PHYSICIANS IN SICKNESS

   I did mention some incidences of physicians who neglected their own health , not sure if it was due to'fear' or shear neglect or feeling of invincibility.In any case their diagnosis gets delayed and outcomes are not all ways favourable . The next story is that of someone I knew.
   This physician was a lung specialist . He was quite overweight or even obese . (now a days if body -mass-index is 25 to 30 , it is called overweight , if it is more than 30 , it is called obese .)He had some shortness of breath and some neck pain . Our job involves misuse of neck . We hold phone by our shoulder and twisting neck , we do many procedures with neck being bent all the time and even writing or working on computer does same thing. This leads to arthritis  of neck . He did CT scan of cervical spine and found out that he had pinched nerves . He had attributed his shortness of breath to being overweight .He had the spine surgery . His pain was better , but the weakness in arms continued to get worse . So now the further work up was done and it showed that he had ALS. In this disorder there is degeneration of spinal column and this leads to weakness and then paralysis , which continues to get worse and one can become quadriplegic . In advanced case they will need respirator and a feeding tube . Once the diagnosis is established , the prognosis was clear and so was the treatment . We as physicians advice tracheostomy to help handle secretions and feeding tube to avoid aspiration and the respirator . HE SAID NO TO EVERYTHING , KNOWING FULLY WELL THAT HE WILL DIE WITHOUT THIS HELP . In this case the diagnosis was not that delayed and even if it was done few months earlier , it would not have changed the outcome , and this brave physician decided not to go through 'torture ' of treatment .(Stephen Hawkins has same thin and he has full support ).