During my first year of medical school, a professor in my clinical skills course shared a timeless adage in medicine: “If you listen closely enough to the patient, they will tell you the diagnosis.” I accepted this statement as a fact of medicine – if I could develop astute history taking skills in my first year, this skill would serve me well throughout my medical training. However, when I volunteered …
Some people have high cholesterol but not much atherosclerosis. We think of their arteries as having nonstick surfaces. We know inflammation can predispose to plaque formation and plaque rupture, which is the trigger of most heart attacks.
We know statin drugs can prevent and reverse plaque buildup, and make existing plaque sturdier and less likely to rupture. These drugs lower blood levels of inflammatory substances. Most doctors focus on their cholesterol-lowering …
The warm rays of the sun serenade me as I drive to work eager to begin another shift. I find a parking spot on the first floor of the garage don my N95 mask and walk towards the hospital. First, I must stop by at the neighboring building and have my temperature checked. Today it is 97.3. I am awarded the sticker for the day; my boarding pass into the …
On the morning of George Floyd’s funeral less than ten miles from our medical center in Houston, I was avoiding the word “Black.” Despite wholehearted pride in the strong Black presence in our community health center’s physicians, staff, and patients, I felt a loss of words that Tuesday morning. There was simply too much pain, grief, and rage in our community.
I was thankful …
Yeah.
I said it.
As an anesthesiologist, especially as a cardiothoracic anesthesiologist, there are few things I am more interested in than how well or how poorly your heart functions and why. And a cardiologist can help me obtain a lot of vital information in that regard. But there several things a cardiologist cannot, and I argue, should not do, when it comes to the perioperative care of patients.
First, a cardiologist’s assessment …
Just another day as you work into the depths of the night. Medicine engulfs your life as your focus is centered on your responsibilities for tomorrow. You may or may not have time to sit down and enjoy a meal in silence. You may or may not have the opportunity to say good-bye or hello to a loved one. I hope we all had the foresight to realize what we …
I believe in the practice of medicine and enjoy teaching others this amazing art. However, after experiencing nine months of interactions through medicine as the daughter of a sick patient, I struggle with my pride in the profession and fear of the health care system.
My mother would proudly tell all her physicians that her daughter was a doctor. I knew she was proud, but I didn’t believe in using my …
High blood pressure is the silent killer. It puts people at risk for heart attacks, strokes, vascular disease, kidney failure. It is basically really bad to have longstanding, undertreated high blood pressure.
But it is also harmful to be told you have high blood pressure when you don’t, and to be treated for high blood pressure when that treatment won’t benefit you. So when your doctor diagnoses you with high blood …
I’ve just discharged a kid with a cough, and there are no patients waiting to be seen. “I’ll be back,” I tell the nurse, as I slip away to the hospital kitchen and unlock the door. I steal two frozen grilled cheese sandwiches from the freezer and throw them into the microwave. Minutes later, I’m in the call room.
I take a couple of bites and can already feel acid rising …
Everything in life starts as a dream. Big or small. My dream was to become a physician since I was quite young — the first one in my family to walk the path. I wanted to understand the science of the human body and help the sick. Heal with my skills, knowledge, and empathy. Hold my patients’ hands with care and confidence. My work was to be like none other. …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 67-year-old man is evaluated for a carotid bruit detected on routine medical examination. He reports no history of previous focal neurologic symptoms or visual loss. He has type 2 diabetes mellitus and hyperlipidemia treated with metformin, moderate-intensity pravastatin, and aspirin.
On physical examination, blood pressure is 128/64 mm Hg, …
Being a cardiologist, the most frequent question coming my way for the last few years is “Doc what do you think about the “keto” [ketogenic] diet.”
All foods contain both micronutrients and macronutrients that are essential for the body to function optimally. The human body requires macronutrients in large amounts, which include carbohydrates, proteins, and fats. These nutrients provide energy for your body in the form of calories. Micronutrients are nutrients …
I woke up to him, pacing the bedroom.
Within an hour, I was pacing the ER at his bedside.
Our experience at one of the country’s best-ranked hospitals lasted only three days before we were discharged home. What led us there will last a lifetime in our minds. When faced with your own mortality (or that of your husband’s), you are forever changed. We are grateful for his continued recovery from myopericarditis. …
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The health challenge recently faced by Sen. Bernie Sanders has brought two issues to the forefront of the 2020 presidential election. Should there be a disqualifying upper age limit to become president, and should an existing health issue preclude a candidate from running for president?
As scientists in the field of aging, we cannot tell the voting public how to answer these questions. What we can do is inform you about …
A professor recently romanticized my idea of clinical reasoning as he began our session by saying, “When you’re a physician, you’re a detective.” He elaborated: “Every fact you have, every piece of evidence you have, must be consistent with your leading diagnosis.” As he said this, my eyes narrowed, and I sat up a little taller.
My fellow first-year medical students and I have begun our official training in clinical reasoning, …
The Skeptical Cardiologist was recently greeted by headlines announcing that an international panel of 14 unbiased researchers had concluded that it was OK for humans to continue eating red meat and processed meat at current levels.
The startling news was a reversal of what the Dietary Guidelines for Americans, the American Heart Association, and the American Cancer Society …
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 …
The storage capacity of the human mind is amazing. One estimate of the size of the brain’s “RAM” is as high as 2.5 petabytes (a million gigabytes). The number is based on the total number of neurons in the brain and the total number of possible connections per neuron. I suspect it is an overestimate, given the vagaries and innate inefficiency of biological systems. Nevertheless, the true figure …
I expect my patients to develop or sense responsibility in connection to their health because I believe personal responsibility creates the basis for a constructive, therapeutic relationship and healing process.
My experiences as a patient have made me understand how difficult it can be to maintain a sense of responsibility. I often yearn for clarity and a “gameplan,” but instead find myself confronted with medical guideline gray areas and conflicting treatment …
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
For years, research and common belief have supported the concept that patient education alters patient behavior and improves patient outcomes. For instance, lifestyle changes, implemented after improved physician-patient engagement and education, have demonstrated clinical benefits in a wide range of chronic illnesses, …
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