There's something irresistibly horrifying about doing an amputation. I did several during training, and a few in practice, before eventually turning such cases over to people who did it more. In a way, it's a microcosm of the perversity and beauty of surgery; of the screaming contradiction that one must somehow accept to be a surgeon. Removing a limb is so many things: failure, tragedy, cataclysm, life-saver, life-ruiner. Gratifying. Stark and ...

Read more...

Ms. A was a sweet older lady with a bad heart who was transferred all the way from Montana in order to get expedited workup for cardiac (heart-related) surgery. Her story of her symptoms and disease course was the story told by hundreds of patients seen at any given hospital every year.  It started with a few weeks of chest discomfort while walking, followed by a day of chest pain, nausea, ...

Read more...

Walking into each room to greet my next patient often reminds me of Forrest Gump: “You never know what you’re going to get.” It’s challenging to have only one chance to get it right but I love being an emergency room doctor. Today, an older lady has slipped at home and she’s taped to a hard backboard with a rigid neck collar in place. It’s routine for all patients involved in ...

Read more...

On a warm and sunny August Sunday, I was rollerblading with my kids on the Shining Sea Bikeway. On mile nine on the trip, I hit a tree root, went flying, and landed on my shoulder.  I could tell immediately that something was wrong -- I couldn’t move my arm and was in the worst pain of my life. Feeling for my left shoulder, it was obvious that I had ...

Read more...

My new glasses were years overdue. The eye doctor understood perfectly my request that the focal point and pupillary distance for my iPad reading glasses had to match my habitual reading style – right under my nose. The result couldn’t be more pleasing. The other day my wife squinted over her iPad and said “I don’t know if I’m getting a cataract or if I just need new glasses. My right ...

Read more...

Though I have been accused by various commenters as protecting my own specialty when I point out excesses, flaws and conflicts of interest in the medical profession, this accusation would be handily dismantled after a fair reading of prior posts.  Indeed, my own specialty of gastroenterology and my own medical practice has felt the effects of the honed Whistleblower scalpel.   If an individual or an institution will not willingly engage ...

Read more...

She was the first Michigan Wolverine I met who taught me their college fight song “Hail to the Victors,”and demonstrated their rabid pride anytime football or basketball season rolled around. (If you know people from the University of Michigan, you know what I mean). She was also one of the smartest and hardest working doctors in our family medicine residency program and one of our two chief residents. So ...

Read more...

As I travel around the country, working in the trenches of various hospitals, I’ve been struck by the number of errors made by physicians and nurses whose administrative burden distracts them from patient care. The clinicians who make the errors are intelligent and competent -- and they feel badly when an error is made. However, the volume of tasks required of them in a day (many of which are designed ...

Read more...

Are electronic cigarettes, e-cigarettes, good or bad? There have been two huge stories recently, which may be seen as conflicting and confusing. First, the good news. The Lancet showed that electronic cigarettes are effective in helping adults stop smoking. How effective? About as effective as the nicotine patch. Of course, more research is needed in this area, but this is a positive step, right? Now, the bad news. A study from the Centers ...

Read more...

My wife recently read me her journal entry from the day our younger son turned two years old.  She had written quizzically that he had still not spoken any words despite a good deal of speech therapy.  For months previous to that birthday, he had also been engaging in repetitive, obsessive behaviors.  He walked circuits around the couch with total concentration, oblivious to the rest of his surroundings.  If you ...

Read more...

Most Popular