While on my inpatient psychiatry rotation, I had the opportunity to work with an adolescent female with a troubled past and a significant history of psychiatric illness. It was through coloring that her barriers broke down and we were able to establish a safe space for difficult conversations. She was safely discharged two weeks after her suicide attempt. As she left, she gave me a hug and handed me this: Through our patients we find ourselves
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I was a junior medical student, wearing a short white coat, pockets stuffed with reflex hammer and spiral bound Washington Manual of Therapeutics, rubber tourniquet and pens and pads. I was on a rotation out at the Dwight David Eisenhower Army Medical Center in Augusta, Georgia. DDEAMC was not too far from my home away from home, the Medical College of Georgia. I think I was in the OB-GYN clinic ...

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Is Physician “Shadowing” a Shady Practice? asks Dr. Elisabeth Kitsis in a post at the Doctor’s Tablet, a blog run through the Albert Einstein College of Medicine. She concludes that yes, it is, and invites readers to share their opinions on having high school and college students shadow physicians. I was reminded of my fantastic 8 week shadowing opportunity as a college student through the Project AHEAD program at the 
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The dream was that reason, in the form of the arts and sciences, would liberate humanity from scarcity and the caprices of nature, ignorance and superstition, tyranny, and not least of all, the diseases of the body and the spirit. -Paul Starr, The Social Transformation of American Medicine In a local bookshop just outside of Boston, a small group made their way to their cherished celebrity bookclub. Tucked away on a foldable chair ...

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Just about thirteen percent of the 100,000 plus resident physicians in the United States are union members -- and many more would choose to join if it weren’t for the fierce pressure exerted by some teaching hospitals, chairs and program directors. Although it is illegal to threaten resident physicians with retaliation for expressing their desire to form a union, the law is difficult to enforce.  Ought medical educators examine ...

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How physician education is similar to Master Sommelier training Medical school becomes a blur after a few years in practice. You forget about all the hours spent in classrooms and then every night after a quick dinner. You somehow block out the “pimping” and public humiliation of being questioned about topics not quite under your belt. The worst feeling? The fear of wondering if you will master medicine enough ...

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Last night, I responded to a code blue while working the night float at the hospital. The patient was a relatively young female who had just completed a coronary artery bypass procedure. Per training, I began compressing her chest to induce blood flow to the rest of her body. As I pushed, the incision reopened and blood began spewing everywhere. I could feel her ribs giving and cracking from the force ...

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Pauline Chen has once again written a brilliant piece in the New York Times: Are Today’s New Surgeons Unprepared? While many comments miss her underlying question, her exposition makes the problem clear. How do we gain expertise? Current theory supports the idea of deliberate practice. How do we conceptualize deliberate practice? Start with a sports analogy. You are trying to learn to make a 6 foot putt. In scenario ...

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In a scene from the 1999 cult classic “Office Space,” three burned-out cubicle drones take a baseball bat to a malfunctioning printer.  While I do not condone violence against innocent peripheral hardware, I admit I secretly fantasize about destroying medical center fax machines. Recently, a chronically non-compliant end stage kidney disease patient on dialysis was admitted for minimally elevated troponins and non-ST segment EKG changes in the setting of a hypertensive ...

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As Dr. David Green reported recently in NEJM Journal Watch, the American Society of Hematology is the latest society to comment on appropriate and cost-conscious care in the ABIM Choosing Wisely campaign. I’ve followed the Choosing Wisely campaign closely and have been using it on the wards and in clinic as academic ammunition. A specialist society’s public advice about showing restraint is an excellent means to challenge the dogma of our ...

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