Start with one excellent childhood experience -- a loved one who is cured. Add a generous helping of baseline optimism, a cup at least.  More is better. Mix in well a half cup of ability to suspend disbelief.  And then, maybe a pinch more. Add a teaspoon or two or even three of denial.  Pollyanna had it right. Remember to include an ounce of prevention -- Worth a pound of cure, so they say.  Suspend ...

Read more...

Recently, a patient of mine died of cancer, whom I loved very much.  She had a special way of enjoying life; a half, wise smile that after our many years together did not take me too seriously and reflected her deep inner strength.  She taught me about joy; I will miss her always.  Her husband, understanding my loss, said that it was alright, that I had done my best, that he ...

Read more...

asco-logo As an oncologist who also specializes in sexual health, I have realized just how essential it can be. I have seen many grapple with the consequences of cancer and its treatment on their own sexual view of themselves (their sexual self-schema) and how it can impact the relationship between partners. For some, the experience draws them closer; for ...

Read more...

As many who are pediatricians or know pediatricians are aware, the quest to end gun violence is a passion for our profession and an advocacy issue of utmost importance for our professional organization, the American Academy of Pediatrics (AAP). Having practiced in areas with a high incidence of gun violence for most of my career until recently moving to California, I have seen first-hand how this tragic issue affects the ...

Read more...

“I should be home well before nine o’clock,” I said to my wife on the phone as I steered my eight-cylinder SUV quietly down the highway at 75 mph with more than 100 miles left to go. “More like eight fifty-five,” I added. “That’s well before nine?” She sounded both weary and incredulous. I knew what she meant. I am not as obsessive about time as I used to be, but even ...

Read more...

At our last visit, she asked me "not to forget us" and gave me a photograph of her family. She included a picture of her daughter, whom I had never met. I had missed her by four years almost to the day because she was shot and killed driving through her neighborhood in the middle of the afternoon. I first met Mrs. P early in my training as a physician in ...

Read more...

A couple of weeks ago I visited the island of Cyprus with family. Having seen a lot of mainland Europe over the last several years, I was keen for something a bit off the beaten track and away from a major city. We thought about a few possible destinations, but opted in the end for Cyprus (partly because of the desperate need for some warmer weather). Booking the trip quite rapidly, ...

Read more...

I’m pulling on my last elbow’s displaced wrist when a nurse pops in, and tells us a critical patient is two minutes away. “Mind staying?” my colleague asks. “Sure.” Paramedics are hunched over the patient as she is wheeled quickly into the resuscitation bay. At the top of the bed, a mask is secured over her mouth and oxygen is pumped with loosely gloved hands. It isn't helping -- her skin is grey -- like ...

Read more...

After four brutal years of medical school, my colleagues and I finally obtained our medical degrees. As graduation approached, I couldn’t help but reflect on the whole experience, but when I tried discussing the matter with my friends, I discovered that we all had difficulty articulating the precise concoction of emotions we were feeling. Most simply summed up the feeling as “weird.” On graduation eve, however, I found myself in ...

Read more...

As an American medical student doing an elective in Thailand, I was initially troubled when I saw how Thai patients were treated. I'm not speaking of the way Thai physicians apply medical science, mind you -- they rely on UpToDate and sundry U.S. guidelines just as we do -- but that was mostly where the similarities ended. Morning rounds with the team of residents (sans attending, but apparently there was one ...

Read more...

I like to read. I always have, and I’m sure I always will. I read almost everything that I come across. I often find myself reading the articles on this site. Some I agree with and some I don’t, but I like that part of the site too. I read, and I learn and I’m informed, and I gain knowledge, but then something always seems to happen. I always wind ...

Read more...

In medical school, you learn very quickly that you can’t know everything. By the end of your first-year anatomy course, you’ll probably give up on learning the names of every part of the body, let alone the intricacies of how they function. As physicians, we must grow comfortable with our limitations. We seek help from our colleagues and try not to let our egos get in the way of patient ...

Read more...

Recently I attended the funeral of a prominent gastroenterologist in my community whom I knew socially as the father of my son’s friend. It was an untimely and rapid death due to pancreatic cancer. He left behind a young wife and four children, two of whom are in college. I would see him periodically at school functions; he would sneak into an event at the last minute and often struggle ...

Read more...

For many people in medical training, one period of time that they look forward to is the elective period. Most of the time, these periods are available for people to explore potential career opportunities, whether it is a certain subspecialty or a research opportunity. Usually, people are not on call and weekends are free, luxuries that are often sparse during the rigors of medical training. Most of the time, one ...

Read more...

Dad had taken a turn for the worse, but my family was not ready to give up on him and consider end-of-life care. Nevertheless, choices had to be made. Would Dad be allowed to pass while in assisted living or have his life prolonged in a skilled-nursing facility? What kind of a doctor am I? When perceiving that a patient is dying, what type of physician neglects to intervene and ...

Read more...

A couple of years ago, “epic fail” was the phrase my teenage son used as I unsuccessfully attempted to beat him in a game we were playing. At the time, I thought to myself it was a harsh but accurate assessment of my performance. And I was certainly motivated to practice on my own so that the next time, things would be different. That same phrase came to mind as I ...

Read more...

I had the pleasure of addressing the AMA Medical Student Section today in a keynote.   As I told them: To make a difference, you need to start with passion.  There was no shortage of that from what I saw during the morning assembly. Here is a short interview I did on Periscope shortly after the keynote.  Enjoy.

In early 2014 I decided to use the six state licenses I had obtained as a locum tenens physician to start practicing telemedicine. Since then I have worked with several telemedicine platforms. I use telemedicine to keep up my outpatient skills. I have found that telemedicine companies differ dramatically in their overall ease of use for the provider. Here are my top 7 tips for deciding which telemedicine company to work ...

Read more...

Many stories have been shared by physicians detailing their experiences during their years as house officers. I trained at an inner city hospital in the early 1970s, and my story was unique. Hospital J was built in the early part of the twentieth century. The structure was nine stories tall, with the ICU, the only air conditioned floor, located at the top. The elevators had not been automated and were still ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 54-year-old man is evaluated because of fatigue. He also notes constipation and cold intolerance. Medical history is significant for tonsillar squamous cell carcinoma treated with radiation 3 years ago. There is no family history of thyroid disorders. On physical examination, the skin is dry. Mild periorbital edema is present. The thyroid ...

Read more...

Most Popular