“How much time do I have?” was the first question Mrs. C asked. She had called me in a panic. Earlier in the week, I had diagnosed her with breast cancer. She called me after learning the bad news from her radiologist. A whirlwind of appointments with oncology, surgery, and radiation oncology ensued, overwhelming her with information. I knew her case — these cells and her pathology — well, having just presented ...

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asco-logoMaybe I should’ve noticed how she looked.  “She” was a new patient, Louise*, and she had been diagnosed with stage IV cervical cancer. Only in her 40s, the diagnosis had hit her extremely hard. At her first meeting, she wanted the “truth,” and I had told her what I felt to be most relevant -- that her cancer had spread, that ...

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I’ve been traveling around the United States working as a locum tenens (in Latin, “place holder” – a more elegant name than “temp”) physician. We’ve all heard of traveling nurses, but more and more physicians are also “living la vida locums,” as it were. There are actually over 100 agencies who find/provide temporary physician coverage for hospitals who need to fill gaps in their full timers’ schedules. You can find out more about ...

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honey High fructose corn syrup, that sweet over-produced commodity of agribusinesses everywhere, has been linked in two miserable ways to bees and honey. The first discovery was made almost two years ago, and the second only 2 months ago. First, most of the “honey” available for purchase in supermarkets is not really honey, but instead an ultra-filtered impostor often produced in China, and ...

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Donate blood This week my toughest case involved futile care.  We admitted a patient with very advanced cancer, dying naturally at home on hospice. Because of last minute family intervention, the patient ended up spending 48 hours on super-max support, dying quite horribly with tubes and lines in every natural and unnatural orifice.  Liver failure, lung failure, kidney failure, bleeding, blood clots and ...

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Americans are notoriously generous and good tippers.  However, there are some servers who get “over the top” gratuities.  How do they do it? 1. They make a concerted effort to reach out and touch someone.  How many physicians enter a room and never touch a patient?  They are touching more keyboards than hearts.  I have learned from complementary healthcare providers that there’s a medicinal value of touching the patient.  Every chiropractor, ...

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In my over three decades of family practice, I have come to the conclusion that we, as doctors, should provide non-medical people with as much medical information as we can. Not as much as we think they should have, or information just related to the problem at hand, but as much as we can provide. Period. I started practicing when many still debated whether we should tell a patient if he ...

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It began like any other day on the OB floor.  My hair was still wet under my cap from my morning shower at 4:30am.  I was just returning to labor and delivery after making postpartum rounds and performing the daily circumcisions.  The doctors and medical students were all congregated for board rounds.  During board rounds we learned who was working and what was going on with each patient. As I approached ...

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shutterstock_87599194 Lately, my virtual inbox in our electronic medical record has seen a surge in requests for prescriptions for the vaccine against herpes zoster, shingles. This has made me think a lot about our responsibility as physicians to inform patients about the evidence behind our recommendations – but who informs the patients when doctors are kept out of the loop or put under ...

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I recently tweeted about Danielle Ofri’s important piece, The Doctor Will See Your Electronic Medical Record Now.  I like the piece, and especially like some of the quotes, but still I believe the problem needs an expanded take. Context represents the major advantage of 38 years experience as a physician.  Over time, one sees trends come and go.  Hopefully one can see the strengths of the “good old days” and ...

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