I am working hospitalist right now. On Friday, a man in his 80s was admitted with difficulty breathing. He had a complicated history, including a heart attack at age 35 with all the subsequent sequela of heart disease. He had an abnormal heart rhythm and was taking a blood thinner for stroke prevention. In addition, he had scarring of his lungs (cause unknown). He was transferred to us from another hospital. ...

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"I'm going to write a column about dating you and call it ‘Sleeping with the Enemy,’" I announced from my rocking chair. His rocking stopped. “The enemy?” The rain was falling on the trees in front of my porch and on his parade. “Why am I the enemy?” “You know, clinicians vs. hospital administrators.” “Really?” he naively asked. “Why don't clinicians like us?” I was surprised he was so in the dark. Before that ...

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Her name is Joann. She has cancer. As that disease goes, it is not much, probably curable, one of those “if you have to get cancer, this a good one.” Still, she sits across from me, her skin pale, eyes tight and she rhythmically grasps her cold, moist hands. She fails to gain any comfort from the knowledge that she is going to be OK. Why? I have not told ...

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The stretcher was wheeled into the operating room.  I had been in this room on three prior occasions, under very different circumstances. But today, as I lay flat on the table, listening to the small talk around me, I tried to breathe against the weight of the baby and the pressure of the procedure.  My husband will later tell me it happened so quickly, but for me, time stood still ...

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It will start as a minor curiosity. Maybe a student will seem slightly too close to the resident on your team. When the grades are posted, you'll wonder why you didn't get honors, but he did. You might wallow for a few days. Make an offhanded comment to your fellow students. Then you'll let it go and move on. Or so you think. Until during surgery when the scrub nurse ...

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I felt a gust of sharp pain a couple of centimeters to the right of my belly button. It will subside, I thought. All pain subsides. It was an easy dictum to follow as a 39-year-old pediatric eye doc who last spent a night in the hospital as a patient in 1977. I’d undergone bilateral laparoscopic inguinal hernia repair ten days earlier, so I was accustomed to brief squalls of discomfort ...

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The young woman sat in the corner of my exam room, facing away from me as I asked her questions. Her answers were short. "I’m from El Salvador." Why did she come? "Because of the violence." Her voice was flat. Her hands trembled. I knew she had suffered terribly and I needed to ask her how. Slowly, quietly, she recounted the gang violence she had fled in El Salvador. The assault ...

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Being in a hospital is a scary and frightening time, and it’s easy for those of us at the frontlines — doctors and nurses — to forget that as we go about our busy work days. Patients are at a very low point in their lives and will remember everything about their hospital stay, including all their interactions, for a very long time. As someone with a keen interest in improving ...

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When I was growing up, RuPaul was all I knew of transgender anything.  She was tall, flamboyant, charming, and I would look at her and try to see the man underneath the drag.  I didn’t know the definitions of drag and trans, gender identity and intersex, ambiguous genitalia and gonadal dysgenesis. Now that I’m a physician, I see transgendered patients on a regular basis -- unfortunately, it’s usually in the setting ...

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Despite above average intelligence and work ethic, the average physician is an absolute imbecile when it comes to the topics of personal finance, investing, and business. The lack of expertise on these critical life topics is having a dramatic effect not only on the financial lives of physicians but also their rates of burnout and thus their patient care. In past decades, by virtue of their above average income, a ...

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