Category Archives: 30 Year Perspectives

I’ve Never Really been Mr. Pullen

Sometimes when someone addresses me as Mr. Pullen it seems strange.  I am not used to the salutation Mr. being applied to me.  I just skipped the Mr. stage of my life.  I took the full speed ahead approach to becoming a doctor.   High school, 4 years of college followed by 4 years of med school then my MD.  Before my 25th birthday I was formally Dr. Pullen, and incorrectly had been addressed as Dr. Pullen for much of the prior 2 years by many patients as a med student on the hospital wards.

In addition I had a young appearance in my early 20’s so just didn’t inspire many people to address me as mister.  These thoughts came to me tonight after attending a social event for local resident physicians and community physicians put on by the county medical society.  I was asked by a young resident physician what I had done in my career prior to joining my current practice.  It seemed to shock the questioning resident that I really had spent almost all of my career, the last 27+ years in my current position.  I was an Army physician for 7 years prior, in residency and in my service tour, but since then my medical career has been as a family physician in my private group practice in Puyallup, WA.  In a community of this size to most people I’m just Dr. Pullen.

I have also had a few mostly young 20’s patients recently who call me Mr. Pullen.  I am surprised every time by how strange this sounds to me.  Not bad nor good, just so different it causes me to wonder why I feel so odd when being addressed in a perfectly natural way.  I wonder if I should be more used to this perfectly natural salutation. I don’t think of myself as pompous or arrogant (does anyone though?) I have thoughts like, “Gee, I should be more used to that why does it startle me a bit.  What’s wrong with me?”

I certainly have high regard for some of the Misters in my life.  Some of the most important and influential mentors in my life have been people I’ve addressed as Mr.  I credit Mr. Morin, my high school physics, chemistry and calculus teacher, with teaching me to think analytically, to look at math problems in practical ways, and with setting me up for success in a science undergraduate course of study.  Coach Benner made us run “wakeups” for addressing him as Mr. instead of Coach, but in all conversations with teammates or others when he was not present was always Mr. Benner.  As a high school basketball coach Mr. Benner helped me learn and believe that simply putting more effort and hustle into any sport or life undertaking can lead to success far beyond where I could get based on my talent or natural skills.

I guess having been Dr. Pullen for 34 years and just a kid for 21 of the other 24 years makes it natural that I never had much opportunity to be Mr. Pullen in our society where physicians are routinely addressed as Dr.  When I travel it is sometimes fun to feel like I’m going incognito and inwardly smiling as hotel personnel and others speak to Mr. Pullen and it seems fine.  Around home, in the office, or other times I am usually either Ed or Dr. Pullen.  Mr. Pullen just really never happened to me and I’m happy as Dr. Pullen. I wonder if in retirement Mr. Pullen will feel more natural.  Some  day I’ll find out I guess.

The Purpose of Progress Notes

As a practicing physician I am responsible for making progress notes to document every patient visit. Over the years I’ve had to prepare progress notes as handwritten documents, as dictated documents that I had a transcriptionist type out, and for the last 15 years as EMR generated progress notes. Throughout this progression of technology in… Continue Reading

Keeping Perspective: A Key Role for the Family Physician

I believe that one of the most important things I can offer to my patients is help in keeping perspective when making medical decisions.  I have a fund of knowledge and experience that adds a layer of perspective to the patient’s own beliefs, situation and overall health scenario.  Hopefully I can get enough of a… Continue Reading

Proton Pump Inhibitors: Can’t Live With Them – Can’t Live Without Them

The bad old days of refractory peptic ulcer disease are behind us. When cimetidine (Tagamet) came along in the 1980’s we had our first really effective tool for reduction of stomach acidity, and in the 30 years since we have had one breakthrough after another. More and better H2 blockers with ranitidine (Zantac) and fomotadine… Continue Reading

Medication Compliance

Can you predict medication compliance for a given patient.  Often I simply ask a patient if they can remember to take medication daily?  Twice daily? Four times daily?  This is a familiar issue for many young women taking birth control pills.  Medications like Depo-Provera, Mirina IUDs and Implanon are in large part popular because they… Continue Reading

Who Remembers When C. Diff was Pseudomembranous Colitis?

Pseudomembranous colitis is the description of the appearance of the colon on endoscopic examination of the toxic colitis caused by Clostridium difficile, often referred to as C. diff.  The Clostridium difficile organism is an anaerobic bacterium that can produce a toxin that damages the colon, leading to a type of colitis that is characterized by… Continue Reading

TSH – Understanding Thyroid Function Tests

TSH is the abbreviation for Thyroid Stimulating Hormone.  Measurement of TSH level is the standard test used by physicians to both screen for and monitor treatment of hypothyroidism.  Understanding the TSH test results is quite simple once you know how the body regulates your thyroid function.  The process begins in the hypothalamus, the portion of… Continue Reading