Words have meaning. And when it comes to cancer, especially advanced cancer, there aren’t many words that have more meaning than the word “cure.” It is that very word and concept that is top of mind for some of us these days.
We clinicians are guilty as charged when it comes to reluctance declaring those who have had a remarkable response to treatments for advanced cancer “cured.” Experience has taught us …
What should a cure for cancer look like?
Whenever I tell people outside of medicine how bad doctors are with money, they are always shocked. Almost universally, they wonder why we don’t save enough money. They understand that – to become a doctor – you must be hardworking, intelligent, and dedicated to the cause. These are the same attributes – when they are applied correctly – that result in financial success. How in the world can …
4 reasons why doctors are bad with money
The common practice in this country (although not everywhere — Europe, for example) has long been to treat all acute middle ear infections (otitis media) with antibiotics. This is not necessarily needed. We now know that for many children another reasonable approach is to wait a day or so to see if the symptoms get better on their own without antibiotics. Parents have an important role in making this choice. …
Are antibiotics needed for your child with an ear infection?
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
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”
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?
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?
Every hospitalist heard that locum tenens work pays better than permanent. Of course, I did, too, when I first started practicing. This was one of the reasons why I switched to the full-time locum tenens years ago.
Now, things have changed since then, and employed hospitalist salaries have been rising steadily over the years. It became obvious, then, that $150 per hour for locum tenens work doesn’t cut it …
Maximize locum tenens income: 4 tips to make more and work less
Whether to have a child before becoming an attending physician is a personal choice, but as a fertility specialist, I’m concerned that many people — including physicians — overestimate the effectiveness of today’s fertility treatments.
In the U.S., the average age at which women have their first child went from 21.4 years in 1970 to 26.6 in 2016. Experts attribute that in part to more people seeking advanced education and taking …
Career or the egg? Is it time to put pregnancy first?
Learn about the differences between polymyositis and dermatomyositis the Medcomic way.
Illustrated by Jorge Muniz and music by Neil Bobenhouse.
Image credit: Medcomic.com
The inflammatory myopathies rap video you didn’t know you needed
If you ask people if there is evil in the world, a lot of them will smile politely at such an obviously Medieval (or Neanderthal) view of the world. Which, of course, is a bit of an insult to both groups who were from all evidence quite intelligent folks.
Some might rattle off some examples of evil. Things like intolerance, racism, sexism, homophobia, transphobia, Islamophobia, and assorted others. Disregard for the imminent …
Working in the ER taught this doctor what evil really means
An excerpt from Recapturing Joy in Medicine,
During my year as chief resident, I was also president of the Florida Association of Family Medicine Residents. The faculty at my residency program inspired me by their excellence as clinicians and teachers. I trusted their judgment and insight, so when they encouraged …
The power of advocacy: How doctors can be empowered physicians
I left a full-time academic position five years ago because I was literally, “check-all-the-boxes,” burned out. In looking back during that time prior to my decision to leave, I recall months of feeling overwhelmed, emotionally exhausted, depressed, and in a sense grieved for the loss of what I envisioned my career path to be until retirement. It was not until one of my favorite patients, Mr. Young, who knew me …
How a patient saved this physician from losing her passion for medicine
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 63-year-old woman is evaluated at a follow-up appointment after undergoing right hemicolectomy for colon cancer 1 year earlier. Her paternal grandfather had colon cancer diagnosed at age 75 years. She reports that she has been feeling well and takes no medication.
All physical examination findings, including vital signs, are …
MKSAP: 63-year-old woman after right hemicolectomy for colon cancer
The best lens for reflection is to be immersed in the places and people that spawned those memories. Why else would reunions matter? Twenty years after we graduated the Yale School of Medicine, I found myself on campus embracing my classmates again. But it didn’t take long before I felt something creeping up behind the celebratory mood. Amid storytelling and laughter, I couldn’t help reflecting on some of the more …
A trauma surgeon reflects on the Yale System, 20 years later
With the recent FDA approval, Zolgensma became the world’s most expensive medication. Priced at $2.125 million per patient, the one-dose gene therapy is a potential life-saver for children with spinal muscular atrophy (SMA). Now, the treatment is at the center of an intensifying debate over the rising price of medications.
Industry watchdogs are outraged. They say Zolgensma is merely the …
The ethics behind the world’s most expensive medication
What if I told you that, as your doctor, I’d rather listen to your memoir than to your lungs? Or that while I find the sound of a beating heart a marvel to behold, I’m more interested in hearing the jazz song that you wrote or talking about the words tattooed on your left wrist. What if …
This physician takes the time to be humbled and amazed by the stories patients share
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