If your ankles — or those of someone you love — look like this, please read this!
As a 'recovering' nurse, my first reaction to this photo was "Yikes!" This woman is only 67, and both her heart and kidneys are in big trouble. Dr. Mary Braun Bates explains why beautifully.
Mary Braun Bates, MD—who writes as Doctoring Unpacked—is an internal medicine physician currently living in New Hampshire. She’s been a primary care physician in both urban and rural settings, as well as with palliative and hospice care. IMO, the latter two root you quickly in reality, not some imagined ideal patient environment where you simply write a patient note and move onto the next exam room. Dr. Bates’ writing reflects a patience and perspective that comes with those experiences. Like me, you may find yourself idly wondering if you could tolerate New Hampshire winters to get her as your physician.
In this episode of our Clinical Connections, we’re reposting Dr. Bates’ story about “Lilly,” the fictional patient amalgam1 she uses for this story that combines real experiences with very real patients.
Lilly is a 67-year-old woman who self-doctors. None of us have, of course, ever done that before.
Lilly’s story started here: Return of the blood pressure time bomb—how Lilly got to the point she is now. Keeping in mind this kind of edema (swelling) doesn’t just come from being hot in the summer; it’s a sign of real issues, as you’ll see in this follow-up post from Dr. Bates, Don’t slap your kidneys around—the real, immediate threat to Lilly.
Follow along with Dr. Bates as she works here way through what got Lilly to this point, and how to manage Lilly’s self-doctoring. If you have a stubborn relative, you’ll relate. And if your ankles or feet—or those of someone you love—ever look like this, yell for help, fast!
All of Dr. Brown’s patient stories are patient amalgams, a blend of patients; any resemblance to an actual person is accidental. Dr. Bates also notes her articles should not be considered personal medical advice for any particular person to take or ignore.


Oh, my goodness, Mary Anne! What a lovely introduction. Thank you so much for your kind words! I love what you say about Lilly and Doctoring Unpacked! As a writer, it's so incredible to set my creations out in the world and to have people understand them! You get it! It's so cool! Thank you.