A patient comes into a hospital with mysterious symptoms: swollen abdomen, chest pain, yellow-tinged eyes. The doctor is perplexed. He wonders what tests to run, what medicines to prescribe, and more importantly, how to diagnose the patient.
This Sherlock Holmes-style medical mystery is just one of many such tales recounted in the New York Times Magazine column “Diagnosis.” Yale clinical instructor Dr. Lisa Sanders, the column’s Sir Arthur Conan Doyle, writes about once a month for hypochondriacs nationwide.
A 1997 graduate of the Yale School of Medicine, Sanders, 48, is a researcher in the Internal Medicine Department of her alma mater and a regular face on Yale’s campus. A published author who specializes in nutrition, she also splits her time as a doctor for Yale Primary Care at Waterbury Hospital and St. Mary’s Hospital in Waterbury.
A former news producer for ABC, CBS and NBC, Sanders decided to apply to the Yale Medical School after covering medicine on television for 14 years.
“I liked TV, it was fun, but medicine is more fun,” Sanders said. “It’s so exciting, so interesting and so important.”
Sanders still maintains close ties with the media and communications. She is now in her third year of writing the “Diagnosis” column, in which she provides a third-person account of both the patient and doctor’s thoughts as the doctor attempts to solve the case.
“That’s the kind of thing you could get that’s exciting,” Sanders said. “You learn a lot about how to think about a case and interesting diagnoses.”
Every story has the same formula, Sanders said: A patient comes with symptoms X, the doctor figures out what he has, gives him treatment Y, and the patient (presumably) lives happily ever after. But although every medical mystery follows nearly the same plot-line, Sanders said there are great ways to make the story interesting as it unfolds.
Her most recent column, titled “Abdominal Pain, Repeated Vomiting, Quickened Heartbeat,” goes through a series of tests of the internal organs as the doctor tries to discover the cause of the symptoms: Gallstones? Eating disorder? Ulcers? After thorough investigation, the doctor discovers the malady is in fact caused by a malfunctioning gallbladder.
“This is really the way I see medicine, as a story,” Sanders said. “If you can’t make a story that makes sense, then there’s something you don’t understand about this case.”
Described as “another one of those great, fortunate accidents,” Sanders was offered the position at the Times after she discussed the Magazine’s need for a medical section with a friend who works there. Immediately after Sanders accepted the job, she went to work on her first article, which was due in three days.
“It worked out perfectly. It didn’t let me get all anxious and nervous and I wrote it the way I thought it should be,” Sanders said.
But before Sanders began her career as a medical columnist, she had already begun work on her book, “The Perfect Fit Diet,” which deflates the myth that one diet can work for everyone. The idea for the book began when Sanders was invited to do research with Dawn Bravata, assistant professor of medicine at Yale. Working with collaborators at Stanford University and Yale, Sanders and Bravata did a systemic review of low-carb diets.
Bravata said Sanders has a talent for communicating the complicated medical research to everyday people.
“I think the key thing is to say that she took the research finding and converted it to a book for public consumption,” Bravata said. “It’s the same skill as when she’s able to take a clinical story and convert it into a column for the Times.”
During their research, Sanders and Barvata discovered that there is no significant difference between the effectiveness of every diet. In study after study, 20 to 30 percent of dieters actually lost real weight while the other 70 to 80 percent either stayed the same or gained weight, Sanders said. She then narrowed down 20 factors, including food preferences and frequency of meals, to determine which diet best works. Using this information, everyone can find the diet that works for them, Sanders said.
“If you want change to be sustained, then you need to make it easy for yourself to do the right thing,” Sanders said. “A lot of people think of the diet as an aberration from the way they normally eat.”
Today, Saunders is doing more research with Bravata on how likely doctors are to recognize and treat their obese patients. So far, the numbers show that a patient has to be between 50 and 100 pounds overweight before the doctor even notices, Sanders said.
“Every major health hazard we know a significant amount about except obesity,” Sanders said. “I would say obesity is probably the greatest health hazard Americans face at this point.”
But while Sanders may appear in the media more and more, she said she still would not go back to being a producer.
“I’m always trying to find interests that you can stay interested in forever, and medicine is endlessly fascinating to me,” Sanders said.