Happiness in this World

Reflections of a Buddhist Physician

Alex Lickerman is a general internist and former Director of Primary Care at the University of Chicago and has been a practicing Buddhist since 1989. See full bio

November 23, 2009

How To Be A Leader

In 2001, just as I was about to take over as Medical Director of Primary Care at the University of Chicago, I expressed reservations to a previous Director about my ability to run a clinic that included several clinicians who were not only older than I but who had actually been my teachers ten years earlier. What she said in response did more to shape my tenure as Director over the next seven years than any other advice I ever received: "What people really want," she told me, "is leadership." Read More

November 19, 2009

The Double-Edged Sword Of Attachment

Several weeks ago, my now 15-month-old son developed a fever to 103.5 F. Usually a champion sleeper, that night he woke several times with a frenetic look in his eyes and a jerkiness to his movements that frankly unnerved me. The heat coming off his little febrile body almost made me start sweating myself. He had no other symptoms to suggest the cause of his fevers, and even though our pediatrician had been reassuring when I'd called early in the day ("fevers in kids are a dime a dozen"), my doctor brain was kicking in full-blast with worry over it's cause. Read More

November 16, 2009

How To Remember Things

Medical school is like entering a grocery store and memorizing the names of every product in the store, their number and location, every ingredient in every product in the order in which they appear on the food label, then doing the same thing in every grocery store in the city. Read More

November 12, 2009

Magical Thinking

One of my patients suffers from chronic constipation due to irritable bowel syndrome. During the literally twenty years since she was first diagnosed, her symptom pattern has remained remarkably consistent: she has perhaps 1-2 bowel movements per week, occasionally accompanied by some mild cramping. Even she admits the symptoms are more a bother than a worry. And yet, every time I prescribe a new medicine for one of her other ailments, within a day or two she calls me up complaining that it's causing her to become constipated. Read More

November 9, 2009

The Good Guy Contract

Twenty years ago, the first woman I ever loved broke my heart. Like many break ups, the end came in stutters and sine waves rather than as an abrupt but mercifully irreversible amputation. Read More

November 5, 2009

What Compassion Is

The other day I was out walking my son in his stroller (my now constant occupation) when a homeless woman approached me asking for money. I'd seen her before in the neighborhood many times, including behind our condominium using drugs. I turned down her request and continued walking, to my chagrin, as if the wind had blown a newspaper against my leg and I'd kicked it away without any thought. Read More

November 2, 2009

Your Neighbor Is An Alcoholic

My patient smiled a toothless grin and told me, "I feel fine, doc." But he was far from it. His liver enzymes had risen into the thousands, his skin was a pasty yellow I didn't need the benefit of sunlight to see, and his albumin (a protein whose level indicates the liver's functional capacity as well as a patient's degree of malnutrition) had fallen far too low. Read More

October 29, 2009

Marriage As A Business Proposal

People marry for all sorts of reasons. People enjoy being married and stay married for reasons that evolve over time. Though studies have shown being married is associated with a longer life span (for men, at least), I don't believe—nor is there evidence—that a married life necessarily results in more happiness in the long run than a life lived singly. Read More

October 26, 2009

When Doctors Don't Know What's Wrong

The first patient I ever saw as a first year resident came in with a litany of complaints, not one of which I remember today except for one—he had headaches. The reason I remember he had headaches isn't because I spent so much time discussing them but rather the opposite: at the time I knew next to nothing about headaches and somehow managed to end the visit without ever addressing his at all, even though they were the primary reason he'd come to see me. Read More

October 22, 2009

When Everything Seems To Be Going Wrong

For me, this last week has been a little rough. I've been working as an attending physician on an inpatient service populated with incredibly sick patients, several of whom are intensely angry about their diseases and are projecting their anger toward me and the team of residents with whom I work. The medical informatics project on which I'm the physician sponsor has just gone live with its most ambitious and radical portion and many physicians are nervous and resistant and are acting out in negative ways. Read More

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