I drive a fast car. Which if you know me, is quite uncharacteristic. I would say that it is one the few possessions that generally doesn't reflect upon who I am. How I chose this car, the make, and model, are a long story not to be discussed here. But let's just say that it has quite a kick. These thoughts jostled through my mind this morning as I pulled into ...

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I have come to believe that humility is an essential component of wisdom. Never have I found this truer than in the practice of medicine. In fact, for almost every atrocious professional error in judgment I have made, I can pinpoint the exact moment where I stopped being humble. Yet time and time again, humility quickly disappears when dealing with the difficult patient. In fact, the label "difficult" assumes the problem ...

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There are parts of medicine that are horrendous. Moments too painful to recount, and events that will break even the most innocent participants. And then, there is unspeakable magic. I live for the days when a patient comes to the office with a particularly vexing set of symptoms. Specialist after specialist bows their head in disagreement. Laboratory values whisper falsehoods with jeering tongues. Symptoms are transient, physical exam signs inconsistent and in ...

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At first, you'll question reality. You will hear your own words, but they'll sound foreign — apart from you. The ground will still reassuringly push back against your toes when you walk out of the room, but you will wonder if they are your feet. Like in a movie, you will negotiate the world convincingly. Yet, you are an actor playing a part. It is not the real you. Be assured ...

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His voice was gruff and his expression surly. "I don't want any more medications." His face was indented by deep clefts, remnants of eight decades of life hard lived. His tone was commanding and certain. I knew that he was fond of me, but I could feel his patience slipping. He neither asked about nor accepted his diagnosis of heart failure. I could tell him till I was blue (or he was ...

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It will start as a minor curiosity. Maybe a student will seem slightly too close to the resident on your team. When the grades are posted, you'll wonder why you didn't get honors, but he did. You might wallow for a few days. Make an offhanded comment to your fellow students. Then you'll let it go and move on. Or so you think. Until during surgery when the scrub nurse ...

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If you are planning on complying with Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), make sure to allot the appropriate time and funding necessary to update/upgrade your practice. Realize that the measures will be arbitrary, the data implementation arduous and the moments for live patient care fleeting. Expect that, no matter how Herculean the task may be, the finish line will move often and unexpectedly. Prepare to get ...

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"Too many times I feel We are losing time once shared And only when you're in ecstasy You seem to really care" I recognize the song immediately — Chuckii Booker's "Turned Away." Not the regular version, but the extended one. As the words rush over me, caressing my nostalgia, a memory, a moment comes back. I was standing behind the counter at Homer's Ice Cream on a brilliant summer morning before the doors opened. We ...

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An excerpt from Five Moments: Short Works of Fiction. “Dad ... you can let go now.” Thomas heard his daughter’s voice from a distance. It awakened him from his reverie. He relived those five moments of life and took their lessons seriously.

  1. Rejoice in the ordinary as if you were a child seeing everything ...

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It would never have gone down this way ten years ago when length of stay was all the buzz. The CT scan would have been done in the emergency department, and the patient would either have been discharged or admitted for a quick observation stay. Bing, bang, boom. One, two, three. Instead, the CT was pushed until morning. A resident saw the patient at midnight and then not a single practitioner ...

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