Halfway through the “Bell Curve,” which is an analysis of differences in intelligence between races, I realized what had been bothering me about Charles Murray’s thesis. It wasn’t the accuracy of his analysis, which concerned me too. It was what he analyzed. The truth, I used to believe, was always beautiful, whether it was what happened in the multiverse at T equals zero or the historical counterfactual if ...

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You submitted your application in July. You completed all of your secondary essays by mid-September. Other than one interview that resulted in a waitlist decision you’ve heard nothing but radio silence. What can you do? Whenever I work with medical school applicants I emphasize that the application process is ongoing because the admissions process is fluid. It is not as if you submit your primary application and secondary essays and the ...

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“And then he said, ‘I … I just want to help people you know?’” The table burst out laughing. I struggled not to spit out my breakfast burrito while chuckling. The laughter slowly died down, and I took another gulp of stale hospital coffee. My classmate was recounting the story of one of the pre-med undergraduates he had begun to mentor. I was too tired to think clearly about why ...

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Chapter 1: Physiology “I am a brain, Watson. The rest of me is a mere appendix.” - Sir Arthur Conan Doyle Bound by flesh and bone, therein lies a mystery of undefined potential which the cosmos cannot even parallel in mystery and in complexity beautiful and terrifying. It is that which allows movement to leave the study hall beneath the starry sky, professors to lull us to sonorous sweet slumber, to remember minute ...

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An excerpt from Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine. Mark Linzer’s research identified workplace chaos as one of the key predictors of physician stress, burnout, and intention to ...

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A before and after study at the University of Vermont Medical Center found that a 24-item operating room checklist did not significantly reduce the incidence of any of nine postoperative adverse outcomes. More than 12,000 cases were studied, and outcomes included: mortality, death among surgical inpatients with serious treatable complications, sepsis, respiratory failure, wound dehiscence, postoperative venous thromboembolic events (VTE), postoperative hemorrhage or hematoma, transfusion reaction and retained ...

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Seconds after I arrive at the ER on a Sunday afternoon, I'm called to see an elderly woman who can't breathe. She's ninety-four, and gurgling for air. On my way, I pass two middle-aged women. They are hovering outside a nearby room, trying to get my attention. One gestures like a traffic guard as she tries to wave me into the room. The other throws up her hands as I ...

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  Since finishing my residency several years ago, I’ve worked in almost every type of hospital up and down the East Coast, from big urban academic medical centers to more rural community outposts. Although I primarily practice hospital medicine, working with both smaller private groups and being a hospital employee, I empathize a lot with my independent practice colleagues and brethren. I almost certainly would have gone down the route of ...

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Running has been a constant in my life, and it always will be. I’ve gone on runs in snowstorms and 100-plus degree heat waves, Christmas mornings and birthdays. That hour or so dedicated to running is sacred, reserved for a few minutes to clear my head, a sort of reset button to each day. I’m surrounded by nothing but the sound of shoes hitting the pavement and gasps of heavy ...

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Dear Mrs. J, I would like to express my deepest condolences on the passing of your mother. She was a magnificent woman, and I had the pleasure of being her doctor for almost a decade. It was a pleasure. During our short visits, she regaled me with stories of childhood and often gently sprinkled in advice gleaned from years of experience. Even as she began to decline, we would sit together ...

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Robert Kennedy, Jr. is an activist, author, and attorney specializing in environmental law.  He is the son of Robert "Bobby" Kennedy, a former U.S. attorney general, and the nephew of former President John F. Kennedy.  Kennedy is president of the board of Waterkeeper Alliance, a non-profit focused on protecting and enhancing waterways worldwide.  He has written a book about the damaging effects of vaccinations due to thimerosal, and to round ...

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This post is based on a "friend of a friend" situation. Important details have been changed to protect anonymity, but not the basic realities I want to discuss. A 49-year old man was diagnosed with a rare form of lung cancer about a year and a half ago. This sad situation is compounded by the fact that he was in a stable marriage with a wife and two children, ages 10 ...

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I was incredibly nervous going into my first day in the inpatient child/adolescent psychiatry unit. “Was this where the truly psychotic kids are? Am I going to be safe here?” I wondered as I casually introduced myself to the staff on the floor. After a morning of sitting in on group therapy led by psychologists and occupational therapists, I calmed down. Against the backdrop of the soothing soft pastel colors, ...

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Recently, the U.S. Senate passed the 21st Century Cures bill with an overwhelming vote of 95-4 and was approved by President Obama. Yet, the controversy continues. Some people worry that this act is destroying our scientific process and sacrificing patient safety issues. Others proclaim that this is a win for the big pharmaceutical companies, who are already winning by a landslide. And then, there are the voices shouting out with ...

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My daughter's biggest fear before starting kindergarten was would she have enough time to finish her lunch in the time allotted. Luckily, she is not a busy medical oncologist in clinic. A medical clinic is not set up for those who take their time. Modern medicine is predicated that within a fifteen-minute visit, you are expected to see the patient, address their issues, place orders, and come up with a ...

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Anyone who knows me, knows I have long been skeptical of the safety of pubic hair removal. We evolved to have pubic hair, and we have no data to say that we have outgrown that need as we have wisdom teeth. The current thinking is that pubic hair plays a role in protecting the more delicate/sensitive tissues of the labia and the vaginal opening. Basically, pubic hair is a mechanical ...

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“I mean, ever since it happened, I just don’t feel safe anymore … they come out of nowhere … my heart will be pounding and pounding … they can get me at night, even if I’m in my mom’s house. I haven’t worked this whole month, and don’t know how I’ll go back.” Ms. Smith is a young white woman who is presenting with panic attacks. “Doctor, the pain is so bad ...

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Republicans have been waiting a long time for this moment. After sixty previous attempts to repeal the Affordable Care Act, commonly known as Obamacare, their moment has arrived. President-elect Trump and Speaker Ryan believe that they can repeal Obamacare and roll back the clock. It won’t happen. Here’s why. 1. Millions will lose health insurance. Pre-Obamacare, nearly 20 percent of Americans went uninsured,  and this disproportionately affected lower-income levels. Those are ...

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As a presidency draws to a close, it is natural to consider the legacy it etches upon the pages of history.  For the most part, a first lady's legacy is a sidenote.  There are a few exceptions, of course.  Eleanor Roosevelt, Jackie Kennedy, and Nancy Reagan come to mind.  I believe that Michelle Obama's legacy will be one of the more notable of the modern era. For better or worse, race ...

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How can a doctor resist an essay entitled, "The Sickness Unto Death?" Kierkegaard, the darkest of the bleak existentialists, begins by asking, “Is despair an excellence or a defect?” Can despair be an excellence? It is December in Oregon, the rain comes down in sheets, with only a few hours daily of half-light. Kierkegaard’s winters in 1840 Denmark must have felt a lot like this, so I press on. “In despairing over ...

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