My patient suddenly leaned forward, swung her hair up, and began to push it this way and that, determined to find and show me the partitions that her hair made when rested in a new equilibrium. It was a warm Thursday afternoon and we were in dermatology clinic. This 20-something young professional had come to have her scalp examined. She'd noticed a sudden increase in the quantity of hair follicles that ...

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The first time scientists sequenced a person’s entire genome, it took more than a decade and cost hundreds of millions of dollars. Currently, such sequencing takes less than twenty-four hours and costs less than $5,000. To put that into perspective, Myriad Genetics charges $3,000 to test for mutations in just two genes associated with breast cancer. The days of affordable genomic sequencing are rapidly approaching. But will such testing bankrupt us? In most consumer ...

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If an ill patient, who unexpectedly has Ebola, landed in Memphis, it is likely that my partner or I would see him. We work as infectious disease doctors at the hospital closest to the airport. The Ebola patient would present with fever, nausea and vomiting, indistinguishable from a flu or a viral illness that hundreds of patients present with each day at our hospitals. But over a few days of the illness, ...

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The electronic medical record that my office uses features a clinical protocol button that we are encouraged to click during patient visits to remind us about potentially indicated preventive services, such as obesity and tobacco counseling and cancer screenings. I once tried it out while seeing a 90-year-old with four chronic health problems. The computer suggested breast cancer, colorectal cancer, and cervical cancer screenings: three totally inappropriate tests for the ...

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In his piece on Robin Williams, Andrew Solomon of the New Yorker states that every 40 seconds, someone commits suicide. Actually, it's every second of every day, as people choose the action, or inaction, that will end their lives sooner. When the patient with metastatic melanoma, who is quite capable of getting to the refrigerator, refuses to take food or liquids, she is taking her life. Her body will ...

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Jack was the very first palliative care patient I met. Visiting him in his home, I feared the worst: emaciation, pain, a fluxing state of consciousness, and the otherwise bed-bound shadow of a former life. Instead, the first sight I was greeted with was a beaming smile beneath a bushy moustache. But for his IV lines and analgesia pump, Jack might have passed for a completely well middle-aged man, certainly ...

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Having been born and raised in the United States, I have become accustomed to the reputation of the U.S. as being ahead of the curve in terms of advances in numerous fields including medicine, and the research that we produce in these fields strongly backs up this claim. I have been reminded of this over the past few days while following coverage of the Ebola outbreak in West Africa. American health ...

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Many organizations cook up recommendations for the number of fruit and vegetable servings you should eat every day.  Well known examples include the USDA which suggests two cups of fruit and two and a half cups of vegetables daily (approximately 8 to 10 servings), the American Heart Association which recommends 8 to 10 and the Harvard School of Public Health suggests somewhere between five and 13 servings of fruit and ...

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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 reevaluated during a follow-up examination for a wrist fracture and anemia. The patient is otherwise asymptomatic. He was treated in the emergency department 2 weeks ago after he slipped in his driveway and sustained a right wrist fracture; mild iron deficiency anemia was detected at that time. He ...

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“No Ebola in West Point” was the reported cry of the local crowd that attacked a quarantine center and freed patients in a township near Liberia’s capital.  Their words signaled skepticism toward the Liberian government and disbelief in the spread of the Ebola virus. The cries of the crowd were met with cries of shock and dismay on Twitter and other social media. “Are they crazy or just stupid?” one ...

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