It's October, and I'm a second-year medical student. My best friend Carly and I have just finished a backpacking trip through South America. We fly out tomorrow from Lima, Peru, and we have just one thing left to do: eat shrimp ceviche, the classic South American dish of raw seafood marinated in lime or lemon juice, oil and spices. We wander along the busy streets until we find the restaurant our ...

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Being sick is a horrible enough time without having to worry about how much it’s going to cost you. Unfortunately, the United States is unique among developed nations in not ensuring that the populace has a safety net that will protect them against exorbitant personal health care expenses. It’s a terrible thing to have to deal with as a physician. I went to medical school to learn how to take ...

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“Life is just a short walk from the cradle to the grave, and it sure behooves us to be kind to one another along the way.” - Alice Childress, American playwright, actor, author (1912-1994) I am awakened in the wee hours by the sound of rain.  Ordinarily I would return to bed in hope of stealing more sleep from night, but this particular day I know I have to rise at 4:30 ...

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About three years ago, our hospital was abuzz about patient satisfaction. Our HCAHPS scores were lower than expected, and there was a push by the administration to improve them. As a hospitalist, I wondered to myself, what could I possibly do to improve them?  I already believed I was doing a very good job communicating effectively with patients. Many years ago, I developed the habit at the end of each encounter ...

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Much of the discussion surrounding the presidential election this year focused on fake news.  There were countless stories in newspapers and on television news shows about these obviously biased and fictitious posts that might have affected the outcome of the election. I could not help thinking during this campaign season that if you think fake news is bad for politics, you should try being a physician. As physicians, we are on the ...

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While having coffee the other day, I came across a video called The Thank You Project. Watch it. I assure you, it’s worth 5 minutes of your time. In 2004, Kellie Haddock, her husband, and their 14-week-old son were involved in a horrible car accident. Her husband was killed on impact, and their son was severely injured.  In her heartbreaking tale, she recounts the roller coaster ride she endured ...

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Halfway through the “Bell Curve,” which is an analysis of differences in intelligence between races, I realized what had been bothering me about Charles Murray’s thesis. It wasn’t the accuracy of his analysis, which concerned me too. It was what he analyzed. The truth, I used to believe, was always beautiful, whether it was what happened in the multiverse at T equals zero or the historical counterfactual if ...

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An excerpt from Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine. Mark Linzer’s research identified workplace chaos as one of the key predictors of physician stress, burnout, and intention to ...

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A before and after study at the University of Vermont Medical Center found that a 24-item operating room checklist did not significantly reduce the incidence of any of nine postoperative adverse outcomes. More than 12,000 cases were studied, and outcomes included: mortality, death among surgical inpatients with serious treatable complications, sepsis, respiratory failure, wound dehiscence, postoperative venous thromboembolic events (VTE), postoperative hemorrhage or hematoma, transfusion reaction and retained ...

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Seconds after I arrive at the ER on a Sunday afternoon, I'm called to see an elderly woman who can't breathe. She's ninety-four, and gurgling for air. On my way, I pass two middle-aged women. They are hovering outside a nearby room, trying to get my attention. One gestures like a traffic guard as she tries to wave me into the room. The other throws up her hands as I ...

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