Jerry once killed a man, his best friend.  He told me about it, unemotionally, but as if it had just happened. He wandered the street like a refugee in a war-torn country, except he was in mid-America: Louisville, Kentucky, as it were.  He was homeless.  I've known him for five years, anyway.  He's approaching fifty, a rough-looking man, large, with thick gray hair, which is quite long now.  He has lost ...

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Tackling: in so many ways, it's what football is all about. Now, of course running, passing and scoring (and strategy) are important parts of football too. But it's tackling that stops the opponent. Without tackling, you can't play football. Or can you? A policy statement just released by the American Academy of Pediatrics (AAP) suggests that we need to do some thinking about tackling and its impact -- literally -- on ...

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Combine a hot start-up valued at 9 billion dollars, an articulate Stanford drop-out CEO with celebrity-like press coverage, and a recent Wall Street Journal report that calls into question the reliability of the company’s “revolutionary” testing, and you have the perfect storm to set the internet abuzz about Theranos. Amidst the melee of accusations, “change-the-world” start-up jargon, and anecdotes of incongruent lab results, something has been missing: an organized, ...

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In May 2003, during my second year of pediatric residency, I had a right temporal lobectomy to remove a seizure focus in my right hippocampus.  Although the surgery proceeded without complications, I was unable to walk unsupported for several weeks after the operation.  My experiences taught me what makes an ...

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"You need to come to the ED ASAP." A new patient was admitted at 2 a.m. and requested for a crisis counselor. Unlike with cases of sexual assault, survivors of domestic violence had to specifically request for the presence of an advocate when I was volunteering in NYC back in 2009. This woman, I’ll call her Sadie, had already taken the first courageous step to seek help. I briskly walked past ...

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Getting mental health right for all Americans is a huge undertaking. For the last 150 years, our “solutions” to mental illness can, at best, be characterized as a series of good intentions that were poorly, if not disastrously, implemented. But while there may be a conversation that needs to happen about how we got here, what’s important right now is how we go about shoring up a system that is ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 59-year-old man is evaluated for a 6-month history of gout. He was doing well on colchicine and allopurinol but developed hypersensitivity to allopurinol, which resolved with cessation of the agent. He then began to have more frequent gout flares; two flares occurred in the past month and were treated with prednisone. ...

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It has occurred to me that this is a terrible idea. In fact, it’s possibly the least beneficial thing for the general health of a population to have gained momentum in recent years. I’m not discussing cigarettes or e-cigarettes or low-yield cancer screening procedures. I’m not talking about diet drinks or sugary drinks. I’m talking about home blood pressure monitoring. It’s a terrible idea. OK, I get it. The idea sounds benign. Buy your own ...

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Theranos is a Silicon Valley start-up dedicated to revolutionizing (some would say disrupting) the medical blood testing industry.  The claim to fame of the company was to use a single drop of blood from a finger stick to run hundreds of tests.  This premise led to a $9 billion valuation and rock-star status for it's founder, Elizabeth Holmes; and was recently threatened by a Wall Street Journal exposé, ...

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The big story recently is that the American Cancer Society issued an updated guideline recommending that women undergo mammography less frequently than before. This announcement was denounced on both “sides” of the perennial debate. Those in the “mammograms save lives” camp are outraged that a scientific society dedicated to cancer prevention and treatment would issue a proclamation that seems to run counter to the notion that “early detection saves lives.” Those in ...

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