I had performed this procedure dozens of times before. It was routine. I stand under the bright lights, I take a deep breath, I wait for my hands to stop shaking, and then, I begin. This time was different, though. The lights were blinding, there were lots of people watching, and there were TV cameras. Oh, and the guy performing before me was a Grammy winner. This was one ...

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It's been five years since she was told she was cancer free. Today she was told it was back, and the future was quite grim. My job was to make sure she understood how to properly take the medication that would reduce the swelling around the tumor so radiation could start as soon as possible. That was my job. Clinically speaking it wasn't the most challenging or difficult issue of the day as I ...

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There are two in the solitary sick room.  Between covers, attached to the IV, connected to the monitor, is the woman.  Cancer assaults her body and she lies trapped.  Constant at bedside is her son.  Whether day or night, weekend or day, he is there.  Always with the question, the concern, the anger. Through weeks of tests, pain and treatment, he is never satisfied. There is always something we are doing ...

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While in residency, I took care of a toddler who was hospitalized following an anaphylactic reaction.  During a diaper change at home the child suddenly developed lip swelling and severe difficulty breathing for no apparent reason. The child was urgently brought to the hospital by ambulance and initially treated in the emergency room. By the time I met her on the inpatient floor her breathing and swelling had significantly improved. ...

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I come back into the exam room, keeping my best poker face, sit down and turn to face her.  She’s on the edge of her seat, nervous and barely able to contain herself, maybe not even sure which answer she wants. Be aware of your food choices, especially when pregnant “Congratulations,” I say. She lets out her breath and smiles, huge. “Thanks!” Once the adrenaline settles down and she can hear me again, ...

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Whenever someone is scheduled for an operation, the assigned nurse is required to fill out a "pre-op checklist" to ensure that all safety and quality metrics are being adhered to. Before the patient is allowed to be wheeled into the OR we make sure the surgical site is marked, the consents are signed, all necessary equipment is available, etc. One of the most important metrics involves the peri-operative administration of ...

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The sense of loss extends beyond the death of a patientAt the end of the year, I find myself thinking about patients usually—and especially those that have passed away. I wonder how their families are coping, how their children are, and whether each day has gotten easier. I think about how my patients died—and whether or not I did enough to ensure that they did not suffer. It's an odd thing ...

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It was 1976 and I was a junior resident in urology at Baylor College of Medicine in Houston, Texas.  I was assigned to a rotation in pathology where my job was to process specimens taken at surgery, dictate a gross description of the specimen and then place the specimens into the cassettes that would be used to make the permanent sections.  I was transferring a prostate biopsy, approximately 0.5mm x ...

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Diagnosis is the foundation on which all care and treatments rest.  If the diagnosis is wrong, most probably so is the treatment.  Diagnosing an illness is an art.  A diagnostician needs to be one part scholar, one part detective, and four parts artist.  He has to be a good listener, open minded, and capable of assimilating a large amount of sometimes confusing data into an accurate picture of a disease ...

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As physicians, we are often called upon to be advocates for our patients. Sometimes they have no other person to turn to. At those times, in particular, we evaluate their health in the context of relationship, family, and workplace. Having practiced family medicine for so many years, and now in counseling medicine, I have had the responsibility of advocating for my patients with their health insurance companies, within their families, ...

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