: There were Stanford researchers overseeing this, what would not now be considered a safe experiment, but was at the time fully approvable. A teenager stayed awake that long and he raises the idea that while 7 hours tend to be the point in which we cluster, where most people need right around 7 hours, you do have this sort of bell-curve and outliers who seem to be able to function just fine on much less sleep. But that doesn’t mean that we should treat going about sleep as some feat of strength or accomplishment, which our society tends to do.

Benson: You’d think anyone staying awake for a week and half would suffer some pretty serious consequences but Hamblin says this particular teenager was one of those mysterious outliers.

Hamblin: According to reports at the time – this was in the 1960’s – he had some mild impairments at certain points, but was generally fully conversant, beat one of the researchers playing pinball on something like the 7th or 8th night, so didn’t at all seem like someone who was “The Walking Dead.” And then ended up sleeping, he said I believe, for 14 hours and then got up and was fine.

Benson: But isn’t that the kind of stress on the body that makes people sick later? People are more likely to come down with a cold or the flue after a few sleepless nights. So many of them take mega doses of vitamin-C or folk remedy immune boosters to try and stay well. But Hamblin says the effectiveness of most of those supplements is a myth.

Hamblin: There are a lot of products out there, most of them in the dietary supplement realm, that claim to broadly boost the immune system and it may be possible to protect yourself from certain diseases like the flu by not shaking hands with someone who’s contagious and by not having any particular immune deficiency like HIV, these products notoriously don’t help with those things and potentially could hurt in that if you feel emboldened by the fact hat you took a bunch of vitamin-C and then you don’t take the basic precautions of washing your hands and covering your mouth when you cough, and getting enough sleep and eating well and generally all those things that improve our immune system – then you can actually end up worse off.

Benson: That’s one of the points Hamblin makes repeatedly. While we can laugh at questions like, “Why do people have dimples?” his book isn’t the literary equivalent of cat videos. Some of the answers are complicated and a few can have serious consequences.

Hamblin: Just because a little bit of something can be good – can be very good, life saving even – doesn’t mean that more is gonna be better. Vitamin-A along with the other fat soluble vitamins is one that you can get too much of, so it’s a quest to resist this tendency to think, “I need to totally avoid something or I need to get as much of it as I can.” When in most cases, we just need to live in that middle ground.

Benson: You can find out more about all of our guests on our website, Our production director is Sean Waldron. I’m Nancy Benson.

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