I have nothing against the patient empowerment movement.  In fact, I think an informed and collaborative partnership is mutually beneficial.  But I can't help but laugh when I read some of these tweets. Death to paternalistic medicine! The age of paternalistic medicine is over! True, the era of doctor knows best is long gone.  But it's a mistake to think think today's health care consumer has any more leverage than before.  It just seems ...

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I mustered up the courage to visit Mary today. Pulling into her driveway, I was greeted with the majesty of autumnal brilliance—golds, rusts, and crimsons set against a brilliant azure sky. A bold display of nature’s defiance against the upcoming long winter’s sleep. Not to be ignored, those leaves that had flamed out early chattered against my every step as I slowly ambled toward the doorway. I took a deep breath and ...

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Sorry for not posting for a while.  It’s not that things have been quiet; they definitely haven’t been. Here’s the update:

  • The construction has been delayed, so the office will open on the 28th of this month at the earliest.  Inspectors are a pain in the buttocks.
  • This delay has kept me from hiring staff, as I need to have a solid start date for them.
  • The extra time has allowed me to do ...

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A sample agenda as the consulting psychiatrist at a geriatric adult home: 8:20am. Arrive at the concrete building. Wave through the locked glass door at the woman sitting behind the desk. She pushes a button and the door buzzes. Pull the door open. Say good morning. She never sounds cheerful when she replies, “Good morning.” Because there is no open stair access, take the elevator up one floor. It travels ...

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Like most Americans, when I learned that twenty children and six adults had been massacred in Newtown, Connecticut, I recoiled. Like most parents, my next thought was for my own son, the image I retain of his happy, smiling self for one moment replaced by an image of his tiny body lying twisted on the ground. Even as I write these words, an emotion I rarely feel—one I often can’t ...

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I wrote in a previous post about what life was like growing up in Newtown, Connecticut. It truly is a picturesque New England town. But what might be surprising is that within that town sat a gem. A hundred acres of wooded rolling hills within which sat an inner campus of professionally landscaped and meticulously manicured ...

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I recently heard from an aging and respected physician the old adage that “what is good for the doctor is good for the patient.” The room full of physicians of all ages and specialties nodded their heads in agreement. This saddened me, as it represents a physician-centric system that oftentimes leaves the patient’s needs and desires completely out of the equation. An area of emerging importance in medicine, whose impact should ...

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May is a recent divorcee in her early sixties. She was working out at the gym when she began to feel queasy and lightheaded. She awoke in the back of an ambulance, and soon, she was in an ER getting blood drawn. “We need to make sure you don’t have a heart attack,” she was told. As the day went on, May underwent test after test to “rule out” ...

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Over the past few years, I have realized that I have come to resent the word "just."  Certainly not in the civil sense of the word: social justice is the driving force behind virtually all the work I do these days.  I am talking about using "just" as a qualifier.  As in, "Oh, I'm just the medical student," or, "He's just a nurse."  We use it blatantly as an offense ...

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When I think of Big Joe, I see his overalls, and how he filled them. And how a couple of months after I operated on him, there was room for both of us in there. Big Joe: farmer, salt of the earth, tough, stoic. On the day I met him, if it'd been Halloween, I might have tried to stick a candle in him. That's how orange he was. My ...

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