I still can’t think about the Sandy Hook shooting without starting to cry. It hit me really hard, because when it happened, I had a first-grader whose classroom was right off the main lobby of his public elementary school. If a shooter like Adam Lanza ever stormed into his school, Liam wouldn’t have a chance. I can’t imagine life without Liam. If he were to die, I can’t imagine how I would ...

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asco-logoShe came to see me, alongside her husband. She was 26-years-old, diagnosed with metastatic myeloma involving her bones, which had presented when she fractured her hip while jogging. Her disease had progressed on treatment and she was to start a clinical trial. Despite being pale, she looked well. I imagined she often heard, “Wow -- you look too good to have ...

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The job of a doctor isn’t to diagnose, prescribe, or examine.  It isn’t to be well read, efficient, or punctual.  The job of the modern doctor is to convince. We now have radiological studies whose theoretical discernment limit is subcellular.  We can not only map clear and obvious genetic errors of metabolism, but also minor variations of the normal.  In a few years, the majority of codes in the procedure manual will probably be laboratory ...

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It was late on a Friday afternoon in November. I was a 21 year-old medical student diligently waiting for an opportunity to practice some medical procedures when a patient was admitted who was happy for a student to “have a go” at taking blood. Cue a bit of anxious excitement (clinical medicine was still new to me) before some inner steeling and a formal consent process. Then, in went the ...

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Brothers, Kamiar and Arash Alaei were imprisoned in Iran in 2008 for their work with HIV. Under a new government, Iran’s health minister, Hassan Hashemi, has blamed “misinformation and unscientific claims” for a dramatic rise in the number of people with HIV. Kamiar Alaei looks at the HIV crisis in Iran and a country facing up to some uncomfortable home truths. Before 1997 there was a huge stigma attached to HIV/AIDS in ...

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About a year ago, I was surprised to find out from my daughter that hookah pens were all the rage among the high school crowd. If you are, like I was, among the uninitiated, this is a device of roughly cigarette proportions that contains a battery, a tiny vaporizer, something to vaporize, and a button to make it go. Most commonly that “something” is propylene glycol and nicotine. Press a button and ...

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When I was an acting medicine intern in Manhattan's Bellevue Hospital at the turn of the century, all employees who provided the hospital's "ancillary services" went home between the hours of 5pm and 8am. It was the job of the on-call interns to fill in. If a patient needed a stat blood draw or IV line replacement in the middle of the night, his nurse paged the intern to do it. If ...

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As health reform sets in, hospitals are gearing up for many challenges. While some of these are new to the health industry, several are against the backdrop of old problems that have plagued us for decades. Speaking as a doctor who has worked in a number of different hospitals up and down the east coast, I would like to identify 5 of these that I believe are fairly universal. 1. Medication ...

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Rural medicine, I guess, can be defined as health care that happens in places that aren't big cities or referral centers. The vast majority of the populated earth's crust that has any health care at all is served by rural practitioners. I have done a little bit of rural medicine in Haiti, in Mexico and now a bit more in South Sudan. I have also worked in a rural health ...

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Who works at a hospital? (Again, just indulge me for now.) Doctors. If you’re a patient at a teaching hospital, this includes medical students (people in school to become doctors), interns and residents (people who have earned the title of “doctor”, but who are still learning their craft), and attendings (people who have completed their formal training as physicians). If you’re not at a teaching hospital, it’s less likely you’ll see medical ...

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