I swiped this editorial cartoon by Steve Sack from the redoubtable Dr. David Gorski’s blog, who goes by the nom-de-web of Orac. Recent epidemiology shows reducing the fraction of vaccinated children in the population rather promptly leads to a resurgence of the diseases vaccines protect against. This is the concept of community or herd immunity.
Epidemiologists debate the concept around …
The Society to Improve Diagnosis in Medicine has on its website this quote:
The current focus on diagnostic error raises an interesting question: Is this a larger problem in 2017 than in the 1970s and 1980s?
In this post, I …
An excerpt from The Other Side of the Bed: What Patients Go Through and What Doctors Can Learn.
As soon as I’d opened my mouth, I regretted it. In the hospital, it’s bad luck to say “It looks quiet,” or anything to that effect. At the sound of those words, …
Victim: Female nurse, age 25
Time: circa 1980
Place: A hospital in a sleepy Southern town with fifty beds, six emergency department beds, one nurse, one doctor and one secretary.
It was an unusually quiet Friday night in this small emergency department.
We all knew Friday was “party day”: pay day, play day, alcohol, pills, drugs, loud music and lots of really bad decisions.
Not only did we cover the entire city, but we also …
Most people reading this would love to lose weight, feel better and live longer. Doctors are a smart and motivated group of people. Unfortunately, that intellect and drive has not prevented us from avoiding an increasing incidence of obesity, diabetes, and hypertension identical to the general population.
While this article may have started out sounding like an infomercial, I promise it will not end like one. …
In the spirit of World Breastfeeding Week, I want to highlight all we can about breastfeeding; why it’s great for you and your baby, some ways to make it easier, and how to manage common challenges.
But one challenge that often gets ignored in the offices of doctors and lactation consultants is the issue revolving around the ethics of breastfeeding. That is, addressing uncomfortable questions like these:
There are two schools of thought about how to extubate patients at the conclusion of general anesthesia:
Allow the patient to wake up with the endotracheal tube in place, gagging on the tube and flailing like a fish on a line, while someone behind the patient’s head bleats, “Open your eyes! Take a deep breath!”
Or:
Remove the endotracheal tube while the patient is still sleeping peacefully, which results in the smooth emergence …
In Sweden, back when I trained, three blood tests were the “routine labs” done at most doctor visits: hemoglobin, white blood cell count, and erythrocyte sedimentation rate. I’m trying to remember, but I don’t think everyone waited an hour to see the doctor, so they must have used a modified rapid sedimentation rate.
The “sed rate,” or “sänkan” as we call it, was invented by Robin Fåhraeus, a relative of one …
1. You might get sent home. If you show up pregnant with your first baby, and it turns out you aren’t 4 cm dilated yet, you will get sent home because you aren’t in active labor. Please don’t cuss out the charge nurse. Yes, you are in pain — we aren’t denying that. But, there are limited numbers of beds on labor suites, and we need to keep some open for …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 21-year-old woman is evaluated for mosquito bites on her arms and legs that she received 1 week ago that she has been scratching regularly. One of the bites on her left thigh is now painful with a small amount of drainage. She otherwise feels well, has no significant medical history, and …
The first thing I remember as I regained consciousness, lying in a hospital emergency room, was hearing a nurse ask my mom if I was allergic to any foods. With my eyes still closed, I said, “asparagus,” thinking this might reduce the chances of anyone serving me what was then a dreaded vegetable.
“Asparagus,” repeated the nurse, making a note on my admission form.
And then, with a chuckle and what must …
My grandmother’s room is silent, save for the plucks of sitar strings and Pixar movie soundtracks I try to stimulate her with. Instead of books, we fill the shelves around her bed with mouth swabs, drab hospital gowns and vials of baby powder. My grandmother — who walked an hour every day, who thrashed me in gin rummy, who rose before sunrise every morning to read — now lies bedridden …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 37-year-old man is evaluated for a 2-year history of low libido, loss of morning erections, fatigue, and decreasing muscle mass. His medical history is otherwise unremarkable. He takes no medications.
On physical examination, vital signs are normal. BMI is 35. The remainder of the examination, including genital examination, is normal.
Laboratory studies:
| Luteinizing hormone | 10 …
ADVERTISEMENT Overweight patients are not necessarily lazyMy nurse practitioner was pleased to see me at my annual physical this year. “So how does it feel to be 20 pounds lighter?” “It feels terrible,” I replied. Allow me to explain. Weight has been an issue my entire life. Raised on a standard Midwest diet of complex carbohydrates and the best processed delicacies that government assistance could buy, I spent most of my childhood socially segregated by my peer group due … The abscess that surprised this emergency physicianI carried it around with me the entire shift. I showed it to my E.R. colleagues, the internists, and even a couple of surgeons. I’d tell them the story. “Never,” one of them said. “Not in twenty-eight years. Never seen that before.” One of them held the small urine jar up to a light and began unscrewing the lid. “Don’t!” I said. “Why not?” “It stinks. You wouldn’t believe how much it stinks. We … CSF is soap for your brainRecently after pulling a couple 20-hour shifts, people kept encouraging me to sleep on my break. They were obviously concerned for my well-being but it got me thinking more about the role sleep plays in our lives. If the average life expectancy is 78 then we spend 30 percent of our lives asleep which is also the same amount we spend in our cars commuting, and a meager 0.16 percent … The unhappy couples after a cancer diagnosis
5 ways to tell if a practice has integrityI stood in line behind a physician, slightly balding and in a long, starched lab coat at the coffee shop in our hospital. As he paid and took his coffee, I noticed that he smiled and called the clerk by name, “Thank you, Terri.” He went on about his day, and I was left to wonder about the man, his practice and what type of person he was. My friend has … MKSAP: 28-year-old man is evaluated for recurrent nephrolithiasisTest your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old man is evaluated for recurrent nephrolithiasis. Medical history is significant for Crohn disease complicated by multiple small bowel strictures requiring resection. He began developing kidney stones 3 years ago following his last bowel surgery. Analysis of the stones has consistently shown calcium oxalate, and he has been adherent to a … An ode to the nurse who saved Jimmy Kimmel’s babyRecently, a nurse at Children’s Hospital Los Angeles noticed that comedian Jimmy Kimmel’s newborn baby had a murmur and was cyanotic and brought it to the newborn intensive care unit for further evaluation. That triggered a rush of activity that led to a diagnosis of a congenital heart defect and heart valve problem and surgery to save the baby’s life. Here’s what the public doesn’t understand: Nurses do this every day. …
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