I have given anesthesia for a lot of breast surgery. I don’t think I’ll ever get used to the fog of pain and sorrow surrounding a double mastectomy.
All surgery is invasive in some way. Amputations, in particular, have a horror all their own; the idea that destroying someone – cutting off a body part, violating a coherent whole – should be necessary in order to save a life is almost …
As a typical guy, there are several painful illnesses that can hit our brotherhood in an instant. No warning was given. No “Get out of jail free” pass, either. Just cruising along, having another fine, healthy day, and bam! — suddenly, you are lying on the floor in severe distress.
The most feared? A testicular torsion. It can happen spontaneously. It can …
by John Gever
Emergency department patients with chest pain may safely be evaluated in the waiting room when necessary, researchers said.
Among 303 patients triaged to waiting-room evaluation in a prospective study, no acute coronary syndromes were missed and adverse event rates overall were lower than among 804 patients who were assessed in conventional monitored beds, reported Frank Scheuermeyer, MD, of St. Paul’s Hospital in Vancouver, British Columbia, and colleagues online in …
I walked into Room 35 to find a three year-old lying on the hospital cot. Her father sat alongside her bed, whispering softly to her. The patient appeared quite tired, wiped-out even, and if it weren’t for her complacent eyes tracking my every move, I would have thought she might be sleeping.
She was visiting our ER because, after a few days of cough and congestion, she had developed a fever. …
by Todd Neale
The recent stroke suffered by Delaware’s attorney general Beau Biden, who is 41, has highlighted the fact that people of all ages are vulnerable, despite seemingly good health.
A statement from Timothy Gardner, MD, medical director of the Center for Heart and Vascular Surgery at Christiana Care Health System in Newark, Del., where Biden was initially treated, said he had suffered a “mild stroke,” although it remains unknown whether …
If a person tries to commit suicide, could that be considered as a statement that this person wishes to die and does not want aggressive treatment to save his or her life?
Not from a legal standpoint, and not if you are living in the United States.
A middle-aged man with a long standing history of depression decides to end his life. He puts a large caliber gun straight to his forehead …
I believe in the peak oil theory.
Think about it, in a closed system nothing is infinite. Since oil is a product of millions of years of decay, unless we use it at the same rate that is it produced, we will run out. I do not have a crystal ball any more than anyone else I know, so I will not hang my hat on when, but will commit to …
by Tricia Pil, MD
This is the true story of a hospitalization as told from three points of view: first, the recollections of the patient (who happens to be a physician); second, events as recorded in the medical charts by doctors and nurses; and third, the version put forth by the hospital.
FRIDAY
Patient:
It is fall 2005, and I am nine months pregnant. A healthy 33-year-old pediatrician, I am a longtime patient of …
The role of autopsy in the medical profession is difficult to overestimate. Western medicine takes its roots from comparative studies between patient’s symptoms and the findings on autopsy.
Participation in an autopsy was one of the most valuable lessons from medical school and residency. If you participated in the patient’s care, there is no greater educational tool than witnessing the postmortem exam. It is especially true if the cause of death …
One of the biggest emergency room problems is contacting patients after they leave.
Patients sometimes leave false contact information — which makes it difficult for the emergency room staff should problems arise after the visit.
The issue was illustrated in a piece from msnbc.com. Many times, results like blood cultures or x-ray findings take time to return. And if there’s something that needs to be acted upon, contacting the …
Are emergency departments solely responsible for the bulk of unnecessary tests?
Most would like to believe so, but emergency physician Edwin Leap says that’s not the case.
He cites an instance involving a primary care doctor and hospitalist:
Local physician, who does not admit to the hospital, sees patient in the office. Patient has uncontrolled hypertension and is having some chest pain and shortness of breath. Local physician contacts hospitalist. …
Bret Michaels continues to be monitored in the intensive care unit after suffering a subarachnoid hemorrhage.
According to his road manager, “further testing this week will help locate the source of the bleeding.”
What exactly does that entail?
As I mentioned previously, aneurysms are responsible for the majority of brain bleeds. Finding that source is critical. Angiography, or …
Our state of South Carolina is a delight. From wonderful people to beautiful landscapes, from a vibrant Southern culture to excellent food like shrimp and grits, it’s a place I’m thrilled to live. But we do lack a few things. And one of the most striking is adequate mental health care.
The state budget, like so many state budgets, has been trimming anything and everything. And of course, mental health coverage …
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by Michael Kirsch, MD
Does anyone out there know why President Obama underwent a virtual ‘colonscopy’ (VC) instead of a conventional colonoscopy earlier this year?
In my gastroenterology practice, we do not offer colon cancer screening to 48-year-old individuals, unless special risk factors are present. Of course, maintaining the president’s health is in the national interest, so I understand why professional screening guidelines might not apply to him. For …
by Dr. Whoo, MD
Q. I just found out last week that I’ll be a new mom in November, making me an official mother in medicine! I’ve been reading the blog for a while, because I love hearing what all of you have to say about your lives. Here’s my question: What tips would you give for surviving residency while pregnant, especially 30-hour calls (without caffeine)?
— From a future mom and …
I am often asked how we get the prices for the radiology imaging tests, such as MRI’s and mammograms, or ultrasounds. Most people assume that my day job as a doc gives me some sort of special access to this info. But that’s just not the case. Anyone can find out testing prices.
However, over the last year, those of us working at LesliesList.org have gotten more experienced and better at …
During residency, there was always a case of misdiagnosed chest pain to discuss in conference. Incorrectly sending a patient home and missing the diagnosis of cardiac chest pain was an infrequent, but repetitively observed, phenomenon.
So as to tread carefully with words, it is sufficient to say that even now, chest pain triage remains a vexing problem.
Chest pain diagnosis is like appendicitis; there are always small numbers of unusual cases in …
Part one of a series.
The first patient I ever saw as a first year resident came in with a litany of complaints, not one of which I remember today except for one—he had headaches. The reason I remember he had headaches isn’t because I spent so much time discussing them but rather the opposite: at the time I knew next to nothing about headaches and somehow managed to end the …
Medicare, the government insurance company for everyone over age 65 (and for the disabled), pays fees to primary care physicians that guarantee bankruptcy.
Additionally, 70 percent of hospitals in the United States lose money on Medicare patients. That’s right, for every patient over age 65, it costs the hospital more to deliver care than the government reimburses. That is why Mayo Clinic has said it will not accept Medicare payments for …
It’s commonly thought that health care in the United States is heavily dependent on diagnostic testing.
But how do we compare with the rest of the world? Perhaps these graphs, courtesy of the New York Times can provide a stark illustration.
Here’s the data regarding CT scans, showing the number of tests per 1,000 people. Guess which country’s on top:
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