by Kate Gray
I call William my spirited child. Like many 3 year-olds, he loves to run and jump, and does it without the slightest sense of fear. His boundless energy has always been one of his most endearing features, but in a split second, it also almost took him from us forever.
A few days before Christmas, my husband Mark and I had some last minute holiday …
Forever grateful to the doctors and nurses who saved my son
It’s not easy being a parent of teens these days. Previously rational children transform into moody, unreasonable creatures whose need to shock is only surpassed by their efforts to fit in.
Add a measure of impulsiveness and experimentalism, and it’s no wonder risky behavior skyrockets during these years. What a parent can do is to keep the lines of communication open, stay informed of the health dangers of some of the …
10 health dangers that your teen may face
One of the benefits, or aberrations, depending on your point of view, of the fee-for-service model is that we surgeons are remunerated for correcting our mistakes and complications.
At first glance this seems wrong. But perspectives differ, and when a doctor has to deal with serious, undeserved complications and is self-employed he deserves to be compensated adequately. So what really is the difference between the two?
A complication may be described as …
Surgical error: The difference between mistake and complication
The following op-ed was published on February 2, 2011 in USA Today.
Last fall, a surgeon at Johns Hopkins Hospital was shot by the distraught son of a patient for whom he was caring. The man later killed his mother, then himself. A week earlier, a patient in a Long Island, N.Y., hospital beat his nurse with a leg from a broken chair, causing serious injuries. The following month, a psychiatric …
Understanding patient violence against health care workers
Proton beam therapy is an effective modality for killing certain types of cancer cells. New England and the Northeast are fortunate to have a proton beam machine at Massachusetts General Hospital, where it has been in use for some time effectively treating patients. This is a valuable resource, serving the entire region and beyond.
But what happens when everyone wants one? Well, we see the medical arms race at work again.
These …
Proton beam therapy and the medical arms race
by Stella Safo
It is Saturday night at an Emergency Department (ED) in Boston, MA and I am faced with a medical student’s dream dilemma: which one of the many interesting cases should I observe? Should I watch trauma surgeons operate on the 17-year-old gunshot victim or work with the ED docs to assess whether a 59-year-old woman is having an acute stroke?
That is exactly what …
Learning to love primary care via an emergency department rotation
Clinician. Diagnostician. Prognostician. Healer.
A physician has many jobs to perform, all critical to the appropriate management of what ails our patients. Without astute physical exam skills or a keen ability to sort through a medical history to uncover salient data, the physician is no better at diagnosing a patient than a Google search (and we’re quite a lot better, in case anyone was wondering). Without a proper understanding of physiology …
Viewing physicians source of care, rather than a barrier to care
No great artist ever sees things as they are. If he did, he would cease to be an artist.
-Oscar Wilde
The physical exam of the head and neck is both simple and challenging. Simple, in that even children are familiar with the shape of the face, the sheen of the eye, the curve of the ear, and the texture of the tongue. Challenging, because when complicated, interlacing structures malfunction, they send …
The physical exam of the head and neck is both simple and challenging
The e-reader battles are clearly heating up, with the Apple iPad, the aggressive marketing of the Kindle
Joseph Kim of Mobile Health Computing argues that it certainly should be, but I think …
Apple iPad, Amazon Kindle, or the Nook for medical students
When I had a heart attack two years ago, I was taken immediately from the E.R. to the O.R. for emergency treatment, including cardiac catheterization and a stainless steel stent implanted in a major coronary artery that was 99% blocked. But, overwhelmed and terrified, I knew nothing about what was about to happen, even though I have a vague memory of the cardiologist explaining something to me before I was whisked …
Patients are not to blame for the miscommunication about cardiac stents
Lack of sexual interest is the most common sexual complaint in women.
The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), which defines psychiatric disorders, defines Hypoactive Sexual Desire Disorder (HSDD) as ‘‘persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity’’ that causes ‘‘marked distress or interpersonal difficulty.’’ Epidemiologic surveys have suggested that from 25 to 50 percent of women report prolonged periods …
Lack of sexual interest is the most common sexual complaint in women
My partners and I have long struggled with the lack of specialty back-up at our hospital. Semi-rural hospitals, out of the way facilities, just can’t always attract specialists. So, we’re happy to have cardiologists every night, but understand that we only have an ENT every third night. We’re thankful to have neurologists, even if they don’t admit anyone. We’re glad to have radiologists, even if they don’t read plain films …
Fewer physicians are taking call in rural emergency rooms
by Jerry Levin
For all of us — young, old, and those in the middle — life is simply an interlude between doctors’ visits. This perspective, while obvious, perennially stays beneath our consciousness since we are consumed by the daily pursuit of personal identity as if our mind-body-and-spirit were to function without incident and without end. More powerfully of late is the recognition that the explosive neglect of mental …
Patients are closing the health gap online
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As reported by MSNBC, the federal government will no longer allow flexible spending accounts (FSAs) to be used for over the counter medications, without a prescription. FSAs, which are offered by many employers, allow you to use tax free dollars for medical expenses that aren’t covered by your insurance. FSAs are a great idea and can be used for things like eye glasses, dentistry, or even …
Requests for OTC prescriptions for a FSA burdens primary care
On the subject of shopping for and preparing nutritious meals, one piece of advice that I like to share is that it’s best to stick to the outer walls of the supermarket and avoid the center. So with only a few exceptions, like flour, oil and beans, that’s exactly how I shop. What does it mean to shop at the edges of the supermarket? Let me show you what I …
Supermarket tips for preparing nutritious meals
If we are going to make rational decisions about health care reform, it helps to understand the medical economics of a primary care practice.
I was ten years out of medical school by the time I joined Narragansett Bay Pediatrics, a group practice in southern Rhode Island, and I was earning a salary of $48,000 for my “part-time” position. I worked in the office 24 hours per week, and covered nights …
Understand the medical economics of a primary care practice
“I have bipolar disorder. Can I be a doctor?”
It’s one of those questions to which there is no real answer. Being a doctor takes a long time, it requires reliability, diligence, and a willingness to learn things you may not want to learn and do things you may not want to do. It requires endurance and passion. You need to be tolerant of many things: arrogant supervisors, irritable colleagues, sick …
Can I be a doctor with bipolar disorder?
Humans are imbued with a competitive spirit. And as a result, we like to count our victories.
There are an infinite number of possibilities in human experience. And when the possibility of death looms over us, the sudden fear that we might not have done everything we might have creates immense distress. This “range” or “number” idea rarely has the effect it is supposed to have. Every kind of sex, every …
The torture and emptiness of psychological hoarding
Last year it was the “Save the Boobs” video. This year it’s the “I (Heart)Boobies” bracelets.
Some people were very offended by the video’s slow-motion close-ups that were more reminiscent of a beer commercial. Now, some schools are banning kids from wearing the bracelets. And in a recent post on Salon, Tracy Clark-Flory made the eloquent case that we’re more than the sum of our body parts, and recounted her mom’s battle with metastasized lung cancer.
I agree …
Save the Boobs, and whether humor has a role in breast cancer
As far as my chemo nurse Olga (not her real name) is concerned, I can do nothing right.
She scolded me for sending an e-mail when she thought I should have called and vice versa. She scolded me for going home before my next appointment was scheduled. She scolded me for asking to speak to her personally instead of whichever nurse was available. She scolded me for calling my oncologist directly. …
Sharing information about your health with specialists is difficult
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