What Mayor Thomas Menino taught us about cancer Beloved and deeply respected Boston mayor Thomas M. Menino died on hospice in Brigham and Women’s Hospital recently.  Menino developed advanced cancer of unknown primary (CUP) in the spring of this year, and after six months of chemotherapy, he elected to stop active treatment.  Reportedly he was comfortable, and surrounded by friends and family at the time of his death.  The press, the ...

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A new study from surgeons at UCLA found that laparoscopic cholecystectomies done at night for acute cholecystitis have a significantly higher rate of conversion to open than those done during daylight hours. Nighttime cholecystectomies were converted 11 percent of the time vs. only 6 percent for daytime operations, p = 0.008, but there was no difference in the rates of complications or hospital lengths of stay. The study, published online in the ...

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Remember when we were trying not to panic about Ebola? Seems like that was only yesterday. Oh wait -- it was only yesterday. But it already seems as if we are trying to remember that we were trying not to panic. I listened to my favorite news radio station out of New York City while driving to the office recently. They address all of the major news stories in the first eight ...

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Walk in the shoes of a cancer patient We sit, we listen, we attempt to focus and absorb what we are required to know. We learn how to give bad news, even using one another as makeshift “standardized” patients. How does one “standardize” a patient anyway? Who knows, who cares, time to cram for the endocrine exam. But what happens when you stop pretending? When you wake up one morning ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is evaluated during a routine examination. He has a 2-year history of nonischemic cardiomyopathy. (Echocardiogram 2 years ago demonstrated a left ventricular ejection fraction of 35%.) He is feeling well and reports no shortness of breath; he walks 2 miles daily without symptoms. Medical history is remarkable for hypertension. ...

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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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