Video: Every Case Tells a Story| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

  • Conditions
    • Axial Spondyloarthritis
    • Gout and Crystalline Arthritis
    • Myositis
    • Osteoarthritis and Bone Disorders
    • Pain Syndromes
    • Pediatric Conditions
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Sjögren’s Disease
    • Systemic Lupus Erythematosus
    • Systemic Sclerosis
    • Vasculitis
    • Other Rheumatic Conditions
  • FocusRheum
    • ANCA-Associated Vasculitis
    • Axial Spondyloarthritis
    • Gout
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
  • Guidance
    • Clinical Criteria/Guidelines
    • Ethics
    • Legal Updates
    • Legislation & Advocacy
    • Meeting Reports
      • ACR Convergence
      • Other ACR meetings
      • EULAR/Other
    • Research Rheum
  • Drug Updates
    • Analgesics
    • Biologics/DMARDs
  • Practice Support
    • Billing/Coding
    • EMRs
    • Facility
    • Insurance
    • QA/QI
    • Technology
    • Workforce
  • Opinion
    • Patient Perspective
    • Profiles
    • Rheuminations
      • Video
    • Speak Out Rheum
  • Career
    • ACR ExamRheum
    • Awards
    • Career Development
  • ACR
    • ACR Home
    • ACR Convergence
    • ACR Guidelines
    • Journals
      • ACR Open Rheumatology
      • Arthritis & Rheumatology
      • Arthritis Care & Research
    • From the College
    • Events/CME
    • President’s Perspective
  • Search

Revisiting Our Assumptions & Preconceptions

Bharat Kumar, MD, MME, FACP, FAAAAI, RhMSUS  |  Issue: February 2023  |  February 14, 2023

As a transplant to Iowa and the Midwest in general, I’m very mindful of this dynamic, so I took “fuel your hunger” at face value. It wasn’t a mistake; it was a genuine insight.

As I continued to think about the sign, I began to focus on the word hunger and all of its connotations. I am privileged to spend most of my life knowing hunger as an abstraction. Personally, I use it mostly to describe an abstract concept, as in hungry for knowledge or power hungry. Sometimes I use it in a medicalized fashion, like hungry bone disease or air hunger. My young kids use the term more literally, but to them it’s rather selective too: “Daddy, I’m hungry for apples,” or “I don’t want to eat. I’m. Not. Hungry.”

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

But many of my patients—the people in this community—likely do not see it from such a lens. For many of them, hunger is not just an abstraction or a nuisance. Hunger is a way of life, which is tragically ironic given that people in these communities often lack the funds to buy the food they themselves grow.

That’s when I gained an insight into what hunger may mean in that context. Hunger is the empty tank. Even though I conceptualized hunger as the presence of an unpleasant feeling, it may be more than just that. Hunger may be defined as the absence of something. In other words, if being hungry is seen as having an “empty tank,” then the emphasis can be more on the “empty” than on the “tank.” And when you engage in a frame shift to look at the world from that perspective, you start to see that “fuel your hunger” makes perfect sense.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Boost Your Immunity

Hunger isn’t the only word in which such a disconnect occurs. As I was reading a children’s book later that week, I saw a similar dynamic with the phrase “coming through the door.” I suppose it is pedantic but coming through the doorway is the technically correct way of saying this because the door itself is solid and impassable. But, by far, the most common situation in which I’ve started to see this dilemma is in the clinic, when patients ask what they can do to “boost immunity.”

I can see why: I too get bombarded by internet ads for supplements for immune boosters even though I have no search history, as far as I can tell, for such products. For people who are searching for information, I can imagine that exposure is even greater. After all, the patients who ask for such a boost are the ones who are being treated with immune suppressants. As a result, they are told that their immune systems do not work and that they are at risk for infections. They may even search for answers online to maintain their immune systems, leading to an even deeper immersion into the belief that their immune system needs to be boosted.

Page: 1 2 3 4 5 6 | Single Page
Share: 

Filed under:OpinionPatient PerspectiveRheuminationsSpeak Out Rheum

Related Articles

    On the Road in Rajasthan: Vehicular-Caused Bone, Joint Damage in India

    March 20, 2017

    In the good old days, physicians routinely made house calls. The decision to visit the literal bedside of a patient was practical: hospital services were primitive and often offered too little benefit to justify an emergency journey by the patient. These physicians carried leather bags, sometimes called Gladstones, that were filled with instruments for eventualities…

    Words Matter, from Clinical Documentation to Case Reports

    January 19, 2018

    Every year, my program goes through a ritual—I scrub my face, put on a smile and meet hordes of medical residents from across the country. And every year, I do my best to convince all of them that Baltimore would be an amazing place for them to complete their medical subspecialty training in rheumatology. Now…

    Rheumatology Association of Iowa Supports Members & Advocates for Patients

    January 20, 2023

    One of the newer state rheumatology organizations, the Rheumatology Association of Iowa, brings together rheumatology professionals, offering connections to fill rural care needs and advocate for policies that support patient care. The organization’s 9th annual meeting will be Feb. 24–25.

    Appreciative Rheumatology: Positivity Beyond Serologies

    April 7, 2023

    Spam, spam, advertisement, spam … wait wait, what’s this? A small envelope, addressed from Maine. I wonder what this is about? Usually, when I get an envelope this size, it’s a letter from someone trying to sell me something or complain about something I have no control over. So imagine my surprise when I found…

  • About Us
  • Meet the Editors
  • Issue Archives
  • Contribute
  • Advertise
  • Contact Us
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1931-3268 (print). ISSN 1931-3209 (online).
  • DEI Statement
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences