Back in the 1990’s, my husband and I spent a year working at one of the largest hospitals in West Virginia.  The patients were the nicest people in the world, and the hospital staff was terrific—kind, generous, and hard working.  Some of the surgeons were excellent, but others definitely were not.   My husband (a cardiac anesthesiologist) and I had to cope with surgical complications the likes of which we had ...

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You would think that for doctors, who work with life and death issues every day, the issues of our own frailties or the tenuous line between health and sickness for our own families would be, if not accentuated, then at least more immediate than to those who, say, do investment banking for a living. But the strange thing is that despite our easy familiarity with human mortality, it is not ...

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It’s unclear how many non-legal persons actually understand how different civil trials are from criminal proceedings.  Most people have heard that juries in criminal trials are told that they can only find a defendant guilty if their belief that the defendant is guilty is beyond a reasonable doubt. Federal courts define this term further as, “proof of such a convincing character that a reasonable person would not hesitate to act ...

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A recent article in the Wall Street Journal is getting a lot of attention: More Doctors 'Fire' Vaccine Refusers. The article discussing the increasing frequency of pediatricians who are “firing” patients/families from their practices because they refuse to take recommended vaccines for fear of autism or other concerns (rampant on the internet, but all proven untrue). It is important to note that not only should physicians be able to fire patients, ...

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The analogy between baseball hierarchy and medical systemsFrom age six through high school, I played baseball. Playing baseball ended, rather abruptly it seemed, when I went to college, but the lure of the game has always remained. To my colleagues, it must seem that I can hardly understand the world without the comfort of baseball analogies. I was thrilled when my son Ryan, age 12, saw the ...

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Lately, I get the feeling that I’m doing something wrong.  I’m supposed to form a partnership with my patients.  My patients are supposed to be the working partner and I’m supposed to be the consulting partner. My job as the consulting partner is to offer sagely medical advice to the boss (working partner).  As a consultant, I’m supposed to help in the making of key decisions, find the appropriate tools to ...

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There was nothing the professor despised more then the syrup that oozed out of his partner's lips when dealing with patients. He often cringed as he walked by the examining room and imagined the hand holding that was taking place behind closed doors. Privately, they argued about the different approaches. One saw the world in terms of black and white, while the other was steeped in a foggy haze of gray. ...

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I have tried to write a letter of thanks but don't know what to say or even how to begin. I don't know the persons I am writing to, but part of their loved one is literally now a part of me. It began with a phone call from my brother. "Jim, what the hell is Fuchs' Dystrophy anyway - do you have it too?" I racked my brain and tried to ...

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Peggy was in her early 70s and suffered from a terrible lung disease known as pulmonary hypertension. So bad in fact, that she had a pump infusing a medicine under her skin 24 hours a day to keep the blood supply to her lungs open. Once started, this medicine, treprostinil, was known to improve life in those with pulmonary hypertension. Unfortunately, like all continuous infusion medicines of this type, it ...

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I was jogging one day while on a business trip in LA and collapsed during the run.  Within hours, I was at the hospital at UCLA Medical Center on a gurney headed for a CT scan of my abdominal cavity.  I remember telling the ER physicians that I was a doctor and recommending my own course of action.  As my advice to the ER doctors went largely ignored, I realized, ...

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