I received the sign-out from a colleague that he was to be transferred out of the medical intensive care unit to our service, as we were the team on call that evening.  My intern and I prepared to see him in the unit before he was moved to our floor, which involved reviewing his chart and having preliminary discussions about continuing his care. Soon after, we arrived to the unit, checked ...

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A few weeks ago, I woke up feeling under the weather. It was day one of seven consecutive shifts. I looked into the mirror. A sullen face with sunken eyes stared back. As I was getting dressed, I felt fatigue trying to triumph over my body. Next came a nagging and rude cough that kept interrupting my sentences. I started to feel feverish, and sure enough, I measured a temperature ...

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The British Medical Journal recently published a paper boasting the astonishing conclusion that medical error is the third leading cause of death in the United States. Headlines aside, the study suffers from questionable statistics that serve up alarmist conclusions about the prevalence of serious medical errors and obscure the road to addressing the tragic phenomenon of death by medical error. The analysis cites four observational studies on incidents that occurred ...

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Recently, a paper written by researchers at Johns Hopkins asserted that medical error was the third leading cause of the death in the United States.  This received -- as you might imagine -- considerable coverage in the media.  The researchers proposed that death certificates should include a qualifier or indicator that medical error was linked to the death, if in fact it was, so that better statistics could ...

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Josef Stalin famously said: "One death is a tragedy; one million is a statistic." Perhaps 250,000 preventable deaths from medical errors, according to an analysis by Makary and Daniel in the BMJ, maketh a Stalin. The problem with Makary’s analysis, which also concluded that medical errors are the third leading cause of death, isn’t the method. Yes, the method is shaky. It projects medical errors ...

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Having recently watched a cable television recreation of the Clarence Thomas confirmation hearings, I am left thinking about how far some of us have come and how far some of us haven't. The confirmation hearings of Supreme Court Justice nominee Clarence Thomas in 1991 changed the concept of sexual harassment in the workplace by bringing the issue to the forefront. By the time, I started residency nearly 20 years after the ...

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You can't pick your parents, and you can't pick the side of your brain that you damage. I always thought that injuries to the left side of the brain would be the worst, because that's where the language centers generally are. And talking is basically all I do. But after seeing uncountable numbers of strokes and brain injuries, I've changed my mind. Right brain injuries are worse. The right side of the ...

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Here’s a leadership challenge: Get a group of highly independent, intelligent individuals to come together to build a boat.  But imagine the blueprint for that boat is vague and untested.  Now imagine that this boat must be built in choppy, progressively inhospitable waters, while said individuals are frantically treading water to stay afloat.  Convincing these smart people that there’s a problem isn’t the issue.  Convincing them to abandon their desperate ...

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Popular shows like Gray’s Anatomy, ER, and House, MD have given the television watching public a good eyeful when it comes to the inner workings of medicine, hospitals, and emergency rooms. They have also shown us how the personalities of those who take up the stethoscope and reflex hammer run the gamut from the sweet, demure, tentative types to the sons of bitches who cut first and ask questions later. I ...

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I was saddened to hear that one of my favorite libertarians, the wonderful journalist John Stossel, has taken ill. True to form, however, he's taking it in stride (he nonchalantly quipped, "seems I have lung cancer"), and I want to take this opportunity to wish him very well indeed. I enjoy his reporting and writing, and have learned a great deal from Mr. Stossel over the years. But that doesn't mean he's always ...

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