I can always use money. Regardless of what the public seems to think, doctors are generally not phenomenally wealthy. So I hate turning business away. But tonight I refused a hospital consult. Why would I do that? Because. The consult was for an 88-year old lady with advanced Alzheimer's Disease. Her sad life was reduced to lying in bed staring at the ceiling.  The patient had been seen by 2 other neurologists during ...

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You are now out of the Gray Zone, and you are now a member of an exclusive club. But membership to this club comes at a steep price.  Membership is not offered, it is not dependent on your income, title nor your social status.  Membership is granted simply by surviving or living with a grave or potentially fatal illness or injury and realizing just how fragile life is and how quickly ...

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I had been running late on another busy summer day. The type of day where you gain one step and lose two. Meetings and paperwork had filled up another summer morning. Baseball games, swimming practices, and soccer scrimmages had filled up another summer afternoon. And for this particular summer evening, I was scheduled to work an odd emergency room shift from eight p.m. to four a.m. While driving to work, I ...

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by Keith Humphreys, PhD When my friend Paul Costello left the Carter Administration, he wrote a funny New York Times article suggesting a special course for departing staffers:

There ought to be an "outward bound" course for White House employees facing exile. Must we face this cruel and unusual punishment cold turkey?
Maybe people were tougher back then - I personally would have collapsed five minutes into the first day of the ...

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by Brian McMichael, MD The NEJM recently published an interesting case in the ongoing series: " A Request for Retrieval of Oocytes from a 36-year old Woman with Anoxic Brain Injury." Usually these cases are diagnostic dilemmas. This one focused on an ethical dilemma at end-of-life. The Case A 36-year-old woman, in overall good health taking oral contraceptive pills (OCPs), was on a prolonged international flight, and ...

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An excerpt from CyberSafe: Protecting and Empowering Digital Kids in the World of Texting, Gaming and Social Media. by Gwenn Schurgin O’Keeffe, MD, FAAP Screen Time and Childhood Have you ever tried to go “screen-less”? I often tell the story of taking my girls to New York City on an April vacation, looking forward to Turnoff Week. This is a semiannual event that encourages families to flip off the screens ...

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October is breast cancer awareness month. There are pink ribbons and wristbands to wear, pink products to buy, and pink races to run -- all to improve awareness about screening and raise money for a cure. And rightly so, because breast cancer affects 250,000 American women every year. Fewer people know that October is also intimate partner violence awareness month. Purple is the color representing the more than 1.3 million women ...

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One of the most common complaints that I hear from people attempting to lose weight is, “I don’t know how to deal with my triggers.”  Most of us have had the experience of eating just one bite of something and suddenly wanting to devour the entire thing.  Sometimes we do, even though we know we won’t be happy with ourselves when we finish. I am familiar with the experience of insisting ...

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There is a white board in every patient's room. This is used to keep patient oriented and provide them with basic information. You would see some data on it, most of the time there is a date scrolled on it, name of the nurse and maybe physician’s name. I recently read an article "Getting the most out the humble white board" by Deborrah Gesenway. This is an excellent read ...

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[Editor's note: Please visit part 1 of Dr. Harpham's take on OpenNotes.] "Our" Chart Does the opportunity for patients to read their medical charts help or hurt patients' ability to become Healthy Survivors? Open notes can facilitate Healthy Survivorship for some patients. Unfortunately, other patients may learn something about their condition that makes it more difficult to get good care or live as fully as possible. Or they may experience feelings that threaten the physician-patient bond. ...

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