Carl didn’t know what was happening to his wife. The German railway clerk from Morfelder Landstasse and his wife Auguste had been happily married for twenty-eight years.They had one daughter, Thekla, and their marriage had always been harmonious -- that is, until one Spring day in 1901 when Auguste suddenly exhibited signs of jealousy. Auguste accused Carl of going for a walk with a female neighbor, and since then, she had ...

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As we learn of new suspected cases of Ebola infection in the United States, causing worries among the population and renewed efforts by the Centers for Disease Control and Prevention to contain the epidemic. A student in the postgraduate course in research ethics that I teach at Albert Einstein College of Medicine recently asked whether we could discuss the Ebola epidemic in class. Because I had prepared the syllabus for the course months ago, I hadn’t ...

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Every time there is a terrorist act or a mass murder, reporters start calling with questions on the psychiatric diagnosis of the perp. The default position seems to be that every religious extremist or political fanatic or mass murderer must be crazy. How else to account for their weird behavior? Naming a diagnosis somehow satisfies a deep human need to explain what otherwise seems an unexplainable act. But names can only ...

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While studying for my recertification exam as required by the American Board of Pediatrics, I came across this question:

 A 7-year-old girl is having difficulty establishing relationships with other children despite repeated opportunities to do so. The girl prefers to stay near her mother or her teacher and will avoid other children. She sometimes cries and can be difficult to calm down after being dropped off at school, so her mother frequently remains ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 66-year-old man comes for a preoperative evaluation before total joint arthroplasty of the left knee. He has a 25-year history of rheumatoid arthritis. He has had progressive pain in his left knee with activity, which limits his ability to hike. The patient has similar pain in the right knee, but it ...

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I was recently injecting anesthetic into a boil for incision and drainage. The abscess swelled and returned an arcing spray of lidocaine laden with blood and pus, soaking the thigh of my cotton scrub pants. A cheap plastic gown would have protected me -- I usually wear one. But I couldn’t find one and had other tasks waiting. My mind went to Ebola and exposed nurse necks. What if this were ...

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No CT scans for old smokers? "Traditionally, doctors used to be called in when needed. But this is now changing. Increasingly it is the doctor who calls the person in by issuing an invitation. Healthy people are asked to visit the surgery for a 'check-up,' or 'screening,' when their computerized records show they are 'due.' Non-attendance is known as 'non-compliance,' indicating an element of recklessness and irresponsibility." - Petr ...

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“If I get a call about smallpox from the ER I’m not coming in,” an infectious disease doctor said to a colleague in the hospital where I was working.  It was the early days of 9/11 and anything seemed possible. “Are you all OK with providing care for Ebola patients?” our section chief asked.  Our ICU is the designated unit to care for all adult patients suspected of having Ebola in our system.  We ...

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The largest challenge facing the infectious disease community in the 21st century is the increasing number of resistant organisms found in various disease processes.  The reason is much more complex than the over prescribing of oral antibiotics for sore throats.  This is not to say that good antibiotic stewardship is an important concept because it is but it must be recognized that the medical challenges of the human population today is ...

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The tragic case of Thomas Eric Duncan represents a failure of communication with consequences that extend well beyond the current Ebola crisis. When Mr. Duncan first presented at Texas Health Presbyterian Hospital in Dallas, his recent travel history from Liberia was reportedly ascertained and entered into the hospital’s electronic health record (EHR) system. Somehow, this critical piece of information never registered with the physician who diagnosed Mr. Duncan, and in ...

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