May is a recent divorcee in her early sixties. She was working out at the gym when she began to feel queasy and lightheaded. She awoke in the back of an ambulance, and soon, she was in an ER getting blood drawn. “We need to make sure you don’t have a heart attack,” she was told. As the day went on, May underwent test after test to “rule out” ...

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Over the past few years, I have realized that I have come to resent the word "just."  Certainly not in the civil sense of the word: social justice is the driving force behind virtually all the work I do these days.  I am talking about using "just" as a qualifier.  As in, "Oh, I'm just the medical student," or, "He's just a nurse."  We use it blatantly as an offense ...

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When I think of Big Joe, I see his overalls, and how he filled them. And how a couple of months after I operated on him, there was room for both of us in there. Big Joe: farmer, salt of the earth, tough, stoic. On the day I met him, if it'd been Halloween, I might have tried to stick a candle in him. That's how orange he was. My ...

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Dear hospitalists, This is just a note to say that we, in emergency medicine, appreciate you.  Like all of us, you are stuck in an endless loop of unending residency.  Don’t worry, it isn’t an episode of The Twilight Zone.  It’s just your life.  No, it’s our life! As specialty after specialty withdraws from the practice of medicine, you, and all of us, ...

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The best clinicians I have worked typically speak enthusiastically of how much they learn from their patients. Perhaps because it is (happily) not a daily event, or perhaps because it is so much more personal, clinicians do not talk much about what they have learned from being a patient themselves. The other end of the stethoscope is a good place to learn about medical care. During the diagnostic phase of my ...

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You have to forgive me, it's not me, it's my mind, it's very slow, and I have to pin everything down. -Lieutenant Columbo With his rumpled raincoat, ever-present cigar, bumbling demeanor and Sherlock Holmesian powers of deduction, disarmingly polite homicide detective Lieutenant Columbo took on some of the most cunning murderers in Los Angeles  most of whom made one ...

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Two weeks before the Newtown, Conn, shooting I was at my doctor's office for an annual physical exam answering questions on an intake survey. Questions like "Do you smoke? How much?" and " Do you wear the seat beat?" And then one question stuck out: "Do you have any firearms in the house? Are they stored in a locked area?" What business ...

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Skill to do comes of doing. -Ralph Waldo Emerson We are in the last steps of getting surgery arranged; the counseling is complete and the consent is on the clipboard. Just as the patient is putting pen to paper, she asks, “When I’m asleep, you’re not going to let some trainee practice on me, are you? I mean, I wouldn’t let the brand ...

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Here in the Boston area, we’ve all been shaken by the news that a known sexual offender raped and molested children for years at a daycare just north of the city—even babies. It’s beyond horrible. For those with a child in daycare, this story is especially terrifying. You can’t help thinking: could this happen to my child? Ultimately, the sad truth is that we can’t always stop these things ...

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A recent editorial in the New York Times about non-physician health care providers or NPPs, has drawn more than 260 comments.  Who are these NPPs and why do so many people care about them? Historically, nurses have a long history of stepping in when there are gaps.  For example, in the early 1900s anesthesia was given by med students and interns and everybody was unhappy, until nurses started doing it full-time, ...

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