“I’ve been with my doctor for years and years,” an elderly man, voice hoarse but lilting with fondness for his caregiver, told a nurse in the primary care clinic where I was waiting to see a doctor. “He’s fantastic.” I was coming to the clinic for a follow-up appointment about an injury for which I’d been seen a few months prior, but neither the initial appointment nor this follow-up were with ...

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From PA to MD: An appreciation for physician education My journey in medicine began as a young child: I was the typical kid who knew I wanted to a be a doctor since I was a child and was thrilled when I was accepted into an 8-year college program which culminated in a medical degree. However, by the end of my undergraduate program, medicine was changing: doctors were spending less ...

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A medical student recently asked my advice on her decision to pursue a career in dermatology. It was about 25 years ago when my own parents encouraged me to pursue this specialty. What was their deal? Perhaps, they anticipated future developments in the field and were hoping for free Botox treatments? As readers know, I rejected the rarefied world of pustules and itchy skin rashes for the glamor of hemorrhoids, ...

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My student’s voice trembled as she answered my question.  “How do you think you’ve done so far?” I’d asked her.  We’d been together on the general medicine inpatient ward for two weeks -- the midpoint of the rotation -- and as was my usual custom I was giving her feedback on her performance by first asking her to rate her performance herself. “OK, I guess,” she replied. I waited to ...

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Medical students are repeatedly taught the importance of the physician-patient relationship.  We are told that to be a good doctor we must strive to exhibit compassion, empathy, respect, professionalism and confidence all while applying our medical knowledge to figure out a diagnosis and treatment plan. If you add in the pressure of doing this within a 15-minute visit, all while answering questions faster than an Internet search, it can get ...

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Where there is love there is life. - Mahatma Gandhi In this first month there is a lot I saw, learned and experienced.  Love tops the list. I became an expert in arterial punctures as I did 4 to 5 of them each day in the floors.  Each time I headed for an arterial puncture, many things automatically came to my mind: collect all of the required supplies, talk to and comfort ...

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Responding to a medical student in pain This evening, I read a post written by a woman who finds herself feeling alone, depressed, desperate, and afraid of losing herself as she goes through medical school. This post is my response to that woman. Dear colleague and friend, You are not alone. You are far from home. You are far from your family. You are far from the desert, the open ...

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Scientist J. Robert Oppenheimer once said, "There are children playing in the streets who could solve some of my top problems in physics, because they have modes of sensory perception that I lost long ago." Like physics, medicine has its share of problems, namely cost control. Like children, we must open our perception to the problem of cost control to consider other possibilities that better account for the issue than the theories ...

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There is much talk about cynicism in medicine, and I remember being confronted by it almost from the beginning. In fact, I still remember how shocked I was the first time I heard a provider describe a patient in a disparaging matter. We were responding to a 911 call regarding a woman in her 30s who was feeling short of breath. I remember being worried; she seemed too young to be ...

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We’ve gone through four dreadful pre-medical years of learning everything from the composition of atoms to how an apple exerts force when falling off a tree.  We’ve taken a massive exam full of content mostly unrelated to our future field only to be put through four more years of intense medical education (and several additional massive exams).  We’ve managed to receive a medical degree and have gone through at least ...

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