It's field trip season in middle school. Which means that all over the country young adolescents are headed to memorials and museums. In New Haven, Connecticut, field trip season means the 8th graders are going to the World Trade Center in New York City. Which means that at my kitchen table, my daughters and I are discussing how safe it is to be at the World Trade Center. Two of us think it's one of the ...

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As an integrative medicine physician, I am often questioned about what I do and how I decided to diverge from the normalcy of allopathic medicine. I usually go into a short spiel about my love for thinking outside the box and creating solutions for patients that seek a kinder, gentler style of medicine; one that blends effective healing modalities from all over the globe with my traditional allopathic training. Most people ...

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unnamed When nurses stand on the steps of our nation's capital, it is a warning that something is seriously wrong in health care. Much like a canary in the coal mine, nurses are the barometer of the health of our hospitals, nursing homes and health care facilities. On May 12th 2016, nurses from around the United States convened on our nation's capital for the ...

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Among the plethora of emails that I receive on a daily basis, there seems to always be at least one sent from my hospital’s information services department. Usually, I receive alerts about system downtime or notifications about resolved tickets. They all have the same general look and feel, and so I hardly ever question that they are official. And then I come across a communication with the message similar to ...

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During our dermatology section in medical school, a classmate recounted having had Henoch-Schonlein purpura as a child.  Over a holiday break, he visited his primary care physician and asked if he could review his records out of curiosity.  His family physician pulled out the index card that served as this man’s medical record.  Yes, you read that correctly.  It was not a chart or computer printout; rather a 4 x ...

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Mental health issues are something I’m passionate about and have a lot of experience with, both professionally and personally. One of the biggest lessons I’ve learned over the years is how complicated and broken our mental health system is. When one or even multiple parts aren’t functioning at their highest level, we end up with a fractured system and patients falling through the cracks. One chasm in our mental health care ...

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Charles Bukowski once said, “Wherever the crowd goes, run in the other direction. They’re always wrong.” How does one become a master?  What process do we use to have the highest probability of success? Here are some examples. "Picasso was an extraordinary craftsman, even when measured against the old masters. That he chose to struggle to overcome his visual heritage in order to find a language more responsive to the modern world ...

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A reader I respect asked me for my thoughts on trigger warnings. Per Wikipedia, trigger warnings are “warnings that the ensuing content contains strong writing or images which could unsettle those with mental health difficulties.” Let’s put aside the last part of that definition, “those with mental health difficulties”, as some articles suggest that trigger warnings are not limited to those with mental health difficulties. Part of ...

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Among hospice staff, it is called “getting it.” One says, “He doesn’t get it,” “I think she gets it,” or, “They definitely get it.” It is a little hard to define, but as with pornography, you know it when you see it.   Nonetheless, given the importance of “getting” good end-of-life care, let us take a moment to try and explain. The 92-year-old patient is bleeding into her head, but has blood ...

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asco-logo Young women get gynecologic cancers, and I have had my share of conversations about ovarian cancers with women in their 20s and 30s. It rarely happens, but when it does, it is devastating. I make it a point to talk with them about their present and their future; although it is something I try to do with all ...

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A new study was released on weight loss and maintenance that has been covered on many sites. Researchers from the National Institutes of Health (NIH) evaluated contestants from Season 8 of the TV show the Biggest Loser. They found that 13 of the 14 contestants studied regained some or all of their weight that was lost during the show. All the contestants studied also had slower metabolic rates than expected; ...

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Props to medical students at the West Virginia School of Medicine for their slick dance moves.  It all to raise money for multiple sclerosis.

On my recent tour of residency programs, I had the pleasure of meeting many foreign medical graduates (a.k.a. FMGs; not to be confused with international medical graduates, who are U.S. citizens who go abroad for medical school). Almost uniformly, they struck me as confident, mature and articulate. Many were older than me, some by as much as 10 or 15 years. Most had extensive research experience, and a few had even ...

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I would have graduated from medical school this year.  That’s right.  Just like you, I’d be getting ready to move to another city and take up residence at an academic medical center to begin my clinical training. Things don’t always work out the way we planned: like Lenny and George in Steinbeck’s, Of Mice and Men.  Sometimes, the best-laid plans have a way of going awry no matter how carefully we prepare them. Cancer.  I wasn’t worried. It was ...

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Now that I’m getting ready to turn 70, I thought I’d summarize what I’ve learned since I finished my residency, when I was 28. Of course, I didn’t learn all this only by being a psychiatrist, since I would hope that most folks have also learned lots in the last 41 years. 1. Psychotherapy is important, particularly if the patient is on the right medication. I won’t do “med checks,” since I ...

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When asked during a recent ICU rotation if I was considering critical care as a subspecialty, I offended more than one person with my response: “No, I really don’t enjoy torturing old people.”  Granted, that unfiltered comment came at the end of a long and sleepless 28-hour shift, but the sentiment holds true. As doctors, we have a number of tools to assess quality of life in research.  We use fancy ...

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Naturopaths are currently engaged in an intensive lobbying effort at the Capitol in order to gain recognition as medical practitioners and inclusion in Medicare. As a retired naturopath who was licensed in two states, I want to offer a primer to this political maneuver: Naturopaths are not who they say they are. To be fair, naturopaths (NDs) are no longer obscure practitioners. NDs are currently licensed or registered in 18 U.S. ...

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Taxes. Doing taxes feels like a financial rectal exam.  I hate doing taxes.  Yeah, I don't like getting rectal exams either. It's not that I resent paying the government for the fine services they render and the high quality of elected officials we have. It's not the existence of taxes I hate; it's just doing taxes make me feel extremely insecure.  Sharing my personal and business finances with my accountant and the ...

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The following is paraphrased documentation, authored by a physician I know, regarding an intoxicated patient in the ER: 1 a.m.: Patient is telling nurse, “Before I leave, I need everyone’s name for my lawsuit. Tell the phlebotomist that if he’s good, he’ll get a cut.” 1:40 a.m.: Patient is making inappropriate sexual comments and is verbally aggressive with medical staff. He is advised to stay in bed. 2:02 a.m.: Patient (who had been sleeping comfortably) wakes up and ...

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My friend Dawn and I recently attended an evening meeting of the Houston Society of Plastic Surgeons.  Since we were invited guests, and not plastic surgeons, we didn’t stop on the way into the lovely formal dining room to pick up our name badges because the organizers had not made them for us.  On the way out, however, we both noticed clear plastic perfectly formed oval objects sitting on the ...

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