Clutching my duffel bag under my rain jacket, I dash from my truck toward a house that was built by Frankie, the man I’m here to give the last massage of his life.
I’ve been massaging people since I was five and have been a professional massage therapist for 40 years. I don’t make house calls anymore, but it’s an honor to give a man the last massage of his life, …
There is a trap used to capture monkeys that uses a tree with a hollowed-out trunk. The opening is just large enough for the monkey to put its hand inside. While the monkey can easily pull its empty hand out at any time, inside the hole is a larger space containing delicious nuts that the monkey craves. When the monkey grabs a large handful of nuts, it is unable to …
The doctor trap: What it is and how to escape it
Recently, my niece gingerly confided that she was going to study engineering rather than medicine. I was certain she’d become a doctor – so deep was her love for biology and her deference to our family tradition. But she calculated, as would anyone with common sense, that with an engineering degree and an MBA, she’d be working for a multinational company making a comfortable income by twenty-eight. If she stuck …
Becoming a doctor in India can be life-threatening
Dear emergency department clinicians:
We at the top of the administrative and regulatory chain understand that you deal with enormously complicated mental health and substance abuse patients all the time. Your resources are limited, and the demands placed upon you are growing.
As such, we (the anointed and well-meaning) wish to offer you some guidelines based on our committee’s extensive lunch-time meetings and brainstorming sessions. All of which, you will certainly understand, …
Dear emergency department clinicians: a letter from administration
In his response to mass shootings in El Paso, Texas, and Dayton, Ohio, President Donald Trump called for an expansion of state laws that temporarily prevent someone in crisis from buying or possessing a gun.
A flurry of states have recently passed such laws — known as extreme risk protection orders — which allow a court to intervene when someone shows warning signs of impending violence. Although the laws are widely …
Taking guns away from people in crisis: Does it work?
We often associate our calling with our career. That’s what I did from the very moment I decided to become a doctor. That’s all I focused on. I studied for it. I invested time and money into it. Like many doctors, my identity was intimately woven into what it means to be a doctor. It’s who I became to the exclusion of everything else.
From the outside looking in, I was …
Doctors: Step boldly into your calling
My classmate and I looked at each other with amusement and embarrassment as we learned that all medical students would now be required to launder their white coats at the hospital. After several complaints that medical student’s white coats did not appear as “white” as they should, the university decided to take matters into their own hands. I looked down at my own white coat, which was due for a …
The white coat serves as a daily reminder of the Hippocratic oath
So, who doesn’t want a better health care system?
We are barraged with stories in the medical literature and in the public press about the terrible state of our health care system, what poor outcomes we have, the inefficiencies in care, complaints about the electronic medical record, inflated costs, lives ruined by medical bankruptcy, and massive social inequities in terms of access …
Stop nickel and diming doctors
Artificial intelligence (#AI) seems to be all the rage these days, as it should be, given its potential to revolutionize medicine in many ways. #AI is actually already an integral part of many of our lives on Google, Amazon, Facebook, and other sites. Siri and Alexa use #AI too, so we can’t easily escape it. Why would we want to?
Of course, one concern about the algorithms is that they often …
The limitations of artificial intelligence in cardiology
Sunlight is diminished by threatening clouds infiltrating the once azure blue sky, clouds that are framed in blackness indicating dangerous times ahead. Nature’s creatures are seeking refuge for they are wise to see the signs of impending danger. If only man was wise enough to take cover.
It was heralded as the dawning of a new age in health care for all: the electronic health record or EHR. My interpretation and …
A call to arms: We are all part of the health care solution
I expect my patients to develop or sense responsibility in connection to their health because I believe personal responsibility creates the basis for a constructive, therapeutic relationship and healing process.
My experiences as a patient have made me understand how difficult it can be to maintain a sense of responsibility. I often yearn for clarity and a “gameplan,” but instead find myself confronted with medical guideline gray areas and conflicting treatment …
What are patients’ responsibilities for their health?
Over the course of little more than a month, we removed 54 tiny toy magnets from the digestive systems of four children. They were lucky: Despite invasive procedures and operations to repair holes in their intestines, their injuries were treated in time, and they will make full recoveries.
In the past, others across the nation have not been …
Toy magnets need to be banned for good
A recent New York Times article entitled, “When You’re Told You’re Too Fat to Get Pregnant” discussed a woman’s journey to having a child, which involved being counseled against undergoing fertility treatment due to her high body weight. She ultimately underwent bariatric surgery, lost weight and was then able to conceive after an IUI (intrauterine insemination) cycle, a fertility treatment that involves placing the sperm at the …
The truth about body weight and infertility
ADVERTISEMENT
Hippocrates didn’t have a server.
In 2012 our practice invested $300,000 into building computer infrastructure and the purchase of a brand-spanking-new electronic health record, commonly referred to as an EHR. The mandate for this purchase was brought forth from the federal government with the intent to improve overall health care communication.
Since this expenditure, terms like image server, ethernet, firewall, hyperlink, backup server, IP address, fax queue, cache server, LAN, domain server, …
When an EHR is hacked by Russians
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 35-year-old man is evaluated during a follow-up appointment for persistent heartburn with chronic cough. He has a 1-year history of gastroesophageal reflux disease and takes pantoprazole twice daily. He reports no nausea, vomiting, or dysphagia. Upper endoscopy performed 1 year earlier showed no abnormal findings.
His vital signs and …
MKSAP: 35-year-old man with persistent heartburn
I was struck by the difference between my care and that of the rest of the system as I cared for a patient recently. She was complaining of a strange pulsating noise in her ear that had started a few weeks before. We chatted for a while, as I asked about any sinus symptoms: If she’d ever had anything else going on like this, what other significant symptoms she was …
The time to listen saved this doctor
When Colorado legalized marijuana, it became a pioneer in creating new policies to deal with the drug.
Now the state’s surgeons, nurses, and anesthesiologists are becoming pioneers of a different sort in understanding what weed may do to patients who go under the knife.
Their observations and initial research show that marijuana use may affect patients’ responses to anesthesia on the operating table — and, depending on the patient’s history of using …
Your anesthesiologist needs to know if you smoke pot
As a law student, I recently was a legal extern at a hospital this summer. It’s a crazy thought because when I started medical school back in Fall 2015, my bus would pass through the pick-up/drop off zone at the hospital every single day at 7:43 a.m. I always saw physicians with their long white coats and coffees in hand walking through the automatic sliding doors. I too saw patients …
What this medical student learned as a legal extern
I wrote about this topic a few years back, but the recent outbreak of measles has once again ignited the debate of just what the government has the right to do or not do in compelling individual actions in support of public health. This is an old question, and it’s worth considering it in historical context.
One aspect of the endless vaccine debate is the aspect of coercion some parents feel …
The government’s role in compelling individual actions for public health
It wasn’t even nine o’clock when the screen on my laptop suddenly froze. From that moment until my last patient left the building, my clinic had no internet.
For my part, the day went pretty smoothly, mostly because of some of my own work habits. It also helped that it was a warm, sunny day, and my schedule was on the light side. Others have frowned at my old-fashioned work habits, …
A doctor survived a day without a computer. Here’s how he did it.
Get free updates delivered free to your inbox.
