Where does doctor stop and computer begin? Who is in charge? Do we care? Are these silly, academic questions from some sci-fi future or is it an onrushing tomorrow? Consider:

  • Ten years ago, the EMR recorded the date you or your nurse gave Sam his flu shot.
  • Today, the EMR reminds you it is time to have your nurse give Sam his flu shot.
  • Soon, the EMR will order the flu shot that the nurse will give to Sam.
  • Tomorrow, the ...

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For 25 years, I have taught medical students how to give bad news.  Step one: Be prepared.  Step two: Find a safe, personal, quiet environment.  Step three, and this is most important: Before you speak, ask.  What do the patient and family understand? Fail to follow this vital rule and reap the whirlwind.   So, therefore, you might ask, if I have such wisdom and experience in this critical area ...

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Cancer patients depend on denial.  Without its protection, we would be overwhelmed by terror.  Denial filters and slows bad news, so we can digest reality in the merciful morsels; thus, we cope.  Without denial, we would shut down, withdraw, and lose hope; healing would not be possible.  However, if we do not move beyond denial, accept the diagnosis and loss, make a plan, we die. Allen, a 43-year-old man, came to ...

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“I had no idea how much cancer sucks.” My patient’s observation seems silly, basic.  Of course, cancer sucks.  It maims, humiliates and kills.  It takes.  What made the statement remarkable was its source.  This is not a medically naïve person, waiting to die. Rather it was spoken by a patient in complete remission, likely cured, who is an expert in cancer care.   To her amazement, it changed life forever. I think that ...

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Short-of-breath, weak, in pain.  Cancer -- aggressive, cold, unfair -- ravaged Roger’s body.  But maybe, just perhaps, there was a modern medical miracle.  A drug.  A single daily pill to attack the genetic growth switch in each malignant cell.  Only, there was a problem.  Not a big problem, really, but possibly fatal.  The kind of real life annoyance of living in a modern medical miracle society.  The co-pay cost to ...

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“So, I told the doctor at the nursing home that I loved my father more than anything. Dad was my friend and the most wonderful man I had ever known.  I wanted everything for him. But, I said, Dad was sick, weak, confused, and he never wanted to live like that. The next morning he was dead.  That was OK by me.” I once participated in a panel discussion about hospice, ...

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shutterstock_118667590 Doctors have a difficult time adjusting to other cultures and because of this flaw, patients, and the medical profession suffer.  By culture, I do not mean religious or philosophical background, socio-economic difference, country of origin, nor even the silence created by language and education barriers.  I am referring to the communication and comprehension chasms that exist between different occupations and physicians. What ...

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It is a heart pounding, head spinning, edge of your seat page-turner; the sort of rare saga that takes your breath away as it changes you, forever.  It hints at a radically different future, a completely new world a few years away, which will disrupt the lives of every man, woman, and child.  Available now, from the National Coordinator for Health Information Technology (ONC), Office of the Secretary, United States ...

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Physician–assisted suicide: the collaboration of two through a professional relationship, to cause the death of one. Ever since Socrates took hemlock, suicide has been part of society, sometimes supported, often condemned.  Today, many argue that we have a right to die, sort of an infinite extension of free speech or thought.   Regardless, to actively involve doctors is a unique distortion of the medical arts, as if stopping a beating heart can somehow ...

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I do not know about you, but I get confused about the Heisenberg uncertainty principle.  Asked for a definition, I usually say something about how when you try to measure something, you change it, therefore one can never be complete or exact in measurement.  However, that is wrong. The uncertainty principle has nothing to do with the effects of measurement, but rather its limits.  If you measure one thing, such ...

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