Physician, Heal Thyself!

Dr. Barbara Brennan practiced Family Medicine in a nearby town for a decade. She was busier than most of her colleagues. Her patients adored her and she had earned a solid reputation as a crackerjack diagnostician. She worked long hours at the clinic and she ran a tight ship at home, managing a large household and even found time to be active in her community. She would be up at five to get everyone in her house on their way, and when she arrived at her office at eight, she always looked beautifully put together and on top of the world.

She never seemed hurried or harried. People wondered how she did it. Her husband, also a physician, admired his wife both as a woman and as a colleague. He had more years behind him as a doctor than she, but he often found himself asking for her medical opinion.

Dr. Brennan had many patients who appreciated her razor sharp diagnostic skills. She diagnosed a pheochromocytoma, a case of fallopian tube cancer, and several other rare medical conditions. She was also well known for her psychiatry skills. In rural America, primary care physicians deliver the majority of psychiatric care. Barbara Brennan moved comfortably between crisis intervention, brief psychotherapy, antidepressants, mood stabilizers and ADHD prescriptions.

There were two kinds of clinical problems she avoided. She didn’t enjoy doing the minor surgical procedures some primary care doctors see as bright spots in their day, and she didn’t enjoy treating fibromyalgia and Chronic Fatigue Syndrome. Suffering from some arthritis herself, she found it draining to work with patients she thought sometimes dwelled too much on their symptoms. It saddened her to see fibromyalgia patients focused on what they couldn’t do, instead of making the most of their physical abilities.

One Friday morning, at the end of an unusually busy week that even Dr. Barbara Brennan thought would never end, she noticed a strange tingling sensation over her right eye. As the day progressed, the tingling turned into a burning pain down most of the right side of her face. She became nauseous and developed a migraine. She had worked in spite of having migraines before and steeled herself to make it through the day. A slight dizziness set in, and she had trouble concentrating.

Finally home, she put dinner on the table, but didn’t eat anything herself. She looked in the mirror for a rash on her face. She asked her husband to double check closely for her. By eight o’clock she went to bed, exhausted and with a throbbing migraine.

Saturday morning her shingles rash was there, subtle at first. Her husband confirmed it and called the pharmacy with a prescription. Her headache was still there and she was still nauseous and lightheaded. She had to move slowly to avoid vertigo and she noticed it took her longer to find words, even to figure things out. As a physician, she knew she must have developed a touch of encephalitis – brain inflammation.

She expected to be out of work for a week, but complications set in. She broke out in hives from the antiviral medication and had to stop taking it after only three days of treatment. Without the medication the shingles flared up again and she became profoundly tired. Over the next few weeks she developed joint pains and muscle aches. She got a sore throat. She felt as if her mind and body moved in slow motion. All she accomplished was to get everybody off in the morning, and by the time she got the dishwasher loaded it was already almost noon. She didn’t take naps, she didn’t even sit down much – it literally took her so much longer to do the simplest things.

She cried in frustration: “What’s wrong with me?”

Her husband looked into her eyes, the right one still framed by the slight scars left by the shingles, embraced her and said what she knew but didn’t want to believe: “You have a post-viral syndrome, maybe early Chronic Fatigue Syndrome”.

Months have passed and Dr. Brennan has not returned to work. She is convinced that she has CFS. She didn’t like it in her patients and she is fighting to beat it in her own case. She now knows first hand how real and devastating this condition can be. She is learning to listen to her body, always doing as much as she can, pushing ahead just a little, so that eventually she can get her stamina and her health back. Sometimes when she pushes herself too hard the sore throat, body aches and tingling over her right eye remind her to slow down again. 

I asked Barbara the other day if she would ever resume her practice. Her answer was: “I can’t afford to ignore my own health. In that job, and at that pace, I did just that.”

Dr. Brennan is living by her own advice – Physician, Heal Thyself!

(Here’s to you, Barbara! With respect and best wishes…)

3 Responses to “Physician, Heal Thyself!”

  1. 1 cathy July 30, 2008 at 12:24 pm

    even good and “human” doctors have to become ill with CFS and/or FM in order to realize the hell we often go through
    I really hope she gets better because doctors with a great intelligence as that woman are needed for chronic pain patients.
    My traumatologist has migraines himself. I suppose that’s why he always understood me and tried to alleviate my pains

    Greetings form a Spain
    affected with FM – CFS – AR, and so on

  2. 2 emmy August 2, 2008 at 5:59 pm

    I was diagnosed with CFS by a physician who after keeping me waiting for 2 hours did a brief 5 minute exam and came up with that. Somehow it gave me the impression that this was something that doctors make up to get you out of their exam room. I eventually quit seeing my primary care doctor who was another member of the same practice because everytime I needed an appointment, he was the only doctor available. So, are you saying that CFS and Fibromyalgia are real diagnosis’?

  3. 3 Lois Weston April 21, 2012 at 7:19 pm

    I hope this good physician and her doctor husband are talking with those in the cutting edge areas-Montoya at Stanford; Jamie Deck-off Jones, in HI; many others. Having this condition, myself-I am now a very broke disabled attorney, and my husband, a brave and talented physician, equally poverty stricken, being nearly immobilized with life threatening complications-I have learned this disease can take everything from you. As a doctor-you can find yourself beyond marginalized, outright shunned, punished even. I am fortunate to be well enough for portions of some days to work part time on a project with many of the top of the field. We are finding huge relief with anti-retrovirals. I hope they look into this area as well. It seems it is the hardest driving people, talented and intelligent, that are stricken with ME/Post-viral syndrome. The very people we need in medicine and science. This disease is real, and the physical/clinical and inflammatory signature is very measurable. There are over 4000 good hard science articles that explore the amazing underpinnings in the immune system in ME/post-viral syndrome, and explain what happens as the immune system destabilizes, resulting eventually in shortened painful lifetimes , also relatively rare, but specific cancers. Fortunately there is much more that can be done, if treating doctors are not slaves to “evidence based” propaganda and hopeless bias. I pray Dr. Brennan and her husband, and her supporting physicians can get her back to being able to do what she does so well. It is a very painful and dehumanizing disease-more so where the healers refuse to attack the disease with the rational, clinical tools and science that do work.

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Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.


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