The horse that came into my life has made me think about many things from a different perspective. I have learned about the horse’s subtle ways of communicating, her extrasensory (compared to our own) perception, and her instincts of flight. I have also become more aware of the energy I bring to my relationship with her. With no learned tricks or horse management skills, I have established a way of ...

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Doctors today are often accused of being uncaring: Their eyes are glued to their computer screens and their attention is focused on test results and technology instead of patients. But some doctors care too much: A seasoned cardiologist blogs about letting his emotions lead him astray in keeping an elderly patient on life support too long. Was it his emotional attachment to the charming, elderly woman, or was it professional hubris, ...

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“I used to be strong, I wrestled the bull,” Sumner Ball said, “but now I can’t even wrestle the rooster.” On the far side of eighty-years-old, he looked lively and trim, and his weathered face hinted at a smile as his blue eyes peered straight into mine. “I think these cholesterol pills are hurting my muscles,” he declared. “I don’t think they’re good for me.” “Is it your back?” I scanned through his last ...

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“Welcome back. How was your trip? Or exile … you were away for a long time.” “Almost a year,” my nine o’clock patient answered. A woman just over forty, she looked tan and physically strong. Her short hair was peppered with gray, different from the last time I saw her. She had gone abroad on assignment for a magazine and a film production company, and before she left, she had joked ...

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I have two patients with phenylketonuria (PKU). Both are about my age. Laura, a non-verbal, slender woman with weathered features but the mind of a very young child, lives in the community. Her sister, Regina, has lived all her life in a nursing home. She doesn’t have a wrinkle in her face, and seems mostly unaware of her surroundings. The two girls were born several years before Dr. Robert Guthrie developed ...

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Marc Lachance is the perfect consultant. Ten years my senior, he had more than mastered his specialty by the time I came to the area. He had also established himself as a mentor to Cityside Hospital’s residents and many young physicians who sent him referrals or called him for curbside consultations. Marc used to live in a rambling farmhouse not far from where I live. But then his elderly father, widowed and ...

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Adrian Bell didn’t look dehydrated, but his diarrhea had come and gone for a week and a half when I saw him a few weeks ago. “Is anyone else sick with the same thing?” I asked, beginning my usual line of questioning. “No,” answered Eleanor, his wife. “Have you had any water to drink from a new or unknown source, or have you traveled away from home?” “No,” both answered in unison. “Any new foods ...

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Suffering ceases to be suffering in some way at the moment it finds a meaning. -Viktor Frankl It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has. -William Osler Back in the 1990s when pain was the newest vital sign, physicians were mandated to treat it, often with powerful medications and without truly understanding the cause and significance of the ...

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A few years ago, a medical journal piece about electronic medical records with built-in decision support announced that the days of super-physicians and master diagnosticians were over. Being a doctor isn’t very glamorous anymore, and being a good one seems rather obsolete with so many guidelines and protocols telling us what to do. A hundred years ago, William Osler, a practicing physician, had single-handedly written the leading textbook of medicine, reformed medical ...

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A family physician in the northernmost part of the United States was acquitted last week of charges stemming from years of guideline insubordination. Interviewed this weekend by members of the local press while he was cleaning the stall of his favorite horse, the silver-haired doctor declined making comparisons between the manure he was shoveling and the now-abandoned numeric cholesterol guidelines, and would not comment on his former accusers’ fall from their ...

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