This is a re-post with new URL – for some reason the original of this post failed.

Precisely at 9:00 a.m., five years ago today, the phone rang and my life changed.

There were two calls, actually, from two physicians. I don’t recall which was first, but one was Dr. Danny Sands (my primary), and the other was orthopedist Dr. Jeffrey Zilberfarb.  Five days earlier I’d seen Dr. Sands for a physical; in my pre-visit agenda email (PDF at right), I’d noted “Shoulder: range of motion complaint,” and that as we’d discussed earlier, I had made an appointment to see Dr. Z on January 2. That visit had been cordial, unremarkable; he’d x-rayed my shoulder.

But in the x-ray Dr. Zilberfarb saw something unexpected, and he’d contacted Dr. Sands. Dr. Sands called me and said, “… I pulled up the x-ray on my screen. Your shoulder will be fine – it’s just a rotator cuff problem. But Dave – there’s something in your lung.” (See lower image.)

He said we didn’t know what it was – could be a fungal thing, could be a scar left over from some old infection – but “we need to find out.” I said, “So, you need me to get back in there?” He said yes.

Imagine hearing “There’s something in your lung” when you don’t feel sick – something significant enough that your doctor calls you at 9 a.m. You immediately start thinking about that spot, looking for any sensation, any sign of trouble. You start wondering, “Do I have a time bomb inside me??” And that’s not a nice feeling to have, when your doctor’s on the phone.

He said he’d called radiology and ordered a CT. In parting I asked, “In the meantime, is there anything I can do?” And Dr. Sands replied: “…Just go home and have a glass of wine with your wife.”

And that is a sobering thing to hear from your physician.
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Well, it’s January, Janus time – the Roman god of beginnings and transitions. He looks back, he looks ahead… he’s amazing!

Soon I’ll post about 2011 and 2012. But first: while putzing with my website today I revisited some way back content, which sets the stage even better for looking ahead. So, a quickie to start the year:

Video oldies – three short talks from the start of my public speaking about healthcare.

• I just found video of the first talk I ever gave (18:03) at a healthcare business conference – e-Patient Connections, Oct. 2009. It’s amazing to go back there and see what we were looking ahead to, back then.
  • The Society for Participatory Medicine had just been formed, and its journal had just launched its introductory essays.
  • Two years later, two dozen e-patients were brought together at the event to create an e-Patient Bill of Rights.
• Six weeks later, December 2009, was this Quantified Self talk (14:43) at Wired headquarters in San Francisco.
  • I loved relating with the tech geeks at QS; it was the first time I dared show the spreadsheet where I’d tracked my tumor sizes.
  • btw, socializing after this event I asked Matthew Holt of Health 2.0 for a bit of start-up advice. He never gave me a penny, of course :-), but his advice worked out.
• Three months later, March 2010, was this impromptu 10 minute interview with the then-enigmatic Dr. Anonymous. (He’s since uncloaked himself: Dr. Mike Sevilla at Family Medicine Rocks.)

Update, 2014: The finished (and still growing) Integration Academy website is here.

I’m en route today to New Orleans for a meeting about adding something back in to primary care that used to be there, a long time ago: care for behavioral and mental health issues. The project is to unite mental health with primary care.

It’s worth explaining why this is being fixed, and why I’m involved. First, please watch this presentation by Ben Miller of the University of Colorado, an expert voice in the field. It describes the NIAC (National Integration Academy Council), a new project of AHRQ, the Agency for Healthcare Research and Quality. This New Orleans trip is for a meeting of NIAC, of which Ben is a leader and I’m a member.

NIAC is the steering committee for AHRQ’s Academy for Integrating Mental Health & Primary Care:

At TEDMED this October I found myself trading tweets with @DrPatriciaFitz, a new name to me. We met, and I learned she’s the Wellness editor for The Huffington Post – which is about the biggest baddest high-publicity blog in the universe.

She was already familiar with participatory medicine and my TEDx talk. We talked, and then she invited me to blog for them! I was thrilled, because as  Wikipedia says, “The Huffington Post has an active community, with over one million comments made on the site each month.”

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