Every week there is another health pronouncement saying what is now good for you and what is going to kill you. Unfortunately, the “what” is often interchangeable — what was supposed to kill you last week is now suddenly good for you or vice versa.
Foods, supplements, and activities, all studied extensively and determined to be either good or bad, then subject to a new study, with the opposite conclusion. How …
When medical science becomes fake news
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 62-year-old woman is evaluated during a follow-up visit for recently diagnosed stage IIIA high-grade serous ovarian cancer. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy and completed six cycles of chemotherapy with cisplatin and paclitaxel. The patient’s paternal aunt was diagnosed with breast cancer at age 52 years. …
MKSAP: 62-year-old woman with ovarian cancer
A patient walks into the doctor’s office and says:
I hate feeling this way. Yes, I know it’s not cancer and it won’t kill me, but this shaking has made me a different person. I can’t sign my name. I drop and spill things all the time. I’m afraid to pick up my baby grandson. I don’t go out anymore because I’m embarrassed. And I don’t know what can be done. …
Steadying patients’ fears about shaking hands
An excerpt from In Two Voices: A Patient and a Neurosurgeon Tell Their Story.
Linda, the patient, writes:
Years later a compassionate optometrist acknowledges my eye pain and frequent headaches. I try different lenses, various prescriptions. When they don’t work, he arranges for me to see one of his mentors at …
A patient and a neurosurgeon tell their story
Long-time “Jeopardy!” host Alex Trebek announced in March that he had been diagnosed with stage 4 pancreatic cancer. Within days, he offered thanks to “the hundreds of thousands of people who have sent emails, texts, tweets, and cards wishing me well regarded my health.” Then last month, Trebek reported that his cancer was in “near remission,” saying that his doctors “hadn’t seen this kind …
The Trebek effect: the benefits of well wishes
An opinion article was recently published in Stat by Daniel Sokol, PhD, who is a London-based bioethicist and lawyer specializing in medical law. His article, entitled “Doctors should use social media with restraint,” discusses the role of doctors on social media. This was very interesting timing for me as I have only very recently embarked on a professional online presence. Mr. Sokal uses Sir William Osler as …
A physician shares her positive experience with social media
Nearly half a million individuals with opioid use disorders are hospitalized each year in the United States. While they are in the hospital, medical providers often treat complications of this disorder, such as bloodstream infections, but rarely directly address their addiction. That’s like pumping up a flat tire without ever looking for the nail that caused …
How hospitals can help with the opioid epidemic
To my residency class:
The clock is ticking, its hands spinning around its face faster and faster until I feel dizzy and disoriented. The remainder of the academic year can be measured in days, even hours for some. The carousel is slowing down to let some off, some on. Some, like me, will remain in the saddles of their brightly painted ponies. The cheerful calliope melody becomes distorted with the change …
Words of wisdom to a residency’s graduating class
A patient groans in agony lying atop a rigid spine board, carried by paramedics into the ER, his neck in a protective collar. The paramedics shout a summary of the accident. Monitors are attached to the man, flashing and beeping the cadence of vital signs. Nurses and physicians swarm. Gloved hands comb through brown hair for bumps or lacerations. They remove his clothes, feeling for pulses in the neck and …
Fasting for Ramadan and being the on-call orthopedic trauma resident
In a recent People article, Jeopardy! host Alex Trebek shared some good news. Diagnosed with stage 4 pancreatic cancer in March, Trebek said he was told that he has been responding very well to his chemotherapy regimen, and that he’s in “near remission.”
He went on to say, “It’s kind of mind-boggling. … The doctors said they hadn’t seen this kind of positive …
How is Alex Trebek doing with his pancreatic cancer treatment?
It is honorable to fight a battle in the face of an inevitable ending while not knowing when that end may come.
First day of third year — the year most medical students take a sigh of relief as they put their Step 1 book on the shelf and prepare to face the wards:
I happened to draw the short straw by having my surgical rotation first, one that often brings an …
A medical student’s reflection of “firsts”
Several weeks ago, as I was walking through the halls of our hospital, out from an intersecting hallway drove a robotic delivery cart.
Unmanned and adorned with sensors so it could tell where it was in the world, it motored along on its way, heading somewhere with a bunch of flashing lights and audible warning signals.
I was told this was part …
What health care can learn from a robotic delivery service
A great deal has been written about physician burnout, especially in emergency medicine.
Inefficient electronic medical records, rapidly decreasing resources, increasing job demands, litigation risks, huge debt burdens from training, and on and on.
But in my opinion, much of this is common to any career. Show me a person that doesn’t ask themselves at least once, no matter what their occupation, “Why am I still here?” and I’ll show you someone …
Being an emergency physician is magical
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Physicians have a long history of discriminating against patients, and racial discrimination only scratches the surface of current problems facing patients who seek access to care. The Tuskegee Syphilis trials demonstrated how the medical community exploited and compromised the trust of African American patients. Recent research indicates that out of a study of 222 residents and medical students, about half demonstrated false beliefs concerning biological differences between white and black …
What happens when doctors discriminate against patients?
Our profession is in crisis, but “human rights violations” and “moral injury” are inaccurate terms to use.
It may be surprising to some that I am writing this piece as I am viewed as a staunch physician advocate. In 2017, I was stunned after a beloved classmate from medical school took his life. I felt I had let him down by missing signs of distress — dismissing them because he was …
The problem with calling physician burnout a human rights violation or a moral injury
As President Donald Trump was fighting with Congress over the shutdown and funding for a border wall, his administration implemented a new rule that could be a game changer for health care.
Now, hospitals must publicly reveal the contents of their master price lists — called “chargemasters” — online. These are the prices that most patients never notice because their insurers negotiate them down or they appear buried as line …
A new rule that could be a game changer for health care
As I listened to my attending explain how during her residency training she was on call every third night, I realized how the definition of “call” had significantly changed since that time. For her, it meant her shift started at 6 a.m. and ended at 8 p.m. the next day, totaling the shift to upwards of 36 hours. My call, on the other hand, was a mere 6 a.m. to …
Should we change resident duty hours?
Chip Kelly was a former coach and general manager of my beloved Philadelphia Eagles. He was a firm believer in his “system” and felt that his players were disposable and easily replaced. Because of that, he proceeded to trade away or release very talented players and replace them with less talented players. Needless to say that without the talent, the team self-destructed, the fans were angered, and it was only …
Is there a doctor on board? Since the beginning of my medical training, I have developed a new anxiety over flying. As an intern, the “MD” had been tagged to my name while my medical knowledge, skills, and confidence lagged behind. Now, at the end of residency, those factors have caught up. Yet my anxiety, while abated, lingers. It remains because, deep down my gut reaction to that question is …
Is there a doctor on board? Not always.
In health care, we are hardwired to do all we can to minimize error and avoid failure. The journey of training and practicing medicine rests on the premise of perfection. And yet, perfectionism and shame are thought to be the two sides of the same coin. As clinicians, we have the privilege of interacting with people from all sections of society during the most vulnerable times of their lives. It …
We care for patients. Why don’t we care for ourselves?
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