When I first read about neurosyphilis in medical school, I became convinced that Mrs. Thatcher, who I detested intensely because it was fashionable detesting her, had general paralysis of the insane. The condition, marked by episodic bouts of temporary insanity, which indicated that the spirochetes were feasting on expensive real estate in the brain, seemed a plausible explanation why she had introduced the poll tax. A little bit of medical knowledge ...

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Following my latest article on health care information technology, and how tragic the situation has become for physicians, I received a lot of correspondence. As always with articles that express physicians’ frustrations with the current batch of IT systems, there’s typically a lot of sympathy and agreement (although I believe that just nodding our heads and saying how bad a situation is, doesn’t really mean that ...

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Recently, a young child died following days of vomiting. He had been in shallow water in a Texas dike about a week before his death. The story was picked up as an alleged case of a rare condition called dry drowning or secondary drowning. The media accounts went viral, spreading significant fear in parenting communities and among those learning about these alleged conditions from the news ...

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Everyone says that medical school gets better, especially third year. The traditional four-year curriculum covers basic science in the classroom for the first two years. Then suddenly, third year plunges us into clinical rotations in the hospital, where we’ve all dreamed of working for so long. Third year is when we transition from learning how to be scientists; we finally learn how to become doctors -- except for one critical, ...

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Physician-comedian Brad Nieder, MD on the first time he heard the word, "STAT!" See more at the Healthy Humorist.

Thinking outside the box is a somewhat cliché way to illustrate thinking beyond the norm and imagining what “could be” with an innovative mindset. This imagery of being stuck in a box rings true for many physicians, given how many of us are quite literally surrounded by the four white walls of an exam room most of our lives. Physicians work hard to treat each patient individually, but this feeling of ...

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This April, my turn to take the medical board exam rolled back around, necessary every ten years for maintenance of certification. I studied diligently for the better part of three months preceding the test (and I think I did well). It was actually pleasurable to go back over details that I had forgotten and to catch up on newer developments in the field. I realized that I don’t do nearly ...

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The patient in front of me is trying to die. Elderly and frail, he is lying in bed. His ribs outlined under the skin that should be smooth. His temples are concave where they should be flat. Both are an outward display of internal damage from his lung cancer. More striking than his cachexia are the strained muscles in his neck and his pursed-lip breathing. He is working hard for ...

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Attendees at the American Diabetes Association’s Scientific Sessions in San Diego this year — many of them young researchers who are active on social media — were surprised to be greeted with the following: “Thanks for joining us at #2017ADA! Photography isn’t allowed during presentations — we’d appreciate it if you’d delete this tweet.” For many, the essence of gathering at conferences is the sharing of scientific information, a peek at ...

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A few days ago, just after dawn, while I was out walking the dog, our home phone rang and my wife answered it. She's used to my pager, cell phone, and home phone ringing at all hours, and so she was not all that surprised when an unidentified voice said,"We're looking for the methadone dose for patient John Q. Smith." She told him I was out of the house at the moment, ...

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After life itself, it is said that God’s great gift is vision. 80 percent of what we learn is through vision. Babies are not born with perfect vision. They develop vision over time. A child who never developed good vision does not know what normal vision is -- he or she assumes that however they see is normal. There is nothing like the overwhelming emotion I have each time I ...

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I will walk into the hospital with a clean, ironed white coat buttoned to the top, dress shoes polished, a tie neatly knotted under my collar, my maroon stethoscope rearing to go -- and I will be largely unprepared for what lies ahead. Along with countless others across the country, I will begin my medical internship, a year considered by many to be the most important in a physician’s working ...

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I cried this morning. It wasn’t because of the patient who coded with a wide-complex tachycardia and died in front of me, and it wasn’t because of the patient who tried to spit on me for not giving her a prescription for narcotics. Nor was it my intoxicated 2 a.m. bar fight patient yelling at my other patients, including one whom I’d recently diagnosed with metastatic cancer. It was because ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. For many years, I've wanted to visit Cuba. When travel restrictions to Cuba were relaxed a few years ago, I hoped that I would get there before the first Burger King opened in Havana. I had my chance in May, as a member ...

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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Alleviating pain has been a primary focus of my career as a physician anesthesiologist. Just as there are physicians who specialize in treating conditions such as cancer, heart disease or allergies, there are specialists in treating pain. These physicians complete four years of ...

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An excerpt from The Three Stages of a Physician's Career: Navigating from Training to Beyond Retirement. The practical aspects of making a medical career transition can be divided into three phases or stages: waking up, taking stock, and taking the leap of faith. Note that this process is the same whether the physician is anticipating a transition out of ...

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At the 8th Annual Patient Experience Summit, Adrienne Boissy, MD, MA, Chief Experience Officer at Cleveland Clinic Health System, encouraged conference attendees to “dream bigger.” So here goes.  It’s time for you to invite patients to speak to promising young doctors during their time at your respective schools. You need to invite patients for regularly scheduled story sharing.  Don’t roll your eyes at me just yet.  It’s time to invest in ...

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There was more than one tooth missing, maybe three or four from what he could tell. He held one in his scraped hand as I searched for the others, not sure what I would do with them if I found them. My little sister’s bike laid on top of him, a paperweight on his frail frame. Blood pooled in his mouth and dripped onto his shirt when it ran out ...

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I see more and more patients decline to participate in clinical trials. Simultaneously, I hear patient advocates on the national stage clamoring for better trial access. Why the disconnect? Let’s explore 7 reasons why clinical trial participation is right for you: 1. The smartest minds in medicine designed this for you. Clinical trials are not designed by one doctor on the fly. Most oncology drugs have been studied for at least six years ...

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“Mr. Jones, how are you this morning?” I ask. A muffled, incoherent reply. “Are you in pain?” “No.” I perform a brief, perfunctory exam — it's unchanged from yesterday. I then glance at his breakfast tray on the bedside table — still untouched. The plastic mug is still full of watery, lukewarm coffee, the rubbery pancakes on the plate are still intact. This is at least the third morning that my patient — who ...

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