One of the first things they teach in medical school is that if you haven’t pretty much figured out the diagnosis by the time the patient finishes sharing their history, your doctor hasn’t done his or her job well.  Certainly, this is a bit of an exaggeration, as many diseases cause similar symptoms. As you share your background, your doctor is creating a list of possibilities of the most likely conditions ...

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When Donna Helen Crisp, a 59-year-old nursing professor, entered a North Carolina teaching hospital for a routine hysterectomy in 2007, she expected to come home the next day. Instead, Crisp spent weeks in a coma and underwent five surgeries to correct a near-fatal cascade of medical errors that left her with permanent injuries. Desperate for an explanation, Crisp, who is also a lawyer, said she repeatedly encountered a white wall of ...

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There was a lot about that place I didn't want to see or hear. The buzzing and whirring of ventilators; the loud call bells; near-dead patients; nurses running around with IV pumps and tubes dangling along behind them; the heart-stopping "Code Blue" warning; or the electrical sizzle of a patient getting shocked as someone screams, "All clear!" I didn't want to do it. Just a few days before, I had buried my mom. First ...

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The patient, age forty-nine, complained of abdominal pain. She was taking both slow- and fast-acting oxycodone to manage the pain, and she also took antidepressants and a sleeping aid. She'd come to the hospital several times in the past year, always with the same complaint. This time, not feeling well enough to drive, she'd come by taxi. The veins in her arms were small, threadlike and collapsed, like those of ...

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Eight months into a healthy pregnancy, my belly suddenly hung lower. I noticed that the baby’s movements slowed, decreased in frequency, and seemed sluggish compared to just a few days before. Concerned that something might be wrong, I called my obstetrician’s office and described what I’d noticed. The nurse I spoke with gave rote and reassuring advice: “Babies often get crowded near the end of pregnancy,” she said briskly. “Drink some ...

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An article from the Wall Street Journal caught my attention, and for all the wrong reasons. It was a review of two recent studies showing that medical trainees have difficulty diagnosing patients with complicated histories or confounding psychosocial features. At least, that’s the way I would describe those studies. The WSJ, however, used much more pejorative language, referring to them as “difficult patients,” “a nuisance,” and “an annoyance.” The ...

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A hospital stay is a right of passage for any patient, but the road to health is often a marathon and not a sprint. Discharge is an essential step in the patient journey, but it can be as exciting for a family as it is daunting. Families can prepare ahead and put all the right pieces in place in order for a “soft landing” home. Here are some of our ...

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Patients with extended illness or chronic conditions often acquire a communicative competence with far more complex medical terminology than their doctors realize. This is important, given that patients are too often seen as passive recipients of medical information, or worse, incapable of understanding their own health data. Recent studies show that one of the most effective prescriptions for increasing health outcomes and reducing medical malpractice rates is improving how doctors communicate ...

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Bringing a child into the world is nothing short of a miracle. It’s not comforting to think about, but even if you do everything “right,” there can always be circumstances beyond your control. Whether you have been told to plan for a stay in the NICU or it’s unexpected, here are survival tips from nurses for orienting yourself to the NICU. 1. Try to see your baby as soon as possible. It ...

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I recently consulted a specialist at a major medical center in New York, and a few days later, here came a questionnaire in the mail. "How much time did I spend in the waiting area?" it asked. How long was I kept waiting in the examining room? How close to my appointment time did the doctor see me? The one thing it didn't ask was whether I cared. There's no mystery about ...

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