I don’t remember how many patients I saw at the health fair before George came to me; none of them were as memorable. George was a tall, stooped man with a serious expression. His skin was weathered but he couldn’t be called elderly by any means. I guessed that his age hovered somewhere around forty. He looked serious and spoke quietly. He had no interest in being rude, but no ...

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As patients, we think of working with medical students as a good deed, a necessary evil to improve the future doctors of America. You spare the extra time, discuss your mother’s sister’s medical history, a detailed account of your drinking (not quite) habit, and succumb to a physical encounter rivaling the awkwardness of a junior high date. But medical students are changing.  Today’s students are starting medical school with more experience ...

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Bambi Syndrome saved my life An excerpt from Pet Goats and Pap Smears. Life changes in a heartbeat. In the “Events of the Cardiac Cycle” lab, four students are assigned to each dog. Instructions: Inject the live dog with epinephrine and study the EKG. Sever cardiac nerves. Carve open the chest and shock the heart. As the dog’s blood pressure drops, remove the heart. Now, stab ...

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Adapted from a keynote address given to the graduating medical class at the University of Toronto. When I was asked to give the keynote to graduates of the class of ’14, it was an honor that nevertheless filled me with terror and a bit of wistfulness. My sense of fear in giving advice to these amazing young doctors comes from not being sure I belong in the same company. They are whip smart, ...

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While running several times over the past week, I have thought carefully about our profession. I cannot imagine having chosen any other profession than medicine, nor any specialty other than internal medicine. But that is me, is it you? A medical tweeter than everyone should follow @medicalaxioms had these tweets recently:

If you become a doctor for wealth or prestige, you are going to live a sad and angry life. Happy doctors ...

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I never understood the loss of empathy during medical training. Until now. It was 4:30 a.m., and I was on the side of the road, drenched in sweat and tears. I had finally slowed my breathing to normal. I was going to be late for rounds. No time to obsess over possible questions. No time to memorize lab values, or practice regurgitating them. I thought of home. My family and friend, who I hadn’t ...

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Learning in medical school often feels like learning a completely new language. There are numerous acronyms (OPQRST, CAGE) and molecules (IL-1, TGF-beta) and more. But most striking to me are two particularly ubiquitous buzzwords: “high-yield” and “protected time.” I feel like I heard both these terms -- and particularly the former -- thrown around every single week of this past school year. High-yield has been used to refer to, as you ...

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My high school graduation ceremony was your typical Californian high school graduation -- the sun hovering lazily over us, a cool, ocean breeze bringing wafts from the sea. As I listened to my principal deliver his address, my attention waned in and out. The sun was too warm and the wind was too soft. When the student speaker came up to speak, I reclaimed my attention to listen to him ...

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Today, I saved a life. And I wish I could tell you a story about fancy heroics -- about an exploratory laparatomy, a chest thoracostomy, or a patient that coded and I was the last person to perform the chest compressions that brought them back to life.  But I can’t.  But I can tell you that I saved a life. She was 16-years-old, and moved here four years ago from a different ...

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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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