shutterstock_100033454 I want to wake up feeling restless and uncomfortable. It’ll be neat to drag myself out of bed to open that first bottle of wine. I’ll drink all of it within an hour. Then I’ll go to the liquor store. The guy behind the counter will know that, everyday, I will buy a pint of vodka from him. He will look at ...

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When I attended the Association of Health Care Journalists (AHCJ) conference in Boston recently, discussion swirled on the topics of unsustainable costs of care, doctors’ incentives under traditional payment models to order more tests and treatments, and the struggles of patients’ family members to avoid unwanted care at the end of life. That Sunday night, I was back at my day job (so to speak) in ...

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Today the road all runners come, Shoulder high we bring you home And set you at your threshold down Townsman of a stiller town. -A.E Housman As the afternoon’s events unfolded, I sat glued to my computer screen between patients.  My life has really been a tale of three cities—Houston, Boston and San Diego.  Boston was where I did my residency training, met my husband, had my three children and my first “real” jobs.  I ...

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A few years ago my best friend ran the Boston Marathon. She came back glowing, proud that she’d qualified, amazed by the crowds and energized by the feeling of community. Never once did she think that she could have died from a bomb exploding at the finish line. America seems to be facing tragedy after tragedy. From the Aurora shootings, to Sandy Hook Elementary, to the Boston Marathon bombings, each time ...

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There was an article in the New York Times recently about the importance of cultivating a family narrative to instill a sense of identity, control, and resilience in children. The more children know about their family story, the better equipped they are to handle stresses that would shake their foundation. Is it possible that, in the realm of personal health and well being, the cultivation of an affirmative ...

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I can remember making rounds with a seasoned surgical attending in medical school.  In typical fashion, surgical rounds were a lot like the military.  The “General” (attending physician) at the front, always commanding respect (and often fear) followed by the chief resident, junior residents, interns and finally medical students.  Cases were presented, statuses were updated and plans were formulated.  Then came the barrage of medical fact questions–mostly directed at the ...

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First a disclaimer: People often receive compassionate, considerate and effective care at hospitals. They have countless interactions which impart the miracle of human caring and enrich their lives. It is also institutionally prevalent to have haphazard care with poor communication, near misses and avoidable misery. I have been working at a university hospital emergency room as part of a mini-fellowship in bedside ultrasound.  It is the first time I have spent ...

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On the morning that I began this post, I read in our local newspaper that Tennessee is soon expected to have a law that would permit public school teachers to offer views on climate change and evolution that are counter to orthodox doctrine on these subjects. No, I don’t think that creationism is science and it should not be disguised as such. Global warming, or climate change, however, is more nuanced. ...

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Has anyone else noticed the growing presence of ultimatums in medicine today? The New England Journal of Medicine published a discussion of the ethics of not hiring smokers.  My hospital adopted this policy six months ago, and they are not alone.   There is a tobacco blood test that new employees have to pass.  If they fail, they can look for a job elsewhere.  I do not know the exact details, but ...

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I was watching a macho shoot-em-up movie the other day; the type where everyone shoots everyone and in the final scene, the dirty blood-stained hero rides homeward on a helicopter or maybe a horse, into a red sunrise or sunset.  He stares blankly, focused on nothing, focused on everything, his look reflecting the turmoil of what he has seen, done and lost.  The hero’s grease-smeared face shows the understanding that ...

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