I recently saw a patient who, against all odds, survived an aortic dissection. Miraculously, he was alive after the wall of his aorta -- the largest and most important vessel in the body -- began to rip apart. Aortic dissections are so violent and agonizing that a large portion of these patients don’t survive. Yet somehow, my patient was still able to sit upright in his chair and recount his ...

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I was recently scrolling through my Facebook newsfeed when I came upon a long message chain started by one of my friends, an older woman from my hometown in New Jersey. She had seen a discussion given by a drug representative who was promoting administering Gardasil to early adolescents for the prevention of cervical cancer, and my friend wanted to know how other parents felt about allowing their children to ...

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In neurology clinic, I was asked to see a young man with epilepsy -- a seizure disorder -- due to cerebral palsy from birth. It was one of my first clinical encounters of my first rotation of medical school, the tenuous transition from knowledge-absorber to translator and caretaker. I walked in to find a patient who was wheelchair-bound and largely non-verbal, and who interacted with the world by tracking gaze ...

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"Hey, Rick. They warned you about me, I hope?" My routine med student opening line elicits a slight smile from my balding forty-two-year-old patient and the patient's wife. As we shake hands, I continue the script. "I'm Nat -- the medical student. What brings you in today?" "Well, I'd like to transfer my care to this clinic. We've brought my medical records." Together, they heave stacks of papers onto the desk. Rick's hands slide ...

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Post-apocalyptic portrayals of medical school. Depressive symptoms in 43.2 percent of resident physicians. 34.1 percent of medical students experience burnout by third year, and that percentage increases during residency, ranging from 41 percent to 74 percent by specialty. We lose hundreds of doctors each year to suicide, at a rate that is twice as high as the national average. Burnout increases the risk that a physician will make a mistake, which ...

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As physicians, we are trained to look for change. We look for changes in lab findings and change medications, and we ask our patients, “what has changed since I saw you last?” We are always trying to get our patients to change in one way or another. Doctors are hardwired to seek changes that produce a dopamine release in our brains. We love it when patients see an improvement in ...

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As a medical scribe to physicians, I’ve entered over a thousand different exam rooms and listened to a thousand different patients give their unique histories, but the morning of October 28th was quite different. On this chilly late October morning, I knocked and stepped into the exam room of my very first "patient." “Mrs. Laura Williams” was an elderly woman, old enough to be my grandmother, but slightly taller and a lot ...

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Readers are slowly learning about my admiration for the Farnam Street Blog.  The about page describes the blog in this way:

My goal is to help you go to bed each night smarter than when you woke up. I’ll do this by giving you tools, ideas, and frameworks for thinking. I’m not smart enough to figure all of this out myself. I try to master the best of what other ...

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“I remember how hard it was to be a third-year medical student,” one of my residents once said to me. “You have to appear constantly enthusiastic. You feel continuously judged and evaluated. And worst of all, you know, deep inside, that if you were to get a cold or something and not show up one day, not one bit of the daily workflow would change because as far as pivotal ...

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Last year, I visited my brother in Rhode Island at Johnson & Wales University. We took a culinary school class together learning about the fundamentals of Italian and German cuisine. What were two medical students doing in culinary school? As a fourth-year medical student, I learn the science and art of caring for the body and mind. Unfortunately, the majority of patients are plagued by ailments secondary to chronic preventable diseases ...

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