You may not remember me, but when I asked how you were, you said, “alive.” A few weeks earlier you were afraid of going under anesthesia and not waking up. They said you’d do great; that this was routine; that we’d see you again soon. Then you coded on the table. I’ve never met someone who was grateful for life the way you expressed to me that day. You may not remember ...

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“I don’t want a tube down my nose. I’ve been through it before and I don’t want it again.” Charlie turned his head away from the team and crossed his arms in defiance. “I’d rather be sick.” I looked at the intern, who looked at the resident, who just said, “Well, think about it. We’ll be back in the afternoon.” “I’m also hungry and haven’t eaten in days,” Charlie added. “Maybe some food ...

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I have reached a new milestone in my medical training—third year—the year when we transition from the classroom into the hospital, from the preclinical to the clinical curriculum. Those who have come before me understand that this is a major turning point in one’s medical education where the theory and memorizing from the first two years is put into play in order to manage patients with complex conditions. It is an ...

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As a member of the medical school admissions committee, I've interviewed many amazing applicants. Here's what I wish I could say to them: 1. Your interview performance is critical. As interviewers, we're amazed by the quality of today's applicants. In fact, many of us wonder if we would get in to med school today. “I can’t believe how much she’s done,” is something I hear time and time again from my colleagues. The ...

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Attending physicians have great responsibility. We have ultimate responsibility for patient care and for medical education. Medical education involves sharing facts, the thought process and bedside manner. Recently we had a “frequent flyer” admission. For a few years, the housestaff labelled this patient as non-compliant – and even wrote it in his chart. He is young (less than 30) and has a chronic disease. He had multiple admissions and often left ...

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Congratulations on your admission to medical school! Your white coat ceremony is coming, and it'll be grand. Your orientation leaders will suggest study skills, where to find scrubs and the best cheap supplements. Maybe more enlightened members of the faculty will remind you that medicine is really about the patients. If your parents are physicians, as so many medical students’ parents are—mine are not—they will reminisce about their own days ...

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On a rotation in internal medicine last year during my third year of medical school, I spent several days watching the residents work to optimize a homeless patient’s insulin regimen. They were understandably concerned with his diabetes medications because he had been admitted in a diabetic coma, but the real reason for the coma, as far as I could see, had nothing to do with his medication regimen and everything ...

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Earlier this year, the physicians at my academic family medicine practice met with two senior officials from our parent health care organization to be oriented to its new initiatives and projects. Their presentation documented the organization's ongoing investments of many millions of dollars into renovating subspecialty care suites and purchasing new radiology equipment that was likely to be highly profitable, but provide dubious benefits to patients. Two of my colleagues asked ...

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Discovering medicines unrehearsed harmony There is something deeply satisfying about hitting the right note on the violin.  On the rare occasion when my left hand is perfectly positioned and my bow arm is applying the perfect amount of pressure on the violin string, the resulting note that resonates from the wooden belly of the instrument is, for lack of a better word, perfect. My favorite piece that ...

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Recently I came across yet another media article with suggestions as to how digital health products can gain more widespread adoption. The writer notes that “we can learn a lot from the pharma and healthcare industries,” and goes on to discuss the importance of engaging the doctor. This article, like many I read, doesn’t acknowledge the downsides of using pharma’s tactics. I have to assume that this is because from a business ...

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