“OK, it is time to move on,” my professor claps his hands together and yells above the chatter.  We all look up from our Netter’s anatomy books and our cadavers.  The smell of formaldehyde burns my nose as the fluorescent lights flicker above. “We have explored the chest cavity and the abdominal cavity.  It is now time to move onto the extremities, starting with the arms.  I want you to unwrap ...

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"I like good strong words that mean something." - Louisa May Alcott My resident and I are removing a large, recurrent cancer from the neck. Dense scar tissue is everywhere from prior surgery and radiation therapy. The going is slow. Each move is arduous, and bleeding obscures the view of the anatomy. “Watch out,” I tell her. “The jugular vein is nearby, probably buried in that scar.” “Yeah,” she responds. “Look at this nerve! ...

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Hardly a week goes by without hearing about another case of police brutality. Many times, seemingly unnecessarily lethal force has been used, and these incidents have sparked protests across America. Each case is unique with differentiating circumstances, but the result is all too often — death. Many people have grouped these incidents together concluding that white officers have unnecessarily killed black men. This has initiated and reinforced mistrust of the ...

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I drive a fast car. Which if you know me, is quite uncharacteristic. I would say that it is one the few possessions that generally doesn't reflect upon who I am. How I chose this car, the make, and model, are a long story not to be discussed here. But let's just say that it has quite a kick. These thoughts jostled through my mind this morning as I pulled into ...

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With the ruination of American teaching using “value-based” purchasing and payment concepts virtually complete, the U.S. government is now training its sights on medicine with similar intentions. With the new MACRA pay-for-performance program, CMS bureaucrats believe they can force health care providers to practice better “quality” care by collecting clinical performance, practice-related, and cost data, and basing payment increases and penalties on the results. There is one big problem associated with ...

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An excerpt from Confessions of an American Doctor: A true story of greed, ego and loss of ethics. The Medical Board of California attorney, Mr. Arnold, proceeded to read the discussion I had with the undercover agent regarding the source of the human growth hormone, including the ...

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For many centuries medical practice was a black art. What physicians did was based upon theories of how the body worked that turned out to be fanciful at best, dangerous at worst. The late nineteenth century brought breakthroughs in the biological sciences, such as the identification of bacteria and new understandings of physiology, which increasingly placed medical practice on a scientific basis. That process has continued over the past 150 years, ...

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Now, I’m just a country doctor, but I have to say I find it very hard to understand why folks in this country, on one hand, keep talking about a doctor shortage in primary care and, on the other hand, keep piling sillywork on those of us who are still here. The net effect is that the doctor shortage is going to be a whole lot worse than it has to ...

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My friend and neighbor died last week.  In his early eighties, wiry, opinionated, well-read, he never tolerated schooling. He built an excavating business with a perfected aesthetic for contouring soil and also built a few homes in town including mine.  When he saw the architect’s lower pitched roof framed on the garage, he had it torn off because: “It just wasn’t right. It looks like a tiny bowler hat on ...

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I have lived for some time with depression. Most of the time, it is nagging in the background, helped by exercise, family and friends. But a few times, despite my best efforts, it has gotten out of control. At the middle of my chief year in November, it came to a head. I was under tremendous pressure to apply for fellowship when I didn’t think it was what was best for ...

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