Ronald Reagan’s last letter to the American people, penned with his own hand in November, 1994, went directly to the point: “My fellow Americans, I have recently been told that I am one of the millions of Americans who will be afflicted with Alzheimer’s disease.” In this deeply poignant moment, the former president explained that he decided to share his diagnosis “to promote greater awareness of this condition,” with the hope that doing ...

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My husband, Mark, called me at my practice. “I’ve been working on something; I need you to come home now.” He spoke definitively, urgently. “Is it the kids?” I was instinctively anxious. “No, not the kids, just come home now.” 6 p.m., a cool evening, an ordinary day. The life before the fact. And then life afterward, irrevocably and catastrophically changed. A tense ride home, then the revelation. “I've been having difficulty ...

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I’m looking at a pile of little boy clothes outside my back door this morning. It often looks like this if we forget to clean up. My kids shed their clothes almost as soon as they are home in search of water play of some sort: hose on the slide, sprinklers, water gun fights. They are supposed to put their clothes in the hamper. That obviously doesn’t always happen. This ...

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A 52-year-old man is evaluated for low back pain of 3 months' duration that is nonradiating, progressive, and worse with ambulation. He reports no preceding injury. Medical history is notable for smoldering multiple myeloma diagnosed 1 year ago; he has been stable since that time. His only medication is as-needed acetaminophen. On physical examination, temperature is 36.8 °C (98.2 °F), blood pressure is 132/82 mm Hg, pulse rate is 70/min, and ...

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A patient of mine brought donuts in yesterday for the staff, and I confess! I had the one with sprinkles. But with the study published in JAMA reporting that 35 percent of U.S. men and 40 percent of U.S. women are obese, I felt the need to talk a little about obesity and reproduction. The endocrine system is tightly regulated by hormones which provide feedback to the brain to control their ...

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(Triage note: 45-year-old male, vomiting for two days. Abdominal pain.) Dr. Stephen Cluff is like Yoda. Judging by body hair, he's more like Chewbacca. But he's short, wise, and with his white hair and arthritic limp, he may as well have green skin, poor sentence structure, and a Muppet's voice. If I'm stumped on a case, I'll ask him. If I'm pissed off about department politics, I'll call him for advice. If I want ...

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It sounded too good to be true when I first heard about Theranos, a company that promised to revolutionize medical testing by making it possible to perform dozens of tests on a single drop of blood, rather than the several tubes that would typically be required. And that wasn't all. Theranos CEO Elizabeth Holmes, a Stanford dropout and media magnet whose wardrobe seems to consist solely of all-black outfits, promised ...

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Removing one’s own IUD is apparently “a thing.” There are even YouTube videos of women sharing their experiences. If you can get a medical degree from Google then why not get your OB/GYN residency from YouTube? All kidding aside, I’m a gynecologist and I’m going to explain why you shouldn’t. It’s not that people can’t technically pull out their own IUDs. It does happen accidentally, albeit rarely. An occasional mishap with ...

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Like nearly every gastroenterologist, we have an open access endoscopy system. This means that patients can be referred, or refer themselves, directly to our office for a a procedure without an office visit in advance. Why do we do this? We offer it as a convenience, so patients do not need to make two visits to see us when it is clear that a procedure is necessary. For example, a referring ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. An 86-year-old woman is evaluated in her assisted-living facility for pain. Four weeks ago, she developed herpetic lesions on her right posterior thorax in a T7 distribution. She was treated with acyclovir, and the lesions healed; however, she has persistent severe burning pain. The pain is so severe that she is ...

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