On a particularly sultry day in a hospital of the Peruvian Amazon, I found myself with the task of telling a group of parents that their babies, who had been waiting in the hallways for days without eating in preparation for surgery, would not be able to have their cleft lip and palate fixed. We, a group of American doctors and medical staff offering this procedure free of charge to ...

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I was rotating through an infectious disease elective at an outside hospital during my fourth year of medical school when I encountered a startling situation. We were called to evaluate a patient who was suffering from an infection called Haemophilus influenzae. Now, I knew that most children were vaccinated against this pathogen, so I was surprised by the consult. I was working on a team with three others: one attending, one ...

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Next month when our youngest child leaves for college, the biggest change may not be in his life but in ours. We are done with dropping them off at school, or giving them driving lessons, or helping them with difficult homework assignments: We will officially become “empty nesters.” My wife and I ponder sitting at the dinner table and standing by the kitchen counter, where exuberant political dialogue takes place, and common ...

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I missed a drug interaction warning the other day when I prescribed a sulfa antibiotic to Barton, a COPD patient who is also taking dofetilide, an uncommon antiarrhythmic. The pharmacy called me to question the prescription, and I quickly changed it to a cephalosporin. The big red warning had popped up on my computer screen, but I x-ed it away with my right thumb on the trackball without reading the warning. Quite ...

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Prologue It’s 1:30 p.m. on a beautiful Saturday afternoon. You’re on call, and hungry, and having not had the forethought to make food ahead of time, you decide you’ll take your chances and see what the hospital cafeteria has to offer. You bustle your way past screaming children, harried caregivers, and distracted hospital staff with their heads buried in smartphones, following signs for the fork and knife. Finally, you arrive. After considering the stack of soaking wet trays ...

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The rise of the Internet has changed many things in the world of the customer.  Now, in the age of the online consumer, a person can search for not only the exact item or service he or she wants, but read hundreds of reviews on that particular item or service.  Thanks to Yelp and a host of other online rating sites, a person can find a reputable painter or contractor ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 36-year-old man is evaluated for a 1-year history of fatigue, intermittent headaches, sore throat, and joint and muscle pain. He reports no difficulties falling asleep and gets 10 hours of uninterrupted but nonrestorative sleep each night. He has seen several physicians over the past year. Evaluation ...

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This is the patient's eight admission over the course of two weeks. The patient is a heroin abuser and has bacteremia and endocarditis. Their heart valve is failing and they are in and out of congestive heart failure. Every day, dozens of medical professionals converge on the patient to give treatment and advice. And every day after hearing that advice, the patient leaves the hospital against medical advice and goes ...

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It was late afternoon. The woman who had seen my colleague, Dr. Wilford Brown, a few days earlier was sitting in my exam room. Her chart note read like a typical unnameable virus: headache, body aches, fatigue, low grade fever. She had always seemed like a level-headed resolute woman, but she had called three days in a row for medical advice because she felt so poorly. And it all sounded ...

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The WHO’s recent announcement of multi-drug resistant strains of gonorrhea raises the specter of a worldwide SuperClap Attack that even the Avengers couldn’t foil. It also comes as yet another ominous reminder of the perils of rampant and indiscriminate antibiotic use. There’s plenty of blame to spread around. True, here in the U.S., consumers can’t buy antibiotics over the counter, but that hasn’t kept physicians and other providers from over-prescribing them ...

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