A baby’s smile reflects the purity in their heart.   An infant’s world is a marvelous place of possibility and love.   Children see themselves as special, capable, even omnipotent.   Time teaches failure, loss, and mortality.  How much we lose of that original perfection, that first excitement, that natural confidence, determines how we face the challenges and tragedies of life; whether we will be happy.  It may even determine how we cope ...

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Top 10 ways to know its time to quit your job as a doctor Attention all doctors: The first three are mine. The rest are from miserable colleagues. All true. And common. If you’re a doctor and you recognize anything on this list, please quit your job. 10. You feel nauseated when you see your clinic logo; you alter your commute to avoid streets with your clinic’s billboard. 9. Discouraged by the general despair among staff, you ...

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Over the last year I’ve become rather addicted to golf. Having always been more into cardiovascular sports I’m actually quite surprised with how much I’ve taken to it. Fresh air, outdoors, lots of walking in beautiful nature and spending time with friends -- what is there not to like? Anyway, I’ve frequented several different courses in the Boston area in just the last few months. Last week, we were due to ...

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I was shocked and deeply saddened when my daughter announced at the dinner table that Robin Williams had died of an apparent suicide. My wife and I and the three of our children home at the time all pretty much gasped audibly in unison, and then for a moment after, you could have heard a pin drop. For a bit after that, we talked about our shock and sorrow. And then after that, ...

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William was doing great.  His C. Diff  was finally gone after a month taper of vancomycin.  He was stronger.  The nursing home staff reveled in how much progress was being made over such little time.  It seemed every one was ecstatic, except for, of course his family.  Every step this octogenarian took forward was accompanied by a litany of concerns and complaints from his daughter. If he was not gaining weight, ...

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I see it again and again in my practice: parents who seem to have forgotten that they are in charge. "You can say no," I find myself saying to family after family. Which is kind of an amazing thing to have to say, if you think about it. You'd think that parents would know that they can say no when their child asks for yet another toy, to watch more television, ...

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For three years before I applied to medical school, I worked in post-Katrina New Orleans helping to rebuild school-based health centers. One of the main challenges, however, was how to create a sustainable safety net for at-risk youth to whom we were hoping to provide much needed health services -- key word being “sustainable.” All too often, there isn't funding to carry out primary care’s mission of improving the health of communities and ...

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Today’s article highlights the lingering problem of physicians buying and selling prescription medications to patients -- at a profit. The medical profession has struggled with this controversial practice  for more than 150 years. In George Eliot’s 1874 novel “Middlemarch,” an idealistic young doctor named Tertius Lydgate questions the ethics of fellow physicians who make handsome profits prescribing and dispensing their own remedies to the townsfolk. His medical colleagues shun him for it. Around ...

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When I was in medical residency, more than thirty years ago, I ran with a pack of fellow residents, all guys who were fit to varying degrees. Once, on an outing, we discussed the -- hopefully -- hypothetical question: "If the need arose, which one of us would we eat first?" "Randy!" my friends gleefully concluded. "His meat would be the most marbled," one added. I've never been fat. More accurately, my body ...

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Internal medicine requires knowledge, deduction, and many skills: history taking, physical examination, analyzing diagnosis tests. When confronting a new patient problem, we use our brains to work on finding a diagnosis. Much like police detectives, we would like to have brilliant diagnostic epiphanies, but often we make our diagnoses by painstakingly collecting all the clues and doing the necessary boots on the ground work. We had a woman admitted to our ...

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