1. A 40-year-old female sees her family physician for burning chest pain after she eats hot peppers. She had it only once while exercising. Her family physician sends her to the emergency department and she gets admitted for chest pain. Rather than going home with treatment for her GERD, she ends up dead. This never should have happened, but the family never learns what really killed her. 2. A 33-year-old father of ...

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He had been in the hospital for 3 months. A rocky 3 months, much of it in the ICU. Now, when it looks like he will be leaving on his way to a near full recovery, his wife tells me she can’t thank me enough telling her husband “she never lost faith in you.” I felt as if my medical practice had suddenly been realigned. All the recent years of practice ...

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I have mental illness. It’s taken hours of talk therapy, months of finding the right dosage and timing of medication, and years of work to learn how to live successfully with it. I’ve redefined how I think and feel, and learned what kinds of people and experiences to limit or allow in my life. Now in my 50’s, I’ve come to know the textures of my own mental illness and ...

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I am guilty of neglect. I’ll admit it. I’ll own it. I’ll embrace it. When I am doing a consult now for one of many hospital emergency rooms, I am sent a pretty standard package of history, nurses notes, doctor’s assessment, physical exam report, lab results and other information that I review prior to actually seeing the patient on the screen and doing my own assessment. Now, on a day like today, ...

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"Your call is important to us.  Please listen carefully because our options have changed." During your current or any prior lifetime, has any phone menu option ever changed? I have more than once experienced an option not offered on the robotic phone menu option choices - a dead phone line after a 30 minute wait. Have you tried this customer plea as I have?  Could you pretty-please jot down my cell phone number in ...

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Recently I was asked to serve as a consultant on a medical matter.  Interestingly, they requested my hourly price for my services.  I thought about this and wondered, "What am I worth per hour in the open market?" It is an interesting question to ponder. I have decided to ask the blog-o-sphere.  Call it a bit of "free market economics."  For the record, 100% of my hourly wage for my services will ...

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How do you choose a doctor?  Perhaps you start with a recommendation from a friend or a trusted physician, then you look at factors such as training, experience, board certification, access, online reviews and of course that vital issue, how well you like the doctor when you meet him or her.  Tough thing, picking a person you barely know to whom you trust health and life.  To this list, I ...

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Medicine, like politics, sports, and everything else, has gotten sucked into a 24/7 sound bite culture in which the most complex issues are spun into a few provocative words on news sites, TV, and radio shows. Enraged readers and listeners then weigh in. As the old expression goes, much heat, but little light ensues. But three recent stories involving medicine are worth a closer look, and cooler heads. First, consider the
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Several days ago, I had the opportunity to listen to a lecture by a visiting physician who practices narrative medicine, a medical humanist.  She is well-known for bringing a voice to the interactions between doctor and patient, the healing relationship, the unparalleled bond formed between these two individuals.  In her talk, she spoke of the "turmoil" that ensues when caring for a patient, caused by the interaction of deep concern ...

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All of us come to the study and practice of medicine through different pathways: some because of family members who were doctors or patients, some out of our own illness or woundedness, some out of intense drive to achieve and serve. I came to medicine because of my grade school classmate Michael. My grade school represented a grand social experiment of the early 1960’s.  It was one of the first schools to ...

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