Radiolab recently aired a show called “The Bitter End” that discusses the end-of-life care preferences of physicians and non-physicians. Physicians are much more likely to decline “heroic” measures, such as CPR, mechanical ventilation, feeding tubes, etc. This comes as a surprise to the hosts and, presumably, to other non-physicians. It’s a good show. I recommend it. (Full disclosure: I like Radiolab.) In the show, Ken Murray argues that physicians ...

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The failure of doctors to talk to their patients about end of life decisions perplexes me.  This gap in vital communication results in poor care, uncontrolled pain, futile treatment and death in hospital or nursing home, where no patient wants to be.  Certainly, for oncologists, every patient they see is concerned about dying and by not opening the topic it leaves each isolated. I have generally taught my students that this ...

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"Discrimination against heavy people, by the general public and medical professionals, might be a greater health and social problem than any extra pounds they may be carrying" argues UCLA Professor Abigal Saguy, PhD, in a provocative essay in the Washington Post. "Despite the fact that body weight is largely determined by an individual’s biology, genetics and social environment, medical providers often blame patients for their weight and blame their ...

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downton abbey If you have not yet seen the fourth episode of the third season of Downton Abbey and wish to be surprised by it, read no further. And if you aren't watching PBS's addictive costume drama currently set in 1920--and, seriously, why aren't you?--read on anyway. This is about medicine, then vs. now. First, to recap the medically relevant aspects of the ...

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Let’s talk a little about health accountability.  Two news items have provoked the following rant: why is it always someone else’s responsibility? The first item was on NPR. The FDA, reacting to the epidemic of prescription drug abuse in this country, is offering incentives to the pharmaceutical company that can come up with a less addictive painkiller.  Such a drug would be a gold-mine for that pharma company because it could ...

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shutterstock_93793456 Young children are naturally petulant, noisy, and self-centered. We’re all born with ourselves in the center of the universe, an impression reinforced by parents who must cater constantly to their young babies. But babies become toddlers, and toddlers become children. Sometime during this transition, parents have to teach their children that they are part of a family. For a family to function ...

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Yesterday I saw a 90-year old woman in consultation.  She presented to the emergency room in September with abdominal pain, and in the process of working her up, a chest x-ray was taken which showed an infiltrate in her lingula, part of the left lower lobe of her lung. As it turned out, there was nothing wrong with her belly, but a follow up CT scan of her chest showed this ...

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Being a single mother in medical school and residency isn't a piece of cake. But, being a single parent in this world isn't a piece of cake, either, and being a medical student and / or resident isn't a piece of cake. Foregoing medical school isn't necessarily the answer to any of that. Here is some general advice I will share with parents, single or otherwise, who are facing decisions about ...

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From the Economist in October 2012 was an article on physician assisted suicide.  In the United States, terminally ill patients can apply for permission to end their lives with the guidance of a doctor in Oregon and Washington state.  Several safeguards are in place to prevent this from becoming the default death pathway (only 0.2% of total Oregonian deaths).  Also, I had no idea that Holland, Switzerland, and Belgium allow assisted suicide ...

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shutterstock_103546670 american cancer societyGroundhog Day was on Saturday this year, and unlike the furry little beast, what I have to say each year around this time is just as good today as him looking for his shadow on Saturday. What is all this about, you are probably asking yourself? It is about an annual update that ...

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