shutterstock_93793456 Young children are naturally petulant, noisy, and self-centered. We’re all born with ourselves in the center of the universe, an impression reinforced by parents who must cater constantly to their young babies. But babies become toddlers, and toddlers become children. Sometime during this transition, parents have to teach their children that they are part of a family. For a family to function ...

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Yesterday I saw a 90-year old woman in consultation.  She presented to the emergency room in September with abdominal pain, and in the process of working her up, a chest x-ray was taken which showed an infiltrate in her lingula, part of the left lower lobe of her lung. As it turned out, there was nothing wrong with her belly, but a follow up CT scan of her chest showed this ...

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Being a single mother in medical school and residency isn't a piece of cake. But, being a single parent in this world isn't a piece of cake, either, and being a medical student and / or resident isn't a piece of cake. Foregoing medical school isn't necessarily the answer to any of that. Here is some general advice I will share with parents, single or otherwise, who are facing decisions about ...

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From the Economist in October 2012 was an article on physician assisted suicide.  In the United States, terminally ill patients can apply for permission to end their lives with the guidance of a doctor in Oregon and Washington state.  Several safeguards are in place to prevent this from becoming the default death pathway (only 0.2% of total Oregonian deaths).  Also, I had no idea that Holland, Switzerland, and Belgium allow assisted suicide ...

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shutterstock_103546670 american cancer societyGroundhog Day was on Saturday this year, and unlike the furry little beast, what I have to say each year around this time is just as good today as him looking for his shadow on Saturday. What is all this about, you are probably asking yourself? It is about an annual update that ...

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Locum tenens (literally "place holder") is professional work done to fill in where help is needed. It is what I have primarily been doing for the last year, and has been an interesting ride. When I decided to leave my practice related to losing a couple of partners and wanting to update my knowledge base and re-evaluate my career, I decided to do locum tenens work. I had always thought that ...

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shutterstock_120254749 As with any disease, prevalence of this narcotics abuse is region-specific; an hour north of the office where I practice, Rio Arriba County in New Mexico is home to one of the highest opioid overdose rates in America - up to five times higher than the national average.  Our patients routinely lose family to addictions; our clinic has been home to a ...

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Would it be silly to ask, “Is the history and physical examination worth performing anymore?” especially in this era of high-technology medicine? Does it matter if the diagnosis is made by the bedside in contrast to CT or echocardiography? Someone did ask, and the answer is intriguing and was debated. Let’s look at the data. Four hundred and forty-two consecutive patients were admitted from the emergency department to an ...

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Do you read the comic strip Dilbert” by Scott Adams?  I read it most every day.  It tells the story of an engineer named Dilbert and the people with whom he works, including notables such as Wally, Alice and the pointy-haired boss.  Mr. Adams daily relates amusing situations of the dysfunctional relations at Dilbert’s work site.  While the situations are hilarious at times, they reflect the actual work processes at ...

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There’s certainly a lot of buzz surrounding the word “holistic” in the field of medicine lately.  For the purposes of what I am talking about in this article, I assume that all, or at least most, doctors take a holistic approach to medicine.  Meaning that they can think across many of the body’s systems, understanding how one condition or component affects the others, and considering each aspect of a patient’s ...

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