Mary Braun, MD
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Latest articles
Physician voices
If only I had managed Mrs. Smith's blood pressure better, she wouldn't have had that car accident. If I had made the case for a statin better, Mr. Wu would not have had the diverticulitis episode. These types of thoughts…
If only I had managed Mrs. Smith’s blood pressure better, she wouldn’t have had that car accident.
If I had made the case for a statin better, Mr. Wu would not have had the diverticulitis episode.
These types of thoughts have been with me for all of my decades of practicing medicine. Somehow, I’m supposed to blame myself for things that are less than ideal about my patients’ situations and about which …
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From passion to burnout: When a doctor’s love hurts
Conditions and diseases
At her first visit, still lightly jaundiced, Jennie wanted to talk about a liver transplant. I told her that she had to be sober for six months before they would consider putting her on the list. She told me proudly…
At her first visit, still lightly jaundiced, Jennie wanted to talk about a liver transplant.
I told her that she had to be sober for six months before they would consider putting her on the list. She told me proudly that she had been sober for three weeks.
“How are you doing without alcohol?”
“Going without alcohol would be very hard for me,” she said, “I have just one glass of wine each …
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Miscommunication leads to misunderstandings: the tragic consequences of misinterpreted sobriety
Conditions and diseases
My energy level was plummeting as Mrs. Jones explained how much her shoulder, her knees, her back, her belly, her head, hurt. She was worn out. "And I don't ever think I'll feel better. I've felt like this for so…
My energy level was plummeting as Mrs. Jones explained how much her shoulder, her knees, her back, her belly, her head, hurt. She was worn out.
“And I don’t ever think I’ll feel better. I’ve felt like this for so long and I think I’ll always feel like this. I’m so sore. And so tired. And my family doesn’t do anything to help. In the evening after I’ve finished making dinner, …
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Depression is a notification that the old patterns are not working
Physician voices
A week after surgery, I removed my splint to take a shower. Now, unprotected, my wrist was made of glass. With my splint on, I was clumsy, but invincible. I did not feel frail until I removed my splint. The…
A week after surgery, I removed my splint to take a shower. Now, unprotected, my wrist was made of glass.
With my splint on, I was clumsy, but invincible. I did not feel frail until I removed my splint.
The shower floor did not feel very different from the ice on the lake. My thoughts were whirring along like this: I cannot squeeze the shampoo bottle with my injured
…
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Thinking about frailty like slow-moving PTSD
Conditions and diseases
I know you want to. I know you would rather have anything other than dementia—even cancer. I know you are happy with your life and want it to continue as it is. If it has to change, I bet you’d…
I know you want to. I know you would rather have anything other than dementia—even cancer. I know you are happy with your life and want it to continue as it is. If it has to change, I bet you’d like to slowly become more frail until one night you just die in your sleep. You do not want to slowly become more confused. You don’t want to live
…
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When your doctor says you have dementia, don’t argue with her
Conditions and diseases
The chances that you or someone you love will be diagnosed with dementia are shockingly high. By age 65, your chances are already at 9 percent. Make it to age 85, and the chances go up to 33 percent. Of…
The chances that you or someone you love will be diagnosed with dementia are shockingly high. By age 65, your chances are already at 9 percent. Make it to age 85, and the chances go up to 33 percent. Of course, if you’re diagnosed with dementia, it will be a struggle for you to think clearly about your diagnosis. So, today, while all of your faculties are still intact, I’d …
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Dementia is worse when coupled with inadequate preparation
Physician voices
First, you have to call up your daughter to pick you up and take you to the lab. It’s hard for the nurse to find your vein. The pain from his fishing around in your arm is not nearly as…
First, you have to call up your daughter to pick you up and take you to the lab. It’s hard for the nurse to find your vein. The pain from his fishing around in your arm is not nearly as bad as the pain you always have in your hip, and back, and shoulders, but it’s the straw that breaks the camel’s back, and you cry a little bit. The …
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A quick CT scan for the frail and elderly
Physician voices
Because everything around us usually works, it can be easy to forget how fragile some of the workings are. My patients see this with their bodies, as they fail, but not so apparent to them are the fragilities of the…
Because everything around us usually works, it can be easy to forget how fragile some of the workings are. My patients see this with their bodies, as they fail, but not so apparent to them are the fragilities of the health care system that we doctors get to see.
Despite what the if-it-bleeds-it-leads press might have you thinking, our health care system is pretty good. Good, however, is never good enough, …
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Warning: The medical system is fragile. And that’s OK.
Physician voices
When I graduated from residency, I was too worried about killing my first few patients to examine the meaning of being an attending physician. An early patient, a 97-year-old retired doc, brought it to my attention. “Being an attending physician…
When I graduated from residency, I was too worried about killing my first few patients to examine the meaning of being an attending physician. An early patient, a 97-year-old retired doc, brought it to my attention.
“Being an attending physician means you attend. When you attend me, all I want you to do is show up. You do not have to do anything. Keep the people with needles, knives, and nonsense away from …
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The key to being an attending physician
Physician voices
Dr. Ryme had been retired at least thirty years from medicine when he met me, his last pupil. I was a freshly minted doctor, and he became the first teacher of a new course at my new school called “Life…
Dr. Ryme had been retired at least thirty years from medicine when he met me, his last pupil. I was a freshly minted doctor, and he became the first teacher of a new course at my new school called “Life as an Independent Doctor.”
At our first office visit, after telling me his life story, he quizzed me, “And furthermore, Dr. Braun, you’re an attending physician now. You are no longer …
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What it means to be an attending physician
Physician voices
I saw Kaitlin (identifying information changed) and her husband Brandon seven days before she died. Kaitlin's cancer had been in remission at our last visit, but this day she looked awful. I estimated she had less than three months to…
I saw Kaitlin (identifying information changed) and her husband Brandon seven days before she died. Kaitlin’s cancer had been in remission at our last visit, but this day she looked awful. I estimated she had less than three months to live. As I think being surprised by death is unhelpful, I decided to test whether they were prepared to take on bad news by mentioning that she didn’t look like …
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After a spouse’s death, a physician is showered with gratitude
Physician voices
I made my 10:20 a.m. patient wait while I told my support staff about my day off. "I was getting an ice cream when I saw a car accident. By the time I got there, it was clear that there…
I made my 10:20 a.m. patient wait while I told my support staff about my day off.
“I was getting an ice cream when I saw a car accident. By the time I got there, it was clear that there were no serious injuries and all I did was to distract the passenger so she wouldn’t panic while we waited for EMS. Her husband hit a tree with their van, and …
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Asking patients the right questions isn’t as easy as you think
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