shutterstock_148383902 I am in my twenties. I am a student in dental school. My seven classmates and I have gathered, notebooks and pens in hand, for the first day of our ten-day rotation at the Veteran's Hospital oncology department. Dr. Steele, a published expert in oral cancer, instructs us to follow him to the outpatient clinic. Some of those he'll examine are initial consultations; ...

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shutterstock_50320798 The scalpel hits the skin immediately, splaying it open with one smooth swipe. Two more swipes through yellow globular fat and I hit the glistening white fascia layer. If this weren't an emergency, I would stop to carefully cauterize the small bleeding blood vessels in the fat layer, but there is no time for that now. I nick the middle of ...

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As a practicing gynecologic oncologist, I have spoken the words, “I’m sorry, you have cancer,” or some version of that sentence thousands of times. And although my delivery is fairly consistent, modified only slightly to improve understanding, my patients’ responses vary from stunned silence to uncontrollable, overwhelming cataplexy. The stalwart emphatically reply “I’m gonna beat this thing,” but the vast majority tentatively wonder “How long do I have?” and retreat ...

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shutterstock_272222642 The selfie, for those of you living under a rock, is a photo of yourself, taken by yourself, by holding your phone out in your outstretched arm, pointing it at your own face, and snapping away. You then post it on your Facebook or on your Twitter for all the world to see and admire. Let me pick out the key words ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old man is admitted to the emergency department with a 1-day history of headache and epistaxis. He has had type 1 diabetes mellitus requiring insulin for 30 years and two episodes of ketoacidosis in the past year. On physical examination, temperature is 36.0 °C (96.8 °F), blood pressure is 100/70 mm Hg, ...

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shutterstock_198931019 "Turn out the light, the party's over," sang color commentator Dandy Don Meredith on ABC's Monday Night Football when a seminal fourth quarter play occurred and the game was suddenly in the bag. For me, that's where it's at right now -- just a few ticks of the clock away First, for the American Heart Association then for the American Red Cross, ...

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shutterstock_131772284 Recent clinical practice guidelines from the United States Preventive Services Task Force (USPSTF) recommend against PSA screening for men of all ages, while other guideline groups, including the American Urological Association (AUA) and the American College of Physicians (ACP), recommend a shared decision making (SDM) approach to the prostate-specific antigen (PSA) test. “Dueling guidelines” can create confusion for people who are ...

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shutterstock_85214245 Below is a letter I have written to parents who are hesitant about giving vaccinations to their children.  I don’t know how many it will convince, but I needed a respectful and informative way to follow up with parents who expressed concerns or declined vaccinations, and this is what I now share with them after such visits.  This is written not ...

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shutterstock_248807428 Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old woman is evaluated during a routine examination. She has very severe COPD with multiple exacerbations. She has dyspnea at all times with decreased exercise capacity. She does not have cough or any change in baseline sputum production. She is adherent to ...

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As a pediatric nutritionist in a clinic that serves children with special needs, I see all kinds of family situations and all kinds of caregivers. Usually, the primary caregiver is a parent. But for a variety of reasons, the primary caregiver may be a relative who cares for the child during much of the day or even has full legal custody of the child. The latter can happen if both parents ...

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