For many people with chronic disease, the toughest thing is convincing themselves they’re not crazy. This is especially true for those with an illness with no clear etiology. For millions of people around the world suffering from multiple sclerosis, lupus, fibromyalgia, chronic abdominal pain, ALS, rheumatoid arthritis, certain types of cancer, chronic fatigue syndrome, and hundreds of other illnesses, just making it through the day is overwhelming. Not only do many of ...

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"Code fifty-two, emergency room.  Code fifty-two, emergency room," blared over the loud speaker in the hospital.  Simultaneously a chorus of beepers went off, like crickets on a sticky summer day. I glanced down at my pager that echoed the same message "CODE 52, EMERGENCY ROOM."  The same message flashed across the screen three more times as I ran quickly down the main hallway.  Code 52 meant trauma.  I was about to ...

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When our daughter Florence was born, we were shocked that a tiny, seven-pound beauty could turn our household (and our entire lives) upside down. Why was it so difficult to deal with one human being, when we often took care of a department full of ill patients? How could someone so cute induce a state of perpetual anxiety, forcing us to question every single action we took? It was disconcerting to ...

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There’s no doubt physicians entering practice today leave their residency programs with a tremendous amount of medical education and training; what seems like a lifetime’s worth of knowledge crammed into just a few, intense years of instruction. Unfortunately, all the time residents spend on rotations, lecture, journal club, and myriad other obligations leaves little opportunity for getting oriented to the more mundane, yet absolutely critical components of practice. As a result, ...

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When I had my first baby, I was a busy resident trying to complete my residency on time.  I didn’t want to extend my residency even if it meant sacrificing time with my newborn.  In order to get my 8-week leave, I banked days whenever I could.  There was one period I worked 45 days straight (well, not straight, I did get the mandatory 24 hours off between once a week) so ...

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On the morning of the tragic mass shooting in Orlando, a tweet by CNN stated, “The White House waived HIPAA regulations so that hospitals could talk with family members of shooting victims, says Orlando Mayor Buddy Dyer.” Many, including me, retweeted this thinking that it was probably unprecedented. Later that day, several Twitter followers informed me that HIPAA had been waived during Hurricane Katrina. Despite rumors to the contrary about 9/11, Katrina ...

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During a busy ED shift, my computer signaled the complaint and location of my next patient: a woman in bed 10 flagged with “GI bleed.”  I almost bolted to bed 10 to ensure this patient was stable, but then noticed orders pending, so my urgency eased. “I see you already saw the patient in 10,” I began, addressing the triage physician. “Yeah, she’s all set,” he replied, without turning from his computer. ...

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(Triage note: 45-year-old male, vomiting for two days. Abdominal pain.) Dr. Stephen Cluff is like Yoda. Judging by body hair, he's more like Chewbacca. But he's short, wise, and with his white hair and arthritic limp, he may as well have green skin, poor sentence structure, and a Muppet's voice. If I'm stumped on a case, I'll ask him. If I'm pissed off about department politics, I'll call him for advice. If I want ...

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As she adjusts her sunglasses, Mary squints to protect her sensitive eyes from the sun.  Four years ago when lymphoma threatened her life, doctors gave her a 5 percent chance of survival. “I really should be dead right now,” she states casually. A bone marrow transplant gave this patient a new lease on life, allowing for the treasured opportunity to mother her 8-year-old son. The transplant has been successful, but her ...

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Ever since the U.S. government decided to link Medicare reimbursement dollars to patient satisfaction scores, hospital administrators have been obsessed with improving the quality of care for patients visiting their emergency departments. While the motivation may be partly financial, the goal of improving the patient experience during emergency department and hospital visits is an admirable one. Unfortunately, many of the tactics used by administrators have done little to achieve that goal. ...

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