Imagine driving through an unfamiliar area, and there are no street signs. How would you feel? Frustrated? Scared? Angry? You would feel these emotions because you had no direction or guidance. Patients need direction when they enter the health care system. Signposting is a tool to provide direction. On the streets, there are posts that have signs. They provide direction; they tell us where we are going. Hence, the name, “signposting.” ...

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This article was originally presented as student remarks at the 2015 Harvard Medical School commencement.  At the end of medical school, I always return to a musing, a zen koan of sorts from Dean Jeffrey Flier. At my white coat ceremony, a close friend and current resident, Dr. Nina Gold was chatting with the dean about the heft of our newly bestowed bright white coats. He asked her, in one beautiful ...

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Being a health care provider has always come with personal risk. We care for all patients, which includes patients agitated due to psychiatric issues, dementia, acute medical illness, alcohol or drug intoxication or just anger. Patients can be extremely volatile and lash out unexpectedly causing physical injury to their doctor, nurse or another provider. Besides the physical risk, patients can be emotionally and verbally abusive as well- and both types ...

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For American conservatives, Britain’s NHS is an antiquated Orwellian dystopia. For Brits, even those who don’t love the NHS, American conservatives are better suited to spaghetti westerns, such as Fistful of Dollars, than reality. The twain are unlikely to meet after the recent press surrounding Charlie Gard, the infant, now deceased, with a rare, fatal mitochondrial disorder in which mitochondrial DNA is depleted — mitochondrial depletion disorder (MDD). In this condition, ...

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“You’re a doctor; focus on being a doctor.” This piece of advice was recently given to me by my own father, in regards to my multiple ambitions outside of the medical field. He himself only recently retired from a long career as a surgeon, so his opinion is the result of years of experience. His advice got me thinking. What makes for career longevity in our field? Statistics show that more than half ...

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More than anything, Willie needed a place to pee. Elaine needed help walking. Willie is homeless; Elaine is affluent.  They both needed someone to listen to them and help them find solutions to their most pressing everyday challenges.  That’s called “co-production of care.” When Willie found out he had congestive heart failure, his doctor put him on beta blockers with diuretics. The medications made Willie feel better, but there was one problem:  Because of ...

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In the early epoch of human development, mankind learned to shape and sharpen wood, stone and metal objects to facilitate plunging them deep into other humans’ chests, abdomens, skulls and eyes in the ultimate form of conflict resolution. Over tens of thousands of years, other less pugilistic and more compassionate humans crudely — but later artfully — insinuated an increasingly sophisticated array of implements into the human corpus to cure diseases, ...

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Part of a series. Can we slow the aging process? The answer is a definite yes. It’s not easy and requires some real diligence, but aging can be slowed. When thinking about a car we all know “old parts were out.” It is equally true for the human body. But less appreciated is the fact that we can either slow or speed up the process, just as good preventive ...

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A study published in JAMA looking at the brains of former football players donated to a brain bank, a highly selective sample, found signs of chronic traumatic encephalopathy (CTE) — a degenerative neurological disease — in nearly all deceased players examined. The mainstream media converged towards numerical consensus.

One of the most difficult situations for a parent is one in which your child is sick. To be in a situation where you cannot control how the child responds to interventions is very challenging. Under normal circumstances, you follow your normal daily routine: up in the morning, breakfast, get dressed, off to school or daycare or activities for the day, a nap in the afternoon, pick up from school ...

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Tele-empathy is not being empathetic over the phone. It is not crying in the sad parts of your favorite TV show. It is not beaming empathetic thoughts magically across time and space. No, tele-empathy is a technology. I should rather say, it's a group of technologies recently being created to increase the empathy of health care providers. "This is rich," you might say coming from an industry that brought us ...

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I've known that I've had tumors in my pancreas since 2009. Until now I've done nothing about them. This might sound like a counter-intuitive, even foolhardy strategy, especially for an oncologist, who should surely know better than to let his disease gain an advantage through his own inaction. But I don't have the "usual" type of pancreatic cancer, the kind that claimed the life of Patrick Swayze and has sentenced many ...

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Cold, sterile and well … clinical. Three words that neatly describe hospitals as many of us know them. In books, on TV and in movies, we see and experience hospitals as impersonal, solemn and sterile institutions — designed only to treat disease. Interestingly enough, while our society has begun shifting away from thinking of health as just the treatment of disease, our hospitals fail to reflect these changes. This is particularly ...

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Patient psychology is increasingly recognized as an important contributor to health outcomes. What patients believe about their health and their providers can significantly affect their initiative and their adherence. It is important to recognize that factors that appear to be unrelated to medical care can influence feelings about that care, as well as outcomes. The reason this occurs is that the brain is not designed to parse out each element of ...

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It’s a scenario that every doctor is familiar with. You are having a busy day and working full steam to get everyone better. You suddenly receive that unexpected message: “Mr. Johnson and his family are very upset and would like to speak with you now.” Most of the time, any physician’s initial reaction will be one of irritation, disappointment or frustration: “My goodness, I’m working so hard here, and we have ...

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On our first night in Dublin, my mother and I head straight to a pub. We sit at a table across the room from a cheerful woman who looks to be in her eighties. It doesn’t take her long to walk across the room and join us. She grasps her pint of beer and takes a long gulp. We learn that her name is Mary and she welcomes us with ...

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Approximately 18 months ago, I was asked to serve as the surgical director for operating room (OR) services at our children’s hospital. The opportunity has been an eye-opening experience in understanding how a hospital functions. ORs are like the economic engine room in a large ocean-going vessel. Without them functioning optimally, the boat stops moving, and is batted about by of waves economic disruption. If surgical admissions drop below a certain ...

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More and more health care practitioners are turning to social media for their medical education. Fellows are learning ultrasound from Snapchat, nurses are learning how to insert NG tubes from watching YouTube, and learners are learning pathophysiology from blogs and podcasts. To reach this audience with credible and reliable content, it is important for medical educators to be present where the learners are, and that means social media. Users are also ...

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Doctors see firsthand the toll that today’s increasingly stressful society takes on patients: Engineers, office managers, teachers, you name it. Work demands have increased, as has multitasking. Pressures outside the workplace add additional stress. Often, parents chauffeuring children to multiple activities must also care for aging parents with increasing needs. Electronic devices, always in hand or close by, command our attention (due to work or personal needs, sometimes simultaneously). Finding a ...

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As Sen. Bernie Sanders prepares to introduce a universal health care bill in the next few weeks, many progressives who support a universal single-payer program worry about its effects on abortion access. Can we win Medicare-for-all while protecting hard-won reproductive rights? As a woman of color, a reproductive rights advocate, and graduate student of public health, I recognize the importance for marginalized groups to stand in solidarity for ...

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