Field Notes #44: Epileptic treatment breakthroughs, inferred empathy vs. earned empathy, & more

Weekly collection of interesting 1 health insight, 2 quotes, and 3 links

Hello, dear friends. Somehow, we are almost to the end of the first month of the year. The weather has been wacky here. A lot more rain, very little snow. A nearby ski slope is still not open for the season because it has been too warm. I wonder what February will bring. How is winter where you are?

1 health insight

This is a little reminder that change does happen, that new treatments do come out periodically, sometimes so fast that the patients don’t even know it yet.

This fascinating NPR story details how treatment for epilepsy has dramatically evolved recently.

About 3 million people in America have epilepsy, and about 1 million of them can’t control their seizures with medication, according to NPR. And some of them weren’t eligible for surgery, either. But now, technology has sped up, creating tools like lasers and surgery robots and high-solution arrays, which allow doctors to see the brain's electrical activity in new ways.

New arrays of high-resolution electrodes go under the skull on the surface of the brain or even deep into the brain to help doctors figure out where a seizure is coming from. The arrays, which use technology developed for digital displays like smart phones, have gone from a handful of electrodes to more than a thousand on the size of a postage stamp!

The challenge now is getting the word out. Dr. Sharona Ben-Haim recommended to NPR that patients with epilepsy who were told years and years ago that there were no good treatment options remaining for them should visit an epilepsy center to see if they might be a candidate for surgery or another treatment now.

As Dr. Alexander Khalessi, a neurosurgeon at UCSD, explained to NPR: “If you think about the brain like a musical instrument, the electrophysiology of the brain is the music. And so for so long, we were only looking at a picture of the violin. But for the first time, we're now able to actually listen to the music a little bit better, and so that's going to help us understand, you know, the symphony that makes us us.”

Listen to the NPR story or read the transcript.

2 quotes

“When I enter a room to find a patient with a labral tear, the empathy is there. This is direct empathy; empathy arising from having experienced what your patient is experiencing.

Inferred empathy is less physically painful but does take some work. It requires applying a personal experience to a patient’s unrelated condition. Inferred empathy is critical as no one person can experience all the traumas that would be necessary to otherwise become an empathic physician. We learn to use a personal experience with pneumonia to understand a patient’s experience with endocarditis. We apply lessons learned from the death of a parent to the patient who has lost her spouse. Inferred empathy is what younger, less experienced physicians and trainees need to be taught.” — Dr. Adam Cifu

“When I talk to people who love winter, the number one thing I hear is that in order to really embrace and enjoy the season, you must go outside in the winter. Feeling like you can’t go outside because of the weather, the darkness, the cold guarantees that winter will be limiting. That, combined with the lack of sun, fresh air, and movement is a recipe for these next few months to feel like a real bummer.” — Kari Leibowitz 

3 links

🤔 It’s Time To Rely on More Than Altruism. It’s Time to Reward Kidney Donors. — Intriguing, detailed essay on how we could reduce the enormous wait for organ donations by allowing donors to be compensated. (Sally Satel, Sensible Medicine newsletter)

💉The FDA considers a major shift in the nation's COVID vaccine strategy — “Under the new approach, most people would be advised to simply get whatever the latest version of the vaccine is annually each fall like the flu vaccine.” (NPR)

💗 Empathy Earned and Learned — This was one of the best reads of my week, a useful and inspiring story of a doctor’s revelation around empathy. (Dr. Adam Cifu, Sensible Medicine newsletter, also quoted above)

To our journeys,

Brianne