Brittany Maynard has passed from this life.  This brave but unfortunate 29-year-old woman with incurable progressive brain cancer drew public attention by choosing to go public with her choice about end of life care. "Brittany suffered increasingly frequent and longer seizures, severe head and neck pain, and stroke-like symptoms," according to a statement Sunday night from Sean Crowley, spokesman for Compassion & Choices, a national nonprofit working to expand end-of-life ...

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unnamed An excerpt from The Public Physician -- Practical Wisdom for Life in a Connected, Always-On World. What you do, where you live, and what you intentionally create as a physician in public should be determined by what you want to accomplish. What are you trying to get done? Perhaps you want to …

  • build a strong public presence to keep your ...

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brittany-maynard Would you base a life or death decision based on one doctor’s opinion? One research article? Google searches? What would it take? I recently read that Brittany Maynard took her own life. Plagued by glioblastoma, she chose to reject chemotherapy, radiation, and hospice. Tomorrow, I have a schedule packed with glioblastoma patients who personify courage, determination, and faith. Glioblastoma (GBM) ...

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There is abundant evidence for malaise in the physician workforce, but little agreement about etiology, treatment options, or prognosis.  As a senior physician who still has a lot of involvement with physicians of all ages, I want to propose an etiologic framework. Perhaps if we agree on etiology, we can look at treatment options. There are three ways to look at what doctors do: the artisanal, the economic, and the scientific. The ...

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Cheryl loved to dance.  There wasn't a time in our house when the the kids weren't jumping up and down on the furniture, the radio blasting, and her body swaying in rhythm.  Ironically, we were dancing when it happened.  It was her fortieth birthday.  The kids laughed and clapped as I dipped her dramatically and she sprung back into my arms.  And then she crumpled.  Tony, my youngest, giggled hysterically ...

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shutterstock_137226314 When teaching about life near dying, it is hard to achieve open conversation.  No matter what one says in a lecture hall or what brilliant writers publish on the terrible state of end-of-life care, change is painfully slow.  While we blame evasion by doctors of challenging conversations, failure by patients to plan or denial by families which blocks open communication, the ...

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shutterstock_118491940 From seeing elegant pictures of our brain and spine, to definitely characterizing masses in the liver and guiding management of orthopedic issues, MRI has an established role in the delivery of optimal care. MRI is an amazing tool that allows us to see inside our bodies and helps us get answers about a wide variety of medical conditions.  As a radiologist ...

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shutterstock_142825543 I thought more highly of business folks until I started working for them.  I thought CEOs and boards of directors of companies had a vision, whether to maximize shareholder profit, or to produce a stellar product or provide a singular service, etc.  Once the vision was elucidated, everyone worked together like a team to make it happen. Then I became employed by ...

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We all want to practice evidence-based medicine.  Yet that phrase is so overused that one must always question the true meaning underlying the use of the phrase. The first assumption that many make is that evidence is a solid structure without nuance.  Yet we can have different experts look at the same evidence and develop different conclusions!  Why else would we have competing guidelines. Consider this quote from Nietzsche: "There are no facts, ...

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shutterstock_104230859 For those of you who have been riding along with me on my journey for the past few years , you know that it has been one heck of a ride. What started out as a little blog to encourage other doctors who were struggling with burnout has exploded. In a good way. My blog came about because I was looking for a ...

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