Neither of the two most important people in Aaron's life could stand to be in the same room with each other.  There was a long colorful history between his ex-wife and his brother, and as his disease began to accelerate, the feuding became quite intense.  They argued over Aaron's advance directives.  They both tried to coerce and manipulate themselves into commanding positions.  The shouting became louder, the fury more fierce.  ...

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Short-of-breath, weak, in pain.  Cancer -- aggressive, cold, unfair -- ravaged Roger’s body.  But maybe, just perhaps, there was a modern medical miracle.  A drug.  A single daily pill to attack the genetic growth switch in each malignant cell.  Only, there was a problem.  Not a big problem, really, but possibly fatal.  The kind of real life annoyance of living in a modern medical miracle society.  The co-pay cost to ...

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With the endless appearance of medical malpractice solutions in the press, any reader would think we have the answers to the logjam -- but no will to implement them.  If you follow the topic, you know every proposal has flaws and limited applications as they relate to individual states or delivery systems. The worst offender seems to be safe harbor protections (i.e., “follow the guidelines and you won’t get sued”). Recently, however, I ...

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When we perceive any object of a familiar kind, much of what appears subjectively to be immediately given is really derived from past experience. - Bertrand Russell, The Analysis of Mind I’ve learned a few more things about Stephen Pasceri, the man who murdered a cardiovascular surgeon in Boston recently.  He had money troubles involving credit card debt.   He declared bankruptcy at one point.  He tried to get John Kerry, the senator, ...

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Whenever I am asked this question, I can't help but think of the punchline to a joke that was once supposed to be funny but would now be considered beyond the pale in all respects, so I won't repeat it. The punch line is: “Just lucky, I guess.” That's the short answer to why we gastroenterologists work in our field. Despite the distasteful aspect of human waste and the perverse ...

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I felt out of place. It wasn’t the dull yellow flickering fluorescence of the hospital lights greeting me well before dawn. It wasn’t the photos of world-renowned surgeons lining the hallways as if monitoring my every step, or that some of those same surgeons were close by rounding on patients. It wasn’t the sea of dark suits swarming around me vying for a prestigious residency position. It was something far ...

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My mother is a very smart woman.  I see it in the way she solves problems, creates complex crafts, and navigates hard conversations. She can't, however, add fractions. She was never very good at math, she says. "I was never very good at math" is a dirty phrase that garners much attention in my household.  My husband, a sixth-grade math intervention teacher, spends just over 170 days each year attempting to ...

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As physician burnout becomes more widespread, it’s time to think about the future. Do you have people asking you if you would be a doctor again? Not a week goes by without me being asked by either a medical student or a practicing physician: Do you recommend medicine to others? Or is physician burnout too rampant, too overwhelming, too all-consuming? That’s one of those super loaded questions. And it doesn’t have an easy answer. Here’s ...

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In the midst of seeing a patient, I got a call from another physician, my dad's new cardiologist. "Looks like he is going to need CABG (open heart surgery) since he has four major blockages." I was expecting this call, and this result, based on his history of diabetes and at least one month of chest pain. It was still shocking to hear. I walked back into the exam to continue the ...

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Self-Portrait-with-Dr

I recently went to Boston to see the Goya exhibit at the Boston Museum of Fine Arts and was thrilled to see one of my favorite paintings by this artist: Self Portrait with Dr. Arrias. The painting was on loan from the Minneapolis Institute of Arts -- a ...

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