Maintenance is the process of maintaining or preserving someone or something, or the state of being maintained. Our certification documents that we have trained (in my case in internal medicine) and that we can pass a test on the breadth of internal medicine knowledge. We accept that the ABIM has developed a test the evaluates our entire exposure to the many diseases and treatments that reflect our patients. The idea of maintenance of ...

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shutterstock_190343936 Help, I need somebody! Help, not just anybody! Help, you know I need someone, help! - The Beatles We are all here on earth to help each other; what on earth the others are here for I don’t know.  - W. H. Auden “Help the doctor!” I’m sure most surgeons have heard this exasperated statement at some point in the operating room. It is said with that special mix of ...

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Early on in my career I called an Indian internist in the middle of the night to admit a patient to him. The patient was an 88-year-old female with advanced dementia, a terminal brain disease. She had aspiration pneumonia, which is often the final common pathway of this illness. She was in respiratory failure, in septic shock and was a “full code.” I can still recall our 4 a.m. conversation: “Hi, Dr. ...

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Significant snow in New England every winter is about as certain as sun in Florida every summer. When I moved to the USA from the south of (old) England to do my medical residency in Maryland, my first few years living in the United States were relatively snow-free. But when I started my first job as an attending physician in central Massachusetts, I was in for a big shock. I had ...

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Our family loves to hike. Traveling the trails is a deeply happy place for us. In fact, I don’t think there’s ever been a time when one of us suggested taking a hike, and everyone didn’t unanimously and enthusiastically agree. A few weeks ago, my family took a lovely hike in a state park in Massachusetts. It was a gorgeous day: temperature in the upper 40s, blue skies, no wind. The ...

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shutterstock_173285570 I am a physician, but I also consider myself a mother hen. When I have a census of patients, I think of them as little chicks, perhaps old roosters, clucking hens, tender capons. Some are old, some young, some have been chased out of the coop by an angry dog, caught in the wires and sent to me for care. Some ...

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pamela wible Ever wonder what patients really want from doctors? Is it the fancy buildings with marble fountains? Is it the board certifications and diplomas on the wall? Is it the expert medical jargon and starched white coats? Nope. None of the above. Listen up, docs: Patients just want the real you. Ya know -- you. The competent and caring you who really listens with compassion. The real you ...

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asco-logoMom. Dad. Happy. Sad. Friend. Trust. I remember playing this game. A friend would say one thing, and then I would say the first thing that came to my mind. For some reason, it would pass the time. I remember how some words would spark an emotion or a memory. Sometimes happy, sometimes not so happy. But, playing that game was one of ...

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She is always a difficult admission. The long chart review. The vague complaints. The entitled attitude. The misdirection. These are expected. As is the cake at her bedside after a diabetic crisis. The two-liter soda after an emergent fluid dialysis. The urine toxicology was positive for cocaine. The staff knows her well. I know her well. I give her the attention, kindness and empathy that I give to every patient. ...

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Recently in the New York Times, Dr. Ezekiel Emanuel suggested that this year's resolution might be to abandon the ritual of your annual physical. The title of his column, perhaps chosen by an editor to maximize glibness and thus provocation was: "Skip Your Annual Physical." But permit me to suggest you don't commit to that just yet. The annual physical exam warrants some more examination, a defense to follow its prosecution. Dr. ...

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