April 23rd, 2010
04:35 PM ET

Colorful conversations: Dr. Lisa Sanders

Lisa Sanders was first inspired to save lives after watching physician and correspondent Dr. Bob Arnot use CPR to save a woman who had collapsed while they were shooting a story for CBS News about whitewater rafting. A few years later, Sanders went to medical school and today is an assistant professor of internal medicine at the Yale University School of Medicine. Her fascination is the work of diagnosis – the science and art of reading the clues of a patient’s symptoms. It’s an obsession she shares with the producers of the hit television show “House,” who rely on Sanders as a technical consultant. She remains a journalist, writing the “Diagnosis” column for the New York Times, and now has written a book, “Every Patient Tells a Story.” Dr. Sanjay Gupta asked Sanders how she knows she has an interesting story in her exam room.

Dr. Lisa Sanders: I’m an internist and I know my patients pretty well, but even then, you don't know what's going to walk in the door. Mystery cases, “fascinomas,” they don’t walk in the door with a sign that says, “I’m a weird case.” They present with symptoms like anyone else. And then it turns into something else.

Dr. Sanjay Gupta: Medical mysteries, what was it about that you decided to take so much time to devote to it?

Sanders: At the heart of a doctor-patient encounter is a little detective story. Sometimes, it’s not really hard. You come in with a fever and a runny nose and some body aches during flu season and you probably have the flu. But often enough, it’s probably not obvious, and I didn't know that. When I went to medical school, I thought I knew medicine because I had covered medicine for several years, and I thought I knew what was exciting about it. And when I heard doctors talking about the uncertainty and the excitement in their voices when they tried to figure out what was going on, I thought, “Wow, I never heard this story told.” I had never even been aware of this. I thought, like most people I think, that diagnosis was like math - you know, six times four is always 24. A fever and a rash, it must always be (DRAMATIC PAUSE). But it’s not. In TV, which is my only experience in medicine, a diagnosis is a one-liner. It’s “I’m sorry, you have leukemia.” That's it! That's the diagnosis! Then you move on to the treatment and the happy cure. I was interested in finding out what happens to lead up to that line.

Gupta: Part of your work is teaching medical students and new doctors to listen, to find things that maybe they wouldn’t have caught if they weren’t listening. But my sense is, maybe that is based not just on your intuition but on your knowledge. Are new doctors allowed to order more tests and things like that, because they don’t have the intuition, the experience and the knowledge that you – or certainly someone like Greg House – has?

Sanders: There’s nobody telling you you can’t order tests, except for insurance companies (LAUGHS). But in some ways, I think great diagnoses are made by the newest doctors. Faith Fitzgerald, who’s a wonderful doctor who teaches at the University of California, told me that unusual diagnoses are often made by the oldest or the youngest doctors. The old, because they've seen it all, and the young because they don't know that whatever they think it is, isn't possible.

To see more of Dr. Gupta’s conversation with Dr. Lisa Sanders, tune in to “Sanjay Gupta M.D.” on CNN at 7:30 a.m. ET, Saturday-Sunday.

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soundoff (4 Responses)
  1. Karl

    Dr. Sanders made a good point stating that a good doctor has to listen to their patients and work with them. I recommend a slightly different approach that works for me. What many doctors and patients don't realize is the doctor works FOR the patient. As a patient I am the employer AND the boss. If a doctor doesn't listen or doesn't perform to my satisfaction, they're fired and I find a better doctor. It's my right as a patient.

    April 24, 2010 at 08:10 | Report abuse | Reply
  2. Dr. Dennis O'Connor

    A comment on the interview where she applauded the fact that as soon as they did the CT Brain, her husband's panic syndrome went away – which made that doctor one of the 'good guys'...

    Her husband absolutely did not meet the criteria for a CT of the brain, so he was exposed to a huge dose of radiation directly to the neural tissue for no medical purpose – and she as a physician should know this... CT is not innocuous... We do cause cancer with CT radiation – albeit at some small (but not insignificant) rate...

    In addition the insurer/someone was defrauded of hundreds of dollars for a procedure that was not medically necessary...

    You may think I am being hypercritical, but I have spent 35 years in medicine and as the only doc in a small town I face this type of decision making every working hour of my days...
    Do I be the patient's buddy and give them what they want? Or do I be the patients advocate and do for them them what is medically best?


    Dr. Dennis O'Connor
    Hemlock, Mi

    April 25, 2010 at 08:25 | Report abuse | Reply
  3. Kevin

    I think the key to being a great doctor is listening to the patient. As Dr. Sanders points out as being a detective and listening for clues that you may not have picked up if you weren't paying close attention. As simple as it sounds... doctors need to take the time to listen to their patients.


    April 26, 2010 at 19:05 | Report abuse | Reply
  4. Dorsey Dalonzo

    Guillermo Valls


    September 11, 2016 at 10:23 | Report abuse | Reply

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.