Brain death is death. This is one of the definitions of death. Even in Texas. Because brain death is death, a do not resuscitate (DNR) order or invalidating a DNR are both meaningless, because you don’t do procedures on dead bodies. This is why taking someone off a ventilator who is brain dead is not homicide, assisted suicide, or even following a DNR, it is simply the cessation of forcing air ...

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One year ago, my book, When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests, was published. My goal in this last year has been to travel around the country and talk about the book and its message of advocating to improve your health. I planned a 48-city itinerary where I’d crisscross the U.S. from Massachusetts to California and back. I’d speak at bookstores, libraries, nursing homes, universities, and community centers. What ...

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As a scientist with a brain naturally inclined to skepticism and analysis, I suppose my spiritualism may be best captured by: Keep the faith, but get the data. While some of my fellow skeptalytics, if I may coin such a term to catalog us, may be inclined to renounce that first clause altogether, thinking there is no need for faith, I am obliged to disagree. We are all a mass of electrons ...

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Most physicians love the profession.  Our medical students and residents want to care for patients, interact with patients and help those patients.  For most physicians, the joy of medicine occurs at the bedside and while investigating patient problems.  The joy does not extend to scut work (defined in the free dictionary as “trivial, unrewarding, tedious, dirty, and disagreeable chores”). Now who defines scut work? Back in the 70's, we would define scut ...

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Numerous strategies by antiabortion groups to curb women’s constitutional right to abortion are frequently reported in the news, and come as no surprise. However, a recent development illustrates novel circumstances in which people are using legal maneuvers to conspire to restrict medical decisions by patients and their families even when the right to abortion is not at issue. On January 8, 2014, a front-page story in the New York Times Read more...

It was the first time I had every flunked a test. My fragile ego was shattered. It was my first year at University of California, San Diego School of Medicine, one of the most difficult to enter. I failed my pharmacology test, not because I was stupid, not because it was difficult, but because I was clinically depressed. A dark cloud covered my head and I could not see. Much of my ...

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Pilots never expect to hit a flock of birds on take off, or flame out an engine in mid-flight.  No one plans to get disoriented in the air or have an equipment malfunction miles from the nearest airfield.  And, it certainly isn’t routine to fly into hostile airspace with a heightened awareness of the known ground threats, the position of each member of your formation, and the safety of the ...

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As a physician, not a day goes by without a new acronym I need to look up, a new policy I need to follow, another box I need to click or another criteria I need to meet -- and this is just to keep up. While the health care picture and its various unknowns loom ever larger in the news, and health information emails overstuff my inbox, it is worth ...

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I recently struggled with an interesting patient care issue related to my illness. I had to cancel several weeks of clinical sessions, which I realize is a hardship for my patients. A few weeks ago, when seeing a long-time patient of mine -- a warm woman with several chronic conditions -- I ...

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Not long ago a woman in my community, who was a patient of an esteemed local oncologist, died.  Let us call her “Beverly” and let us say she died of “breast cancer.”  I am familiar with the details of the case because one of my partners saw her in consult, but HIPAA and common courtesy forbid me to be any more transparent.  Beverly was very popular in our town and ...

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