We both agreed that it was unfortunate. I sat on Paul's living room couch with a computer perched on my lap as he recounted the events of the last few weeks. His business flight was interrupted by severe spasms of cough and high fever. He called me upon landing, and based on my advice, went to a local urgent care center. After waiting for a few minutes, he was seen by ...

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shutterstock_210331261 It's metoprolol. m-e-t-o-p-r-o-l-o-l The nurse on the other end of the phone sighs as she tolerates my tirade regarding pronunciation. They all know that I am particular about such things. For metoprolol is neither metoclopramide or metolazone, and the difference could be life altering. I live in a world of words. Trained in a language created to parse pertinent details. Dysarthria or dysphagia? Paroxysmal ...

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Everything eventually expires. I looked down at the bottle of natural spring water in astonishment.  It had an expiration date.  Scanning the empty hospital cafeteria on an early Sunday morning, I wondered what on earth about spring water could go bad?  It had no living parts,  Nothing that serves as nourishment for wayward bacteria or fungus.  The container was sealed.  Pristine. I figured it was another fiscal hoax, perpetrated on unsuspecting consumers.  ...

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shutterstock_222269452 I assumed she asked because besides being a hospice volunteer,  I was a medical student and wouldn't get spooked by a dead body.  She probably didn't realize that it was my first week of classes, and I hadn't experienced much yet. She walked into the room with her head slightly bowed forward.  She was physically and emotionally exhausted.  Because of a scheduling ...

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shutterstock_192230474 The American Board of Internal Medicine is irrelevant.  It has always been.  I realized this when I first certified in internal medicine in 2002.  The test was largely fact-based and filled with information that I would never need to know in practice.  It did not measure my diagnostic acumen, or my physical exam skills, or my ability to listen and empathize ...

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I remember being more confident that most of my peers.  The look of dread on my fellow interns face pre-call, and the fatigue post-call always seemed unnatural to me.  Maybe it was on account of my lifelong pursuit of medicine.  I felt nothing but elation at the newly branded "M" and "D" that came after my name on the hospital badge.  I was no longer a volunteer, no longer a ...

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I used to think that there was a communication gulf between doctors and patients.  Somewhere in the hubbub of the harried office visit some secret sauce was missing.  A divide that was so fundamental that both parties often left the room feeling disjointed and uneasy.  Patients wondered if doctors truly heard them.  Physicians wondered if anyone was listening to what they were saying.  The tension ebbed and flowed but never ...

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Behind every doctor is a little boy or girl who once watched helplessly. Maybe it was her father or grandfather who suffered under the weight of a disease that was deemed all but incurable. Perhaps her own skin was battered and bruised by the repeated trauma of an unrelenting tourniquet.  She swore that when (if) she got older she would protect the innocent from such things.  Her vow was the ...

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shutterstock_141318316 I understand that there is a difference between perception and reality.  I also get that the kind of people one meets on a tropical vacation in the middle of March are of a certain economic and sociopolitical status. Nonetheless, I am amazed at how history seems to repeat itself.  Year after year, while sitting in the shade and relaxing by the pool, ...

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Loss is something all humans face in their everyday lives.  As a physician, the effects are often magnified.  People die, they move away, they graduate from your services, or occasionally they pursue care elsewhere.  Parting can sometimes bring relief, and others a deep sense of failure.  But with Clara, I'm not sure we actually parted.  Mostly, I was left with confusion. Clara came to me by way of the nursing home.  ...

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