Bucks Montgomery Physician Winter 2021 - 14

CREATIVE CORNER

Unsolved
Mysteries
by Chris Drumm, MD

by Chris Drumm, MD

T

hey made a show about the Karate Kid that takes place 30
years later. And everyone seems to love it. Everyone in my
generation remembers rooting for Danny LaRusso to use
his crane kick to save the day. But why? Because humans overall are
nostalgic. We love things that are familiar. We love a redemption
story. As a physician I realize certain beliefs that I have now may
be scientifically proved different in the future. I am accepting of
realizing that more data will change my thoughts. I have changed
my thoughts. I am now rooting for Johnny Lawrence in Cobra Kai.
Patients come to see me after ER and hospital visits for specific
visits called transitional care management visits. They often
complain about the food and communication. I take my time
and review the diagnostic tests. We discuss any medication
changes. Rarely after these visits do they complain about me.
Why do you ask? Nostalgia. They know me. I know them.
This cannot be quantified. I do not always have to be the
physician making the medication change or ordering the CT
scan, but I will be the familiar face discussing the plan.
There are new medications coming out all the time. New
imaging tests have also arrived on the scene. Elastography for
fatty liver and CT calcium scoring tests for coronary artery
disease screening. Lots of new medications with X's and Y's and
Z's. Some medications have all of these letters. Like XYZAL.
Yet I still reach for amoxicillin and lisinopril and ibuprofen.
My favorite diagnostic tests are still EKGs and CXRs. Why? I
have nostalgia. My favorite guidelines, medications and exam
techniques go back to the good old days of residency.
Medicine is inspiring and ever changing. It trains your brain
to have to always question and ask for more data. I love
everything I learned in training but realize that I am open to
new things. Coumadin was used all the time. Now DOACs
are here to stay. I never checked Vitamin D. Then I checked
a lot. Now I almost never check. Mild ear infections do not
need antibiotics. My mind is blown. But it is ever changing.
We can love nostalgia yet be open to changing our minds.
Some beliefs never die. But some of our beliefs should. I am open
to change while loving the past. Even Johnny Lawrence went from
saying " Strike First. Strike Fast. No Mercy. " to realizing that those
are only words on a wall. Cobra Kai. Never die. Keeps patients alive.

12 BUCKS/MONTGOMERY PHYSICIAN

winter 2021

G

rowing up I loved Unsolved Mysteries. But
I think we all did. The super creeping music
followed by Robert Stack's deep thundering
voice. It is a show that does re-enactments of different
mysteries. Often times it is a murder, a kidnapping, or
a questionable suicide. We were all drawn in and by the
end of the show everyone has a thought as to what
happened. Quickly we are invested and want to help find
answers for these families. The reason for episodes is
that the team investigating does not have the answer.
It was at this time I realized that I loved collecting
information to help solve a problem. Robert Stack
inspired me. I love playing Clue and think that
Ms. Scarlet should never be in the Conservatory
with a rope. I went to a murder mystery and many
thought I was the murderer because they did not
believe I was actually a physician. This is the world
of diagnosis. We collect information, focus on
history, follow up with an exam and then order labs/
diagnostic reports to try and figure out the answer.
Thankfully, Netflix has brought back Unsolved Mysteries.
It quickly rose to number one on the Netflix list. Why?
Because we as humans are problem solvers. But this
show is helpful to young physicians. The premise of
the show is to get a great history, present it to the world
and see if others can help add information to come
to a final diagnosis. From Agatha Christie to Robert
Stack to Anthony Fauci, we need problem solvers.
I see patients with symptoms and complaints that
have not been diagnosed. But I will not give up.
Robert Stack never did. But the show has inspired and
helped influence my training. Hear the history again.
Bring patients back for another visit to hear how the
history has changed. Ask colleagues for advice. Ask
the patients what diagnosis they are concerned with.
Examine a patient more than once. Order tests that
fit your differential diagnosis. Patients are not like
test questions. You do not need an answer after a
15-minute visit. Do not give up. Listen and learn. At
the end of the day you may realize that Mr. Green
fell in the kitchen while holding a knife because his
neuropathy was due to Charcot Marie Tooth.
Bucks Montgomery Physician Winter 2021

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