Four adages I learned in medical training that I still speak of today: “Common things are common.” (The alternate version of this that might have more appeal to zoologists: “When you hear hoofbeats, think horses, not zebras.”) This cautions physicians to remember that it is more likely that the patient has a common condition than a rare one. Although it is prudent to consider all the possible diagnoses that might match a given ...

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Dear Jane: Thank you for asking me about my perspectives on medical school. Here are some general principles that you might find useful in your own training: 1. View everyone as your teacher. Everyone you encounter will teach you something. Be open to what they have to offer. Yes, your professors and attendings, the “official” teachers, will educate you. Patients, however, will often be your best teachers. Listen to what they say, watch how ...

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This article is making the rounds among physicians on Twitter. Much of the information in the article, unfortunately, is accurate. For some of the reasons stated there, I left the “traditional” health care system and pursued work at the “fringe.” Part of this is due to my clinical interests: I like working at the intersections of different fields. For example, I like the intersection of psychiatry and hospital medicine, which is called 
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When I was a resident one of my attendings said, “You know why patients are called ‘patients’? It’s because they have a lot of patience. For us.” Patients in hospitals do a lot of waiting. They wait for physicians. They wait for nurses. They wait to use the bathroom. They wait to undergo procedures. They wait for their IVs to stop beeping. They wait for the person next door to stop ...

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Everyone noticed him before we boarded the plane. He asked the airline representative at least three times to confirm that he had a seat. He looked like an adult, but the tone of his voice was that of a child. “Yes, you have a seat, Michael. It’s 7B.” Grey cargo pants covered his short legs. The sleeves of his striped polo shirt collected below his elbows, making his arms look even shorter ...

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As I noted earlier, hospitals permit around-the-clock observation of patients. If you don’t need around-the-clock monitoring, you don’t need to be in the hospital. Who is doing this around-the-clock monitoring? Nurses. Therefore, whether you are a patient or a physician, one of the best things you can do is get on the good side of the nurses. If you are a patient, a nurse watches over you and your care. ...

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Who works at a hospital? (Again, just indulge me for now.) Doctors. If you’re a patient at a teaching hospital, this includes medical students (people in school to become doctors), interns and residents (people who have earned the title of “doctor”, but who are still learning their craft), and attendings (people who have completed their formal training as physicians). If you’re not at a teaching hospital, it’s less likely you’ll see medical ...

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As a fourth year medical student I did my “sub-internship” in oncology. I hoped that this rotation would help me choose what specialty to pursue: internal medicine or psychiatry. One of “my” patients was a woman with breast cancer that had spread to her liver and lungs. Fluffy brown hair fell to her shoulders. Wrinkles surrounded her puffy eyes that held jade green irises. Though she was in pain, she was ...

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Involuntary commitment refers to hospitalizing people against their will for psychiatric reasons. It is a controversial topic because this is where medicine and civil liberties intersect: Physicians have the ability to take away the rights of fellow citizens. (I suspect that few people who become psychiatrists realize that making recommendations about involuntary commitment is part of the job. I certainly did not know this. I also did not appreciate the ...

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I remember when we dragged ourselves to the large lecture hall every morning, backpacks slung over our shoulders and cups of coffee in our hands. Six to eight hours of lectures awaited us. I remember where we all sat in that lecture hall. I remember the future ophthalmologist who sat behind me and made snarky comments while certain professors gave their lectures facing the chalkboard. I remember students sitting six rows ...

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