The other day some cardiologists on Twitter were discussing whether a patient should be blamed if a permanent pacemaker lead became displaced. The consensus seemed to be that it was probably poor placement (i.e., operator error), rather than patient behavior that caused leads to dislodge. The discussion reminded me of an attending plastic surgeon of mine during my resident days. He was one of the most obsessive-compulsive people I ever met. ...

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Over the course of pre-professional and professional education, my colleagues and I have had numerous moments of self-doubt.  Would the next organic chemistry exam eliminate my 3.99 GPA?  Would the MCAT decide what medical schools would immediately ignore me without ever meeting me?  Would the sheer volume of material weed out the persons sitting next to me in medical school or would it weed me out instead?  Would being yelled ...

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Medicine is obsessed with numbers.  Or rather, journalists and medical administrators are.  Here are two related examples of how large a grain of salt one must put on numbers. Cardiac surgical procedures, like everything else in medicine, have quality indicators.  One of these is what we doctors call “30-day mortality.”  What this term means is that surgeons are evaluated in part on how many of the patients they operated on died ...

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Question: My family (including two small children) and I are relocating this summer for my husband’s new job after seven years of living in the same area for residency and fellowship to a city where I know no one. I am scared about leaving our support network of friends and family nearby. Can you offer advice on starting over in a new place? Answer: I would guess that almost every physician family has ...

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An iconoclast must not only have abundant common sense but the gift of the gab to state the obvious. Simply stating won’t do. You must rub it in.

My favorite iconoclasts are Peter Skrabanek and Thomas Szasz. Skrabanek was a general practitioner who authored Death of Humane Medicine and Rise of Coercive Healthism. Szasz, a psychiatrist, who volunteered that he entered psychiatry to unveil its pseudoscience, is the Voldermort ...

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As a fellow in cardiology, you sign up to be part of a specialty that can involve emergencies. As a first-year fellow, usually you are running things by other senior fellows and attendings, and typically you are not the first person to make a decision on a plan. At times, though, there can be an exception to that rule, and it is an exception that can make you realize that there ...

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Eonia I Mnimi (Eternal Memory)  - Greek Orthodox Funeral Blessing “Have you ever seen anyone die before?” my cousin asked me, from across the bed. “Sure I have, plenty of times,” I answered. We were flanking her father, my uncle (really, my mother’s cousin, but extended Greek families are complicated; suffice it to say that our families are very close). He had just taken his last breath. *** My uncle had been declining for several years with 
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When he and I first met, he told me that he had a doctoral degree in psychology, was the CEO of the jail, and could speak 13 languages. To demonstrate, he said, “Hong tong ching chong lai tai!” He then punched the door to his cell and shouted, “GET THE F-CK OUT OF HERE, B-TCH!” I did. The next week, he answered my questions about the pencil drawings on his walls. “My name ...

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Ever heard of a doula? Doula is an ancient Greek word that translates as “woman who serves.” Specifically, it’s come to mean someone who serves as a birth attendant, a person trained in childbirth who acts in support of a birthing mother. A doula provides knowledge, comfort, and an extra pair of hands -- whether it’s to provide nourishment or massage, or help a mother find a comfortable position. As you may ...

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shutterstock_263182502 Being a nurse is one of the most important jobs in any society. It is also one of the most respected. Public opinion polls consistently rank nurses as the most trusted profession -- usually ranking well above physicians. And it’s for good reason. Patients in hospital may forget who their doctor is, but they will rarely forget their nurse. The doctor ...

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