On her first day of rounds as a Yale medical student, Dr. Lisa Sanders MED ’97 examined her first patient — a war veteran who complained of severe, persistent back pain, but had been written off by many doctors as a pill-seeking hypochondriac. Rather than ignoring his pleas for help, Sanders chose to listen to her patient’s story, and with a resident’s blessing, went ahead with the needed tests. Sanders’ concerns turned out to be justified — an initial hip X-ray showed that the patient’s bone had been eaten away by metastases and a subsequent chest X-ray revealed a large mass in his lung. The diagnosis: lung cancer.
“If you let the patients tell the story, you’ll get way more information than if you ask them a series of yes or no questions,” Sanders said.
Now an internist on the faculty at the Yale School of Medicine, Sanders has lived her life telling stories, an art which she said is inextricably tied to making an accurate diagnosis. An Emmy-winning broadcast journalist before she returned to school for a medical degree, Sanders now combines her medical practice with work as a consulting producer for the hit Fox TV program “House,” a show that was inspired by her interest in the diagnostic process.
House Executive Producer Tommy Moran ’89 said the show’s premise originated from Sanders’ monthly New York Times Magazine column “Diagnosis,” which she has been writing since 2002. Moran said Sanders worked with writer and creator David Shore to develop the story line for the pilot episode and has since met with the writers and producers at the beginning of every season. The House team pitches Sanders their ideas, and she provides medical direction so the plot can unfold as accurately as possible, he said.
“She’s very helpful because not only does she have her own practice, but in doing her own articles, she meets with a lot of other doctors,” Moran said. “She has a lot of stories.”
The focus on the diagnostic aspect of medicine, rather than simply on the drama of illness and tragedy, sets “House” apart from many other medical television shows, Sanders said. She thinks that exposing the general public to this step is important, and that in that sense, “House” acts as a tool for education about internal medicine.
“[The show took] this moment in the medical process that no one really cared about before … and really looked at it,” she said. “I looked at my column as a recruiting tool for internal medicine, but I think “House” is the real recruiting tool.”
Sanders’ path to medicine was anything but traditional. As an undergraduate at the College of William and Mary, she majored in English and took a job with ABC the year after she graduated. Less than 10 years later, while working for CBS News, she won the Emmy Award for Outstanding Coverage of a Breaking News Story. But by then, Sanders said, she was ready to move on professionally and decided that of all the subjects she covered as a journalist, medicine intrigued her most.
After a year at Columbia University’s Post-Baccalaureate Premedical Program, Sanders was accepted to the Yale School of Medicine “as part of the 10 percent of the class they reserve for weirdos,” she said. In addition to her time in the hospital, Sanders is currently researching the nutritional aspect of obesity as well as clinical decision making and the way diagnostic decisions and errors are made. She has published two books — “The Perfect Fit Diet: Combine What Science Knows About Weight Loss With What You Know About Yourself” in 1994 and “The Perfect Fit Diet: How to Lose Weight, Keep it Off and Still Eat the Foods You Love” in 1995.
Sanders said telling stories is part of the job for physicians, particularly when they write a patient’s “History and Physical,” a report in which they compile all the information possible about the patient prior to making a diagnosis.
“The worst thing about a lot of doctors is that they are such boring writers,” she said.
Sanders said she thinks one of the differences between writers and doctors is that while writers try to get a sense of the big picture, doctors triumph at a very specific level. She said she views the “History and Physical” as a story in itself, and tries to keep every detail in mind — from the setting to the patient’s clothes to the emotions at play — in order to craft a picture that fully describes the scene.
Ilena Silverman, story editor for the New York Times Magazine, who edits Sanders’ column each month, said Sanders takes both of these roles — that of a doctor and of a writer — very seriously, and she works very hard at both things.
“The combination of her own passion for what she is doing and her desire to be able to articulate it and convey it in her own narrative way is what makes her a great writer,” Silverman said. “She really thinks of herself, and we think of her, as a writer — a writer who is a doctor and a doctor who is a writer.”
Yale’s Chief of General Internal Medicine Patrick O’Connor said he thinks Sanders’ writing is unique because while there are many representations of medicine in the media, none dissect a physician’s thinking process as effectively as does Sanders’ column, which gives the public real insight into the investigatory aspects of medicine.
“Her work in The New York Times allows her to translate what she’s doing at the bedside with residents and students to the general public,” O’Connor said.
Jaideep Talwalkar, clinical instructor of internal medicine and pediatrics at the School of Medicine, said he agrees that Sanders provides an unparalleled glimpse into the physician’s struggle to “makes sense of constellations of signs and symptoms,” while still managing to shed light on the human aspect of the medical profession.
“She also captures the humanity in medicine and shows how dedicated physicians can be to their patients (and patient’s families),” Talwalkar said in and e-mail. “Not to mention that she has a real gift for telling stories.”
On a trip to the set in Los Angeles last week, Sanders said, “House” star Hugh Laurie asked her if she thought the show would ever run out of new story lines. Sanders said she assured him it would not, as every day, a different patient walks in her door with a different story.
“You never run out of stories, because this is what doctors talk about all the time,” she said.