Thanks! I'll definitely take a look at that sometime this week.
What do people think of the article?
Now that I am not sleep-deprived and mentally depleted from an exam marathon, I took the opportunity to read it fully. Thank you so much for sharing it.
The writing is excellent, and the subject fascinating. As a nurse who has cared for many stroke patients and a friend of two women who had strokes in their early 20s, I am touched by her openness in exploring what her stroke felt like and what it meant for her as a person.
As a future physician, I am grateful to her for including medical details. She had symptoms for years that might have suggested a PFO, the detection and closure of which may have prevented her strokes. Migraines and exercise intolerance are nonspecific symptoms, but this is why excellent primary care matters. This wasn't something that was going to be found in a 15 minute, focused clinic visit at a med express. To have prevented her strokes, she would have needed to have a relationship with a thoughtful primary care doctor who took the time to investigate her minor complaints and consider whether they might have a common cause. I don't blame anyone for missing the diagnosis. Rather, I'm saying that to catch it would require something very different than the assembly line medicine model. Her story inspires appreciation of the responsibility that I am taking on, and the need to take it quite seriously.
I wonder what other end organ damage she may have experienced due to emboli reaching other capillary beds? The brain announces its ischemia, but what other silent ischemic events occurred elsewhere? Were there any other clues that were missed, dots that she hasn't connected yet?
I'm terrified at the idea that she was driving in between the stroke and the diagnosis. I find driving to be a nerve wracking endeavor with all of my brain engaged.
I can see why her marriage ended. There were problems there before the stroke, to be sure. If my spouse were to become quiet and less fluent, I wouldn't keep drinking and being jolly with friends, that is for certain. I know it is easy to look back and say what should have been done, but I am very sensitive to changes in the behavior of people that I know well and care about. I couldn't just ignore something like that, even on NYE.