Larry Istrail is an internal medicine physician.

The exciting future of our physical exam with point-of-care ultrasound

Tech
November 15, 2021

In a 1968 episode of Star Trek, Captain Kirk is kidnapped by humanoid aliens, tortured unrelentingly, and shackled to the ceiling by his wrists. Science officer Spock and Dr. McCoy find him disheveled and minimally responsive. They release him from the chains and set him on a nearby table for examination. Dr. McCoy urgently takes out his medical tricorder, a device that can check organ function and …

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The exciting future of our physical exam with point-of-care ultrasound

In the COVID-19 era, point of care ultrasound has proven invaluable

Conditions
August 13, 2020

Amidst the crushing human and economic carnage inflicted by the COVID-19 pandemic, one innocent bystander has been cowering in the dark corner of medicine’s past, clinging to its final breaths of iconicity: the beloved stethoscope.

For over two centuries, there has been no better physician archetype than the quintessential rubber tube donned confidently over a crisp white coat. This recognizable image has been with us in part since 1816, …

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In the COVID-19 era, point of care ultrasound has proven invaluable

Does coffee lead to cardiac arrhythmias?

Conditions
December 26, 2018

Coffee —”because of the caffeine which it holds,” described Dr. Henry Elsner in a 1911 review article in the journal of Hypertension and Arteriosclerosis — causes “increased rapidity of the heart’s action. It makes the heart irritable, it increases the power of the heart’s contractions, it places an extra load upon the kidneys, increasing the urine flow. Because of these effects, I have for some time …

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Does coffee lead to cardiac arrhythmias?

A reminder of life’s pale blue dots

Physician
December 28, 2015

February 14th, 1990 was not any extraordinary Valentine’s Day here on Earth. Couples dined, candles flickered, hands were held. On a day characterized by love, companionship, and joy, an enormous marvel of human ingenuity named Voyager One was embarking on a solitary trip into the cosmos. Initially launched 13 years previous by NASA to explore the universe, this spacecraft stood alone in the silent void of deep space, six billion …

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A reminder of life’s pale blue dots

What spending time with critically ill patients taught me

Education
March 16, 2014

A hospital is not the homiest of establishments. The bright neon lights, strange smells and piercing high-pitched beeps that radiate from the rooms of dormant patients fill the halls in a symphony of annoying sensory stimulation. But to someone recovering from a relationship that just ended, hospitals are heavenly. When the lonely silence of your one bedroom apartment is overwhelmingly loud, beeping IV lines and incoherent mumbles are surprisingly therapeutic.

As …

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What spending time with critically ill patients taught me

The largest barrier to achieving humanistic nirvana in medical care

Physician
April 14, 2013

The dictionary defines humanism as “a system of thought that centers on humans and their values, capacities, and worth.” No sector of the economy comprehends this definition better than a small business. In a sea of competition, the small business whose primary focus strays from its customer’s best interests will surely sink. Those with business experience will undoubtedly attest that, whether in a hair salon or restaurant, a happy customer …

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The largest barrier to achieving humanistic nirvana in medical care