My puppy looked sick. Not just any sick but “get an attending, two large bore IVs, start fluids, get her on a monitor, move her to the resuscitation bay” sick. And I was scared. “You have to take her to the vet!” I pleaded with my husband as I sprinted down the street to get home to get the keys to the car.
As I sat at home waiting for updates …
What my dog taught me about my patients’ feelings
“If only there was just one more creative way to increase my child’s sugar intake,” said no parent ever.
As a pediatric cardiologist, I spend much of my day counseling parents of children with obesity, hypertension, and hyperlipidemia. I tell them to increase their physical activity. Remove all junk food from the house. Join a sports team. Cut back on refined sugars. And of course, I am always thrilled when a …
How youth sports might be a risk factor for heart disease
Results of a much-anticipated trial on fish oil and vitamin D generated conflicting headlines recently.
Some stories declared good news about the popular supplements.
Reuters wrote that fish oil “can dramatically reduce the odds of a heart attack while vitamin D’s benefits seem to come from lowering the risk of death from cancer.”
The Washington Post reported fish-oil medications were found “effective” in protecting …
The recent fish oil and vitamin D studies: Go beyond the headlines
Back when cholesterol target numbers ruled unopposed (before 2013), we all checked fasting lipids every three months. Before 2012, we also checked liver function quarterly in hapless riders on the cholesterol pill merry-go-round. That year the FDA announced there had not been enough reports of statin-induced liver problems to recommend routine monitoring.
I have many colleagues who still do this, and who also routinely monitor routine labs quarterly …
Effective clickbait doesn’t just happen. It’s carefully crafted.
Take this wildly misleading article from CNN: Not exercising worse for your health than smoking, diabetes, and heart disease, study reveals.
It’s one example — among many generated daily by various news outlets — of how a mundane observational study can be transformed into viral internet gold. In the days after it was published, this story was liked and …
The carefully crafted way of how health misinformation spreads
An excerpt from Dead Execs Don’t Get Bonuse$: The Ultimate Guide to Surviving Your Career With a Healthy Heart.
The details of the careers and tragic deaths of these CEOs are a matter of public record, and the disruption that followed their deaths was enormous. Take Ranjan Das, for example. …
What we can learn from the tragic deaths of CEOs
I mused while staring blankly towards the electronic tracking board, where I foresee reading the triage call “My tracker said, I have AFib.” I delved into what is in my armamentarium to handle this crisis of the digital age. The stethoscope around my neck suddenly seemed archaic.
We the physicians have resigned to the redundant clicks on the electronic medical records (EMR). While still recovering from this inescapable occupational hazard of …
Why physicians should embrace fitness trackers
Healers, scientists, leaders — these are all terms that we equate with being a physician. As we spend our years if not decades in training, we strive to become all of these components. But when you miss something — the small details, the nuances of a history and these are the clues that could lead to healing it can be disheartening. When it comes to your own family member, such …
My brother, a physician, died. Could I have done more?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 56-year-old man is being evaluated after his 18-year-old son had a syncopal episode during a high school basketball game and was diagnosed with hypertrophic cardiomyopathy (HCM). The patient has had no symptoms, including with physical activity such as golfing or playing tennis. Medical history is unremarkable, and a review of family history …
MKSAP: 56-year-old man with a family history of hypertrophic cardiomyopathy (HCM)
Science is in a constant state of flux. Theories are put forth to explain natural phenomena, based on the best knowledge of the day. These theories are tested. If they correctly predict future observations, the theories become more credible. If, however, these theories fail to predict accurately, they require modification or outright dismissal.
What is considered “settled science” one day may be turned upside down the next day as new data comes …
A reminder that science is never settled
The announcement that the next iteration of the Apple Watch can both monitor the wearer’s heart rhythm and, if a suspicious reading emerges, perform an electrocardiogram, could be a boon for users and their doctors. Or it could be a massive headache for the health care system.
The new watch continuously monitors the wearer’s heart rate. It …
Should the Apple Watch monitor your heart?
Everyone always jokes with doctors, “What happens if you get sick?” Some of us laugh off the question. The busy schedule of health care often means our own health comes last. However, what happens when it’s a chronic disease that requires treatment? Then the answer to this question is a little different.
I am a family medicine physician dealing with congenital heart disease (CHD). Saying that someone has congenital heart disease …
A physician with congenital heart disease
“Good morning, Mr. S! How are you feeling today?” I ask as I step into his hospital room. Yesterday, Mr. S was admitted for infective endocarditis and has been tolerating antibiotic treatment well. I am a medical student on my acute cardiology rotation taking care of him.
“I’m feeling fine,” he says, and I proceed to ask about how he slept, if he’s experiencing any chest pain, palpitations, shortness of breath, …
Music is creating beauty in the most surprising of places
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The supervising resident’s Voalte phone dinged: “Dr. Mel: Please meet Dr. Rosemond at room 514 for Cardiology rounds.”
She scrolled up a few texts and saw that her male counterpart who had rounded the previous day had been addressed as “Dr. Stearnes.”
When Mel mentioned the discrepancy to Jacob Stearnes, he just shrugged and said, “The cardiology nurse probably doesn’t even know my first name.”
When Mel mentioned the discrepancy to her husband, …
Moving beyond National Women Physicians Day
I started internship July 1, 2008, as a terrified 25-year-old blank slate. Most days started with a combination of nausea and dread as I pumped myself up in the resident parking lot — conveniently located a mere 1/2 mile from the entrance to the ivory tower I called home.
The days were long. The nights were longer. Every month I had the chance to be a brand new idiot as a …
A physician’s return to the ivory tower
There are gifts given and gifts taken away. And Jacob’s abilities could be described as nothing less than a gift. He was a violin virtuoso. Or at least, that was the word the university professor of violin pedagogy fumbled with over and over again as she ushered the eight-year-old Jacob out of her office and cornered his parents. He was immediately enrolled in an advanced curriculum, taken out of …
Gifts given and gifts taken away
Last year, a cardiologist at my institution presented the story of a patient he had cared for and correctly diagnosed with a not uncommon condition after several other physicians had failed to do so. The patient was a 72-year-old man with near syncope after exercise for several months, with no other symptoms or clues to the diagnosis. The cardiologist asked him to discuss each episode in detail, and the man …
Is Watson the answer to all of our problems?
Sometimes I wonder if I am wired differently from other doctors, in terms of what I remember on my own and what I need some help with.
The other day I got a “medical call” that simply said, “Mr. Brown called to report his blood pressure is 120/80.”
With more than fifty calls in my inbox and no memory of what the issue was with Mr. Brown’s current blood pressure, I replied: …
The problem with telephone messages in primary care
The trouble began when I needed to open the electronic health record (EHR) system for the tenth time that day. EHRs have significantly changed the way we practice medicine. They have completely eliminated the need for storage and transport of paper charts, reduced prescription errors secondary to illegible handwritings of physicians and provided an excellent platform to maximize billing for services rendered. However, in terms of creating a smooth workflow …
I didn’t become a physician to do data entry
Mr. Smith was a sixty-eight-year-old man who came to the Veterans Affairs hospital where I was a medical student complaining of chest pain.
“With chest pain, it’s all about the story,” my resident, the physician in charge of our team, said. We talked to him to find out what he was doing when it started, how long it lasted, how intense it was if it was still there.
His electrocardiogram hadn’t shown …
A case for at-home hospital care
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