Should medicine have a cosmological constant?

Physician
December 10, 2016

It was Albert Einstein’s “biggest blunder.”

Using his general theory of relativity, Einstein devised a formula that predicted the universe was expanding. This was an unfathomable idea, though. How could the universe expand with all the gravitational forces pulling the heavenly bodies together.

In Einstein’s time, the universe was thought to be stationary. A universe that was anything but stagnant was an inconceivable idea since celestial matter would spin out of control, …

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Should medicine have a cosmological constant?

How to create a modern superhero

Physician
September 23, 2016

You start out by working in a busy emergency department.

You see patients with all sorts of complaints: abdominal pain, headaches, and chest pain. Vomiting, diarrhea, and dysuria. Ankle sprains, bug bites, and allergic reactions.

Domestic violence, rape, and child abuse.

You don’t ever let the stress of the job take away your humanity. You treat your patients with empathy and respect. You listen to their stories, treat their symptoms, contact the police, …

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How to create a modern superhero

Patient satisfaction must start with nursing satisfaction

Physician
June 28, 2016

Ever since the U.S. government decided to link Medicare reimbursement dollars to patient satisfaction scores, hospital administrators have been obsessed with improving the quality of care for patients visiting their emergency departments. While the motivation may be partly financial, the goal of improving the patient experience during emergency department and hospital visits is an admirable one.

Unfortunately, many of the tactics used by administrators have done little to achieve that goal. …

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Patient satisfaction must start with nursing satisfaction

Spare your loved ones from this dreaded scenario

Physician
March 7, 2016

What if you woke up tomorrow and learned that your grandmother had been kidnapped overnight by a couple of strangers, thrown in a white van, and taken to a distant warehouse where she spent the subsequent forty-five minutes being tortured before finally succumbing to her death?

Where she was repeatedly beaten in the chest, where a tube was shoved down her throat, where she was tasered with high voltage, where a …

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Spare your loved ones from this dreaded scenario

Drinking diarrhea to save lives

Conditions
March 30, 2015

If it weren’t for the coming together of people from all over the globe, the influenza pandemic of 1918, also known as the Spanish Flu, would not have had the devastating effect that it did. It is estimated that at one point this deadly strain infected one out of every five people on earth and ended up claiming the lives of approximately fifty million people (in comparison, nine million combatants …

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Drinking diarrhea to save lives

Can serendipity be engineered?

Conditions
December 3, 2014

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You know the story. It goes something like this:

On an ordinary September morning in 1928, Alexander Fleming, a Scottish bacteriologist working at St. Mary’s Hospital in London, came back from vacation to find that one of his Petri dishes containing Staphylococcus aureus growing in culture had been contaminated by greenish mold.

Instead of throwing a fit, Fleming grew curious over this finding. After …

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Can serendipity be engineered?

When treating neo-Nazis, should physicians have a choice?

Physician
October 21, 2014

shutterstock_113334004What I found most disturbing about the man’s arm was not the deep, stellate laceration on the underside of his biceps.

It was the swastika tattoo next to it.

“Sir,” I said, “we’ll have you fixed up in no time. I’m going to numb up the wound, irrigate it, then repair the laceration with sutures and send you home on antibiotics and pain …

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When treating neo-Nazis, should physicians have a choice?

“I want to give up my son”: Is that child abuse?

Physician
September 24, 2014

The case

A thirty-five-year-old female presents to the emergency department on a weekend afternoon with the following chief complaint: “I want to give up custody of my son.”

The patient is well dressed — and so is her four-year-old son, who is sitting comfortably on the bed playing a video game on his mother’s cell phone.

According to the patient, she is a single mother with no support system. Her son’s father deserted …

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“I want to give up my son”: Is that child abuse?

Recognize the potential victims of human trafficking

Conditions
August 24, 2014

If you’ve ever worked in an emergency room, you’ve likely treated a victim of human trafficking.

We all have, often without knowing it.

With nearly thirty million people in modern-day slavery around the world, there are more slaves today than at any point in history.

Human trafficking is defined as “the recruitment, harboring, transportation, provision, or obtaining a person for labor or services, through the use of force, fraud, or coercion” for the …

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Recognize the potential victims of human trafficking

What if jet lag was infectious?

Conditions
August 2, 2014

Jet lag, also known as desynchronosis or flight fatigue, is defined as “extreme tiredness and other physical effects felt by a person after a long flight across several time zones.” Besides insomnia, symptoms of jet lag include weakness, fatigue, dehydration, body aches, diarrhea, dizziness, headache, irritability, and memory loss. Jet lag is one of the circadian rhythm disorders; others include shift work disorder, sleep phase disorder, and irregular sleep-wake rhythm.

Symptoms …

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What if jet lag was infectious?

Preventing nightmares: A guide for medical students and residents

Physician
July 2, 2014

Nobody likes waking up in the middle of the night gasping for air. When you make a mistake in the emergency department, that’s exactly what happens.

They come in all sorts of shapes and colors:

  • The sixty-year-old man diagnosed with a strained lower back muscle who comes back with a ruptured abdominal aortic aneurysm.
  • The fifty-four-year-old Hispanic female with generalized malaise who goes into cardiac arrest from a missed myocardial infarction.
  • The two-year-old with …

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Preventing nightmares: A guide for medical students and residents

Ignaz Semmelweis and the lessons of fear and medical innovation

Physician
May 25, 2014

The man who saved more lives than any other physician (in the history of humanity combined) died in a mental institution — unrecognized and shunned by the medical community. He was beaten by guards and died a miserable death. Dr. Ignaz Semmelweis was a Hungarian obstetrician practicing in the mid-1800s, years before Louis Pasteur came up with his germ theory and Joseph Lister popularized hand washing.

While working as an assistant …

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Ignaz Semmelweis and the lessons of fear and medical innovation