The first test tube baby was born July 25th, 1978 in the north of England. Louise Brown was called the “baby of the century” by some and a “moral abomination” by others. It wasn’t Brown who critics accused of being immoral, of course. She was just a blameless infant. Instead, it was her doctors who came under fire for their new fertility treatment—in vitro fertilization (or IVF). Roman Catholic theologians …
Radiolab recently aired a show called “The Bitter End” that discusses the end-of-life care preferences of physicians and non-physicians. Physicians are much more likely to decline “heroic” measures, such as CPR, mechanical ventilation, feeding tubes, etc. This comes as a surprise to the hosts and, presumably, to other non-physicians. It’s a good show. I recommend it. (Full disclosure: I like Radiolab.)
The failure of doctors to talk to their patients about end of life decisions perplexes me. This gap in vital communication results in poor care, uncontrolled pain, futile treatment and death in hospital or nursing home, where no patient wants to be. Certainly, for oncologists, every patient they see is concerned about dying and by not opening the topic it leaves each isolated.
“Discrimination against heavy people, by the general public and medical professionals, might be a greater health and social problem than any extra pounds they may be carrying” argues UCLA Professor Abigal Saguy, PhD, in a provocative essay in the Washington Post.
“Despite the fact that body weight is largely determined by an individual’s biology, genetics and social environment, medical providers often blame patients for their weight and blame their …
If you have not yet seen the fourth episode of the third season of Downton Abbey and wish to be surprised by it, read no further. And if you aren’t watching PBS’s addictive costume drama currently set in 1920–and, seriously, why aren’t you?–read on anyway.
This is about medicine, then vs. now.
First, to recap the medically relevant aspects of the story: Lady …
Let’s talk a little about health accountability. Two news items have provoked the following rant: why is it always someone else’s responsibility?
The first item was on NPR. The FDA, reacting to the epidemic of prescription drug abuse in this country, is offering incentives to the pharmaceutical company that can come up with a less addictive painkiller. Such a drug would be a gold-mine for that pharma company because it could …
Young children are naturally petulant, noisy, and self-centered. We’re all born with ourselves in the center of the universe, an impression reinforced by parents who must cater constantly to their young babies. But babies become toddlers, and toddlers become children. Sometime during this transition, parents have to teach their children that they are part of a family. For a family to function …
Yesterday I saw a 90-year old woman in consultation. She presented to the emergency room in September with abdominal pain, and in the process of working her up, a chest x-ray was taken which showed an infiltrate in her lingula, part of the left lower lobe of her lung.
As it turned out, there was nothing wrong with her belly, but a follow up CT scan of her chest showed this …
Being a single mother in medical school and residency isn’t a piece of cake. But, being a single parent in this world isn’t a piece of cake, either, and being a medical student and / or resident isn’t a piece of cake. Foregoing medical school isn’t necessarily the answer to any of that.
Here is some general advice I will share with parents, single or otherwise, who are facing decisions about …
From the Economist in October 2012 was an article on physician assisted suicide. In the United States, terminally ill patients can apply for permission to end their lives with the guidance of a doctor in Oregon and Washington state. Several safeguards are in place to prevent this from becoming the default death pathway (only 0.2% of total Oregonian deaths). Also, I had no idea that Holland, Switzerland, and Belgium allow assisted suicide …
Groundhog Day was on Saturday this year, and unlike the furry little beast, what I have to say each year around this time is just as good today as him looking for his shadow on Saturday.
What is all this about, you are probably asking yourself?
Locum tenens (literally “place holder”) is professional work done to fill in where help is needed. It is what I have primarily been doing for the last year, and has been an interesting ride.
When I decided to leave my practice related to losing a couple of partners and wanting to update my knowledge base and re-evaluate my career, I decided to do locum tenens work. I had always thought that …
As with any disease, prevalence of this narcotics abuse is region-specific; an hour north of the office where I practice, Rio Arriba County in New Mexico is home to one of the highest opioid overdose rates in America – up to five times higher than the national average. Our patients routinely lose family to addictions; our clinic has been home to a …
Would it be silly to ask, “Is the history and physical examination worth performing anymore?” especially in this era of high-technology medicine? Does it matter if the diagnosis is made by the bedside in contrast to CT or echocardiography? Someone did ask, and the answer is intriguing and was debated. Let’s look at the data.
Four hundred and forty-two consecutive patients were admitted from the emergency department to an …
Do you read the comic strip “Dilbert” by Scott Adams? I read it most every day. It tells the story of an engineer named Dilbert and the people with whom he works, including notables such as Wally, Alice and the pointy-haired boss. Mr. Adams daily relates amusing situations of the dysfunctional relations at Dilbert’s work site. While the situations are hilarious at times, they reflect the actual work processes at …
There’s certainly a lot of buzz surrounding the word “holistic” in the field of medicine lately. For the purposes of what I am talking about in this article, I assume that all, or at least most, doctors take a holistic approach to medicine. Meaning that they can think across many of the body’s systems, understanding how one condition or component affects the others, and considering each aspect of a patient’s …
As a physician, do you care enough about your patients? It is my belief – and my experience – that physicians care deeply in ways that we demonstrate through our hard work, our commitment, and our willingness to go beyond the ordinary almost every day of our professional lives. What often gets “lost in the soup” of busyness is the communication of that caring in a mindful, purposeful and comfortable …
Once upon a time a doctor first attended 3 or 4 years of college, then finished 3 or 4 years of medical school, trudged through 1 to 8 years of residency training to hang out “a shingle,” and finally begin to practice medicine, usually in solo practice. Those days are long gone. Time has expanded—schooling and training are longer.
Breaks are taken between and during this once but no longer traditional …
