by Doctor D, MD
A teacher asks Doctor D about a diabetic teenager in his class: “His sugar readings are often over 400. His mom says this is normal. Can this be normal?”
What is normal?
a) A state of harmony within the body and mind that leads to health and well-being.
b) The typical or status quo for a person; the way things usually are.
c) WTF? There is no such …
What is normal for a teen with diabetes?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 32-year-old man is evaluated in the emergency department for a 5-day history of worsening crampy abdominal pain and eight to ten loose bowel movements a day. The patient has a 5-year history of ulcerative colitis treated with azathioprine and topical mesalamine; before this episode, he …
MKSAP: 32-year-old man with crampy abdominal pain
When anyone brings up the idea of end of life care, you are thrown a political football. Yet, the failure to have these discussions with your loved ones creates an expensive and emotional mess.
I can’t tell you the number of times I’ve been sitting at a table with friends and this issue has surfaced with almost unanimous consent: they all want to …
End of life care requires individual family decisions
On May 15, 2011, 147 students embarked on their careers as doctors as they graduated from the University of Pennsylvania School of Medicine.
One student, Jenny Rowland, who will pursue a career in Radiology and continue her training at Penn, shared her personal thoughts and emotions as she prepared to graduate.
by Jenny Rowland, MD
I’m not a typical PennMed student.
I’m 31 years old, and I …
The difficult road to becoming a doctor
So, you’ve cut off your breast(s) and poisoned and radiated your body. You’ve hit all your medical milestones – surgery, chemo, herceptin. You’ve recovered and the hair on your legs has grown back to plague you, and you have gotten back to a normal life. Work, jobs, family. Shaving.
Yet you are changed. You didn’t expect this, but each time you get dressed or undressed, you can’t help but notice your mastectomy …
Cancer will always be a part of a patient’s identity
Most of us are uncomfortable talking about our waste products, urine and feces. However, changes in the color and odor may signify disease that can be treated or prevented. This article will review causes of discoloration of urine and when there is a change in the odor of urine.
For hundreds of years doctors have looked at urine as a barometer of what is happening in the body. The urine can …
Pay attention to the color and smell of your urine
I recently had the opportunity to go to the anatomy lab and help the first years go through the pelvic anatomy. What a blast! There is nothing like dissecting a cadaver to tune up one’s surgical anatomy skills, and helping young eager medical students through it is a great experience.
Prior to going into the lab, I spent many hours going through Netter’s atlas to brush up on the anatomy so …
Going through Netter’s to teach medical students pelvic anatomy
by Mariana Perroni, MD
The following post was written on February 27, 2010, while working as a volunteer in a field hospital in Haiti. It was called Love a Child Recovery Center and it was run by us (Albert Einstein Hospital – São Paulo – Brazil), Harvard Medical School and University of Chicago Medical School.
We …
The power of music at a hospital in Haiti
When bad medical news hits, the blow can be devastating.
Shock is almost always the first thing people feel, followed by anger, fear and often a profound sense of sadness.
At times like these it came be extremely difficult to collect your thoughts and decide what to do next. Your head is likely to flood with questions that arrive at various moments – in the middle of the night, in the shower, …
How patients can handle bad medical news
I am a “Gleek.” I admit it.
A Gleek is a self-described lover of Fox’s show, Glee. The show features a diverse group of teens who are in the school’s show choir. Glee focuses on the lives of these teens, in and out of school, while emphasizing certain storyline elements with entertaining Broadway musical-type performances.
The show itself, however, is not the point of this post. Last week was an unexpected …
Using Glee for teachable moments to teens
An excerpt from Med School Admissions Secrets.
by Jason Spears
There are currently 134 allopathic medical schools in the United States and you need to select approximately 20 schools.
You are not going to randomly pick, instead there is a system to getting into medical school.
The first step is ranking schools in the following manner:
Obviously, the top-tier med schools have high admissions standards based on MCAT and GPA. No …
The science of getting into medical school
Holy crap.
My medication did not arrive today.
How can this possible be happening? Do they not know this medication is not optional?
Let me recap. I called over a week ago for a refill. I am only allowed (by my insurance) to use the (non-local) specialty pharmacy that they own for this medication. They told me my medication would arrive yesterday, which was the day after I’d use my last …
How a specialty pharmacy denies a physician his medication
Genomics promises to fundamentally change much of medical care. But the ultimate value of this new understanding of basic human biology will in many cases come with fits and starts. The saga of belimumab (Benlysta) and Human Genome Sciences (HGS) is illustrative.
Systemic lupus erythematosus (SLE) occurs in somewhere between 300,000 and 4 million Americans according to the …
Belimumab (Benlysta) to treat systemic lupus erythematosus (SLE)
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by Rima Rudd, ScD
We take the written word for granted.
Signs and billboards are everywhere – offering directional information, alerts, warnings, and advertisements. Streets, public squares, buildings, agencies, and institutions are numbered and named. We are surrounded by the written word in public locations and within public and private institutions. Individual entrances and even elevators in some large buildings carry names. The lobby, the inside …
Navigating any health care facility requires sophisticated literacy skills
“Code Blue ICU … Code Blue ICU”
I was greeted by the PA system as I walked into the hospital this morning. A shiver ran down my spine as I quickened my pace. The days of running to codes are long gone. But since I have a patient In the ICU I was curious and just a little bit worried.
As I walked through the sliding doors I passed the room full …
How real life medicine is less glamorous than residency
by Tom Lang and George Lundberg, MD
A not-so-obvious truth is that evidence-based medicine is literature-based medicine.
That is, the quality of the scientific literature directly affects the quality of the evidence.
Quality, in turn, depends in large measure on reporting research completely and accurately.
In response to ample evidence that such quality is often missing from the literature, dozens of reporting guidelines, such as the CONSORT Statement for reporting randomized trials, are …
How the quality of the scientific literature impacts the evidence
The insurance middleman has taken a toll on the family doctor. New practice models plan to change that. Physicians in Seattle, Silicon Valley and Boston are proving what the rest of the world already knows. When you have a high function primary care system, there’s less money spent and better health outcomes.
Before House, M.D., …
Direct primary care and the Marcus Welby vision of primary care
One of our purposes e-Patients.net is to help people develop e-patient skills, so they can be more effectively engaged in their care. One aspect is shared decision making. A related topic, is understanding the challenges of pathology and diagnosis. Both posts teach about being better informed partners for our healthcare professionals.
I’ve recently learned of an another topic, which I’m sure many …
Practice variation from the perspective of an e-patient
When someone gets sick, what are their options?
They can try to make an urgent appointment that day, but how many of your doctors actually offer that? Most people will have to wait for weeks, if not months, for a regular appointment. Even if you go to a walk-in clinic, the wait will likely be hours, and you’re not sure if clinics can take care of everything, so you head to …
Emergency medicine, we can do better
When does medical school officially begin? Is it when you are given your white coat? When you sit through your first orientation activity? When you listen to your first lecture? Or when someone first mistakes you for a doctor?
While medical school commencement is truly is an amalgam of all of these things, the answer to this question is …
Medical school starts with anatomy lab
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