The call comes in at 9pm or so.  The patient sounds sick as all hell.  The Surgeon listens to the random assortment of numbers and vitals the nurse provides and clicks off his cell.  He finishes reading a boring Berenstain Bear story to his daughter and tucks her into bed.  He looks at the clock and runs some mental numbers.  By the time he arrives at Hospital, close to ten.  See the ...

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Who is your favorite addict? I guess we have to talk about addiction as a preface to that question. Everybody I know takes psychoactive drugs, except maybe some Mormons, Seventh Day Adventists, and the like. All drugs are habit-forming, but only a subset of psychoactive drugs can produce psychological and physical dependence, tolerance, and withdrawal symptoms when taken away, the usual definition of addiction. Most people who become addicted to one drug often ...

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I recently saw a number of tweets from parents and fellow pediatricians on Twitter criticizing Marissa Mayer for announcing that she’d return to work within 1-2 weeks of the delivery of her first child. First off, I’ll start with my assumptions: I’m authoring this post in the belief that Ms Mayer has access to quality health care–that is, she has the ear of a board-certified obstetrician, a board-certified pediatrician, and access to ...

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My two oldest children recently left for semesters abroad: Michaela went to Paris, and Zack to Beijing. I have all sorts of Mommy nervousness about this, but in my heart I know they’ll be fine. They are adults now, at 21 and 20—and not just adults, but capable, responsible, great people. I don’t know how that happened. I know that sounds stupid. And it’s not like I have no clue at all. ...

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Could “mommy porn” have value in the doctor’s office? Unless you live in a cave (and we physicians sometimes do), you have heard of British author E.L. James’ modern erotic 50 Shades of Grey trilogy, 30-plus million copies sold, overwhelmingly to women. The trilogy is an erotic love story about a naïve college graduate who rescues an abused billionaire – a blend of the Story of O, Pretty Woman and ...

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Whatever your opinion of the Affordable Care Act, you must admit that it’s good to see the American public talk about reducing health care costs, offering more efficient delivery systems, and expanding health care services to more of our nation’s people.  There’s no easy (or cheap) way to provide health care to all Americans, particularly with the inefficiencies and absurdities that characterize our current health care system, but ...

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It happened again.  I was talking to a particularly sick patient recently who related another bad experience with a specialist. “He came in and started spouting that he was busy saving someone’s life in the ER, and then he didn’t listen to what I had to say,” she told me.  ”I know that he’s a good doctor and all, but he was a real jerk!” This was a specialist that I hold ...

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As emergency physicians who are trained in acute resuscitation and thrive in high-stress situations, we tend to roll our eyes at the less acute complaints our patients come in with. “Back pain for three months? Headache for a week? Why are they here now?” Patients, too, complain about this. “Can’t they see it’s not a real emergency and go see their primary care doctor? This must be costing our healthcare system ...

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It was a cold winter day in 2009 when my life changed forever, however, it would be months before I figured that out.  On that fateful day, a drug-addicted surgical scrub tech assigned to my operating room stole syringes of fentanyl, a potent intravenous narcotic, from my anesthesia cart.  According to news reports, investigative summaries, and the scrub tech’s confession, once she took the syringes, she used them on herself. It’s ...

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It’s National Primary Care Week, an annual celebration when members of the primary care community come together across the country in events largely organized by trainees to celebrate, promote and advance primary care. So what makes this year different? Put simply, the momentum for advancing primary care in the US has never been stronger. Those of us who believe that a robust foundation of primary care is essential to the health ...

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