Illness is the night side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place. - Susan Sontag, Illness as a Metaphor Words are important. ...

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I have spent many blog hours bemoaning the inadequate communication going on in hospitals today. Thanks to authors of a new study published in the New England Journal of Medicine, I have more objective data for my ranting. A prospective intervention study conducted at 9 academic children’s hospitals (and involving 10,740 patients over 18 months) revealed that requiring resident physicians to adopt a formal handoff process at shift ...

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The most valuable lesson about teaching that I ever learned occurred in high school. I took my first algebra test. The questions were easy, and I wrote down the answers. All my answers were correct, but I got a B. After each answer, she wrote “show your work.” She explained that while algebra questions start out easy, they become more complex over time. Only through careful understanding of ones thought ...

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Pamela sits on the examining-room stool, looking at me expectantly. I am in my first year of medical school. I do as I've been told to do in medical skills class: I observe my patient -- without judgment or assumptions -- and try to figure out what questions to ask, based on the information I am given. Pamela has curly, strawberry-blonde hair and looks to be thirty, just a few years older ...

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Life is full of choices and each choice has the potential to open certain doors and close others. I choose medicine. It is a demanding career, but even as a 7th grader, I knew what I was signing up for. What I didn't know was how much this profession could influence the trajectory of my personal life and the types of relationships I’m able to maintain. I grew up genuinely thinking ...

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shutterstock_145074796 Like most second-year medical students, I have the MP3 files of Goljan’s high yield pathology review lectures on my phone. Unlike most medical students, I rarely bring myself to listen to them, always opting for their Motown or punk counterparts instead. I often feel guilty about this -- listening to them would make for more efficient car rides and walks home -- ...

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shutterstock_179528855 Ironically, we had just finished our endocrine unit when I noticed a lump in my neck. Perhaps school had made me more vigilant, or perhaps I merely fell into the realm of hypochondriac medical student, but I couldn’t ignore this lump. I set up an appointment with my doctor fully expecting a diagnosis of medical student neuroticism. Instead she agreed that it was ...

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Recently, Dr. Peter Kramer published an intriguing, well-written, but poorly reasoned and potentially dangerous “thought piece” in the New York Times. His article, “Why Doctors Need Stories,” contains several logical flaws and erroneous arguments, but the overarching concept is a classic straw man argument. He creates a false and highly misleading notion of what evidence-based medicine ...

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In September, Doximity, a closed online community of over 300,000 physicians, released its ratings of residency programs in nearly every specialty. Many, including me, took issue with the methodology. Emergency medicine societies met with Doximity's co-founder over the issue and echoed some of the comments I had made about the lack of objectivity and emphasis on reputation. I wonder if it is even possible to develop a set of valid ...

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One of the hardest parts about medical school for me has been the constant pursuit of approval. Having a pass/fail system during pre-clinical years helped ease things some, but there remains a personal desire to prove myself. In front of attendings, all I can focus on is performing my physical exam just right, presenting in the perfect manner, and nailing the assessment and plan. Unfortunately, my strong desire to look ...

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