During the four weeks of my ICU rotation, I came to know Mr. S well. I was the medical student on the intensive care team, managing patients alongside the primary surgeon. Mr. S was on the road to recovery when I started to follow his hospital course. Every morning we rounded, one more of the numerous tubes attached to his body were removed. He grew stronger, gradually able to speak clearly ...

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Donald is large. Very large. At more than 600 pounds, he is a mountain of flesh with a small opening at the top through which he speaks. "My stomach hurts," he says, his voice surprisingly high and childlike. It is 10:00pm in the emergency room, and I am already swamped with patients I'm trying to move through the ER before my shift is over. Asked if he's ever felt this kind of pain before, ...

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A nurse masters the art of medical slangA nurse masters the art of medical slang An excerpt from ASSUME THE PHYSICIAN: Modern Medicine's "Catch-22". “What did you learn today?” I asked, fearing the answer. I was suspecting a recitation about the new methods of documenting nursing competencies, or a delineation of the process by which she helped the hospital maintain its “magnet” status to attract more ...

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This post is a question, an invitation and a challenge. How can we bring technologies we take for granted back home to those in the developing world? Many before me have spoken with outrage about the reality of two worlds: one of abundance, and the other where people live like they have in centuries past. The situation is more complicated since even poor people may have some technologies like cellphones now, but vital lifesaving technologies ...

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One of the spinoffs of being an oncologist is that you do not to take the world for granted.  Each morning, I walk around the yard and smell the morning breeze. I am thankful for my children, my wife and my own health.  I am thrilled, if occasionally skeptical, to have the opportunity to pay taxes in a country that I love.  So, who would believe I would take our ...

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From MedPage Today:

  1. Congress Grapples With Primary Care Pay. Some Democratic lawmakers have expressed interest in extending the pay increases for primary care physicians in Medicare and Medicaid that are temporarily in effect under the Affordable Care Act (ACA).
  2. Stem Cells as Tx for TB? Bone marrow stem cells were safe to give during treatment for multidrug- and extensively drug-resistant (MDR, XDR) tuberculosis (TB), ...

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A colleague once said, “Every plan is excellent, until it’s tested. It’s execution that’s the problem.” And so it is. Clay Shirky wrote an excellent article about the gulf between planning and reality. Although the focus was on the misadventures of Healthcare.gov, the US government’s insurance exchange website, the broader lessons that he presents are worthy of consideration in many ...

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Statistics show that about 1 in 5, or 20 percent of all Medicare patients are readmitted to hospital within 30 days of discharge. That’s a staggering number, not to mention all those patients that are readmitted frequently during the course of a year, but not necessarily within 30 days. The problem of frequent hospital readmissions is actually one that exists all over the world and not just in the United States. ...

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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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My cancer shows how our world is ruled by love I recently wrote about how our world is ruled by love, and circumstances conspired to show me just how true that really is. Love is when I go to the ER at UCLA, where I work, for a cough and feeling that “something isn’t right,” and even though my complaints are mild, I’m brought right in and ...

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