Posts by Brett Hendel-Paterson

Ebola and “Unknown Unknowns”

I did not think I would ever quote Donald Rumsfeld in one of my blog posts, but some of the missed opportunities as well as the media and public panic surrounding the Ebola epidemic in West Africa have brought this quote to the forefront of my mind this past week. First, let me share my personal view of the Ebola crisis in West Africa. It is a tragedy in all senses of the word for Guinea, Liberia, and Sierra Leone. As a wealthy country and as global citizens we have a moral obligation to assist in the control of this outbreak and to help these countries build/rebuild their health and economic infrastructure after the devastation wrought by this disease. If the moral argument does not do it for you, remember that we have self-interest here, too. We benefit domestically from increased control of the disease in Africa and fewer cases…

The Doctor Patient

[caption id="attachment_11096" align="aligncenter" width="594"] Selfie of my pale self in hospital garb on day #2 in the hospital[/caption]   As you can see, no glamour shots for this month’s post. I knew it would come at some point, and my first hospitalization related to my CLL came in a big way in mid-July. Given my interest in global health, it was only fitting that I managed to get sick while out of the country. The plan for July had been to help teach our Asian Clinical Tropical Medicine course in Bangkok, Thailand and Siem Reap, Cambodia for two weeks, followed by a much-needed family vacation. I felt well during the course, but at the very end of it I noticed I was really tired. We enjoyed 2 ½ days visiting Angkor Wat and other sites in Cambodia, then headed to Chiang Mai, in northern Thailand. Initially, I thought I was…

Knowing What We Don’t Know

I thought I would start this month’s blog post with a case. A 36 year-old previously healthy woman presented 5 days into an illness which began with fever, fatigue, severe joint pain, painful mouth sores, and a diffuse skin rash. Her fever lasted 48 hours, and she has been afebrile since. She continues to have severe debilitating joint pain, fatigue, mouth sores, and a diffuse red skin rash. On exam, she was afebrile with normal vital signs. She was quite uncomfortable due to the joint pains and she had aphthous ulcers. There was no frank joint swelling, and the remainder of the exam was normal. Labs revealed normal hemoglobin, a mildly low white blood cell count, and a mildly low platelet count. Electrolytes, inflammatory markers, and the liver panel were normal. What are your thoughts on diagnosis or further work-up? How should we proceed? By the way – the patient…

What Is Your Passion?

Every spring, I wonder, "What I was thinking?"  Spring is the run-up to our Global Health Course at the University of Minnesota, which starts in early May. It has taken myself and others hundreds of hours of planning, meetings, paperwork, phone calls, and e-mails to pull this off.  We are a small program considering the scope of what we do, and we rely heavily on compassionate and interested experts from around the world.  Anything that takes this long to plan begs the question if all of the time input is worthwhile. But shortly after it begins in early May, it becomes clear. Our course is made up of about 2/3 resident physicians across internal medicine, pediatrics, med-peds, family medicine, and emergency medicine, as well as interested attending physicians or providers from the local and national community. Their passion for service and inquiry, in addition to their life experiences are an…

The Next Dose…

After my last post about “the gift of cancer” I must say that CLL has felt much less like a gift this month.  Joining the ranks of those with “a diagnosis” has given me a some insight into what our patients face all the time.  Recently, I received my second dose of humility.  I capped off a truly exhausting week in the hospital with a routine lab follow-up.  The last day of my 85-hour week I had my CBC checked, and my platelets dropped from the 100s to the 30s.  My first reaction was denial.  Lab error.  Unfortunately, they dropped further the next day and I realized that the little red bumps on my legs weren’t some skin reaction, but petechiae.  Bummer.  Turns out that in addition to the 2% of people diagnosed with CLL under age 40, I also joined the 20% who develop idiopathic thrombocytopenic purpura (ITP). The…