Have you ever tied your shoes and found that the bow unraveled and you almost tripped over your own laces?  Learning to tie your shoes is a life skills task that you learned as a toddler unless you were trained on Velcro straps!  You performed the task of tying your shoes nearly every day of your life believing that you were doing it correctly.  After viewing a TED talk, ...

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My last patient, Joyce, a 45-year-old single mother of four with high blood pressure and diabetes, is late. She was in the emergency department last week with dizziness and blurred vision, a blood sugar of 345 and a blood pressure of 190/110. Her last office visit was a month ago, when weighing in at 222, she joked that she wished she could pull those numbers at the casino’s slot machines. She ...

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Once an alcoholic, always an alcoholic. This is one of the main tenets of Alcoholics Anonymous, and it serves to encourage its members to commit to absolute abstinence. It is also a belief, I have come to realize, held by the many medical residents I have encountered. When an alcoholic patient is admitted to the hospital, it is no secret that he (or she) is an alcoholic. This is because it feels ...

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Every year 300 to 400 physicians commit suicide. More than 10 percent of doctors are thought to have depression, a frequent precursor to suicide. Rates of depression and suicide among physicians are higher than in the general population. Many reasons including stress, heavy workload, sleep deprivation, lack of autonomy, and lack of outlets for personal care may contribute to higher vulnerability in doctors. High-profile suicides this past year by medical residents have led ...

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The medical condition provocatively called exploding head syndrome, or EHS, brings back the disturbingly graphic images of the 1981 sci-fi horror flick Scanners where the main character blew up people’s heads with the power of telekinesis. Fortunately, as ominous as exploding head syndrome sounds, no skulls have actually exploded, and the condition is reassuringly non-life threatening. For the people who experience the symptoms of EHS, however, the ordeal can be ...

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Measles Makes an Unwelcome Visit to Disneyland Health Alert after Disneyland linked to measles outbreak Mickey, Minnie and measles for nine Disneyland tourists The headlines from January 7th and 8th told an increasingly serious story about America’s vaccine civil war -- a story that was to explode in the weeks ahead. We’ve come to expect that kind of story to be uncovered by a major news network with expertly trained, ...

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medpagetodayFrom MedPage Today:

  1. Trends in Teen, Young Adult Suicide Differ by Gender. Patterns of suicides among adolescents and young adults changed dramatically from 1994 to 2012, with major gender differences in these 19-year trends.
  2. Early Hot Flashes May Predict Heart Disease. Early-onset and frequent hot flashes and night sweats in women were ...

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A few weeks ago Bill Maher made a number of critical remarks about medicine and physicians. I sent Mr. Maher the following response in an effort to address his comments. I am sharing this with you in hopes that other physicians will also speak out in defense of our profession. Dear Mr. Maher, Let me start by saying that I have been a fan for many years. While I do not always ...

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Three years ago I received some of the best news of my life -- that I have dopa-responsive dystonia. (Yes, a neuromuscular disorder was welcome news.) Painful, life-interrupting muscle contractions had made the dystonia diagnosis likely several years before, despite poor response to standard treatments, and I was fighting through graduate school: trying to compensate for medication-induced memory problems, increasing need to work from bed, and a disappearing social life. ...

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More and more hospitals are realizing that the 30 to 50 percent of waste occurring within their organizations is not only real, but a tremendous opportunity.  This is good news for both our patients and our health care system.  The bad news is that many hospital executives believe that this waste is largely limited to processes like materials management, ER wait times and operating room first-starts. The next step in our ...

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I read with interest the recent article written by Dr. Rourke Stay, "What ESPN doesn’t tell you about MRI in professional athletes,” and couldn't agree more.  The bigger issue, however, is what ESPN may leave out of broadcasts about sports injuries.  Prominent figures on the air often espouse their knowledge with enough charisma to convince even the most doubting fan that their opinion is more than just an armchair ...

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To most physicians my illness is a routine incident in their rounds, while for me it's the crisis of my life.  I would feel better if I had a doctor who at least perceived this incongruity.  - Anatole Broyard For medical students to treat illnesses of all kinds, we must first fill our brains with thousands of facts, everything from anatomy, to physiology, to microbiology, and biochemistry. We essentially become robots, pounding ...

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In medical school, I was taught to keep my distance. To remember that the patient is the one with the disease. I was told to protect my heart, to be a little cynical, a little deprecatory, to keep a separation between me and the patient. Because they can hurt you. For 18 years, I met people on what was arguably the worst day of their lives. You have cancer. You have ...

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medpagetodayFrom MedPage Today:

  1. Flu Vaccine: A Matter of Time. The flu vaccine was about 23% effective this season.
  2. Supreme Court Spars With Both Sides in Subsidies Case. The Supreme Court pummeled both sides with questions during Wednesday's oral arguments over the fate of the subsidies granted to people enrolling in health insurance ...

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Please choose one: The three words blink in front of me on the computer screen. Please choose one: Patient is-Male     Female  I click FEMALE. I watch as the auto-template feature fills in the paragraph for me based on my choices. Patient #879302045 Patient is: 38-year-old female status post motor vehicle accident. Please acknowledge you have reviewed her allergies, medications, and past medical history. I click YES. Have you counseled her about smoking cessation? I click NO. A little, animated icon of a doctor pops up on the screen. His mouth begins ...

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I am sorry that you are in the hospital. You are feeling ill. The noises are loud, people are walking in and out of rooms, and you aren’t sure of what to expect.  You are probably nervous.  This whole situation is a disturbance to your life. You would rather be at home -- I can understand that. Few people want to be in the hospital. I don’t know what brought ...

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shutterstock_227904523 This morning, a friend of mine posted an article on Facebook that was titled, “Dear anti-vax parents, we’re not mad at you. Sincerely, your doctor.” She had captioned it, “Maybe when all the vitriol and anger and judgment dies down, maybe we can start having conversations like this, instead.” The funny thing is that I had posted the exact same ...

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There are many good reasons for Congress to enact President Obama’s proposal to raise the Federal minimum wage to $9 per hour.  Many of these reasons, from economic stimulus to possible reductions in gaping income inequality to much-needed financial relief for working families, have been extensively discussed in the public sphere.  However, one important benefit of increasing wages has not received enough attention: improving mental health. Numerous studies show that poverty ...

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Just because it’s simple doesn’t make it easy. Take a look at habits. Do you floss? We all know the advantages, and it doesn’t take a rocket scientist to do it. Yet only 28 percent of people say they floss regularly. How about covering your mouth when you cough? Again, it’s not difficult, but we all know people who fail to grasp the concept. Unfortunately, the same is true for hand-washing. ...

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I went to the retired firefighters dinner last week and had a great time, probably because I happened to land on a table full of contemporaries: men who worked at pretty much the same time I did. Inevitably, conversation turned to our memories of some of the older firefighters we had to deal with as we worked our way up the seniority ladder; "getting time on" is what it was called.  ...

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