She was 94-years old with advanced Alzheimer's. She thought it was 1954 and asked if I wanted tea. Not a bad memory for someone in a hospital bed with a broken left hip. She'd fallen at her assisted living facility. It was the second time in as many months. She'd broken her collarbone on the previous occasion. Over the past year, she'd lost 30 pounds. This is natural in the progression of ...

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COCA-COLA-coke-31873267-1920-1080 Responding to our justifiably increasing preoccupation with widespread obesity, the Coca-Cola Company has released a masterful television ad on the subject. They characterize their own efforts, and invite us all to "come together" to combat this scourge. The whole "come together" concept receives great emphasis, with evocative images from the (presumably) good old days of: "I'd like to buy the world a ...

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shutterstock_116824810 It wasn’t until I became a nurse that I realized how long a hospital hall could be! And, whether we are walking, rolling, or running down those halls, our steps can seem endless. Oh sure. Current hospital halls may be relatively short, compared to the immense and cavernous wards of days gone by. But hospital halls have an open and hollow resonance of ...

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It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity. The woman lying on the gurney was motionless.  Her chest moved up and down with a timid but halting regularity.  The calmness of her face was in sharp contrast to the panicked despair of the ...

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A sample agenda as the consulting psychiatrist with a homeless outreach team: 8:17am. Arrive at the office, which is in a tall building that is a short walk from the New York Stock Exchange. Speak with the case managers and social workers about who should be seen that day. 8:55am. Walk with a case manager to the ferry terminal meet Paul (note: all patients described here are composites of people ...

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Juan Gonzales, (not his real name), is a somewhat demented elderly Hispanic male, who I met last week in an intensive care unit. He spoke little English, and I spoke limited Spanish.  His devoted family was at the bedside, and fortunately his daughter was able to provide some history. He was admitted with palpitations and dizziness and atrial fibrillation with a rapid response. His family had just moved him from Miami, ...

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I'm told every doctor has their list of unsolved patient mysteries. Those patients where something terribly awful or something miraculous happens for which you lay awake at night trying to understand. The nature of doctors is to want solve problems and figure out medical mysteries in sleuth-like Sherlock Holmes fashion. It's these unsolved mysteries that you remember as they perplex you for days, weeks, possibly years after. For me, it happened ...

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shutterstock_115746469 By the time I met her, Ms. Jacob had been in the hospital for 202 days, 15 hours, and 38 minutes. 39 minutes. 40 minutes. Starting work on a floor that prided itself on delivering comprehensive, efficient care, I studied the computer monitor describing patient lengths of stay, wondering why this woman had been here 25 times longer than the average patient – ...

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When I first decided to pursue a career as a physician scientist by enrolling in the medical scientist training program, my goals seemed very clear; to bring what I learned at the bench to the bedside.  Today, as a junior faculty member in a department of pediatrics who spends most of my time in the lab, this now clichéd phrase continues to echo in my mind. Yet, I am concerned ...

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There are surprising misconceptions about what family physicians actually do in practice. Americans maintain a fond respect for the classic image of the family physician, making house calls with black handbag in tow. They admire the Marcus Welbys of the world. While this classic image is endearing, it should not be confused with the 21st century family doctor.  The modern family physician is trained to engage in the adaptable world of health ...

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