My husband, Mark, called me at my practice. “I’ve been working on something; I need you to come home now.” He spoke definitively, urgently. “Is it the kids?” I was instinctively anxious. “No, not the kids, just come home now.” 6 p.m., a cool evening, an ordinary day. The life before the fact. And then life afterward, irrevocably and catastrophically changed. A tense ride home, then the revelation. “I've been having difficulty ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. An 86-year-old woman is evaluated in her assisted-living facility for pain. Four weeks ago, she developed herpetic lesions on her right posterior thorax in a T7 distribution. She was treated with acyclovir, and the lesions healed; however, she has persistent severe burning pain. The pain is so severe that she is ...

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USMLE Step exams are a rite of passage in medical education. They mark the  transition from pre-clinical years to clinical years, from medical school to residency and from intern to resident. One of the more difficult aspects of the transition to residency was convincing myself that I really was a doctor. The habits of explaining my role as a student, of hedging every statement with “I’ll need to ask the ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 50-year-old man is evaluated for a 1-year history of increasing urinary frequency and urgency and occasional urge incontinence. He has no symptoms of urinary hesitancy or incomplete emptying. The patient has primary progressive multiple sclerosis. Medications are dalfampridine and vitamin D. On physical evaluation, temperature is 36.8 °C (98.2 °F), blood pressure ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 77-year-old woman is evaluated 4 months following a left middle cerebral artery ischemic stroke. The severity of her stroke required prolonged initial hospitalization and a 3-month stay in a rehabilitation center before returning home. Residual deficits include dense right-sided hemiparesis and dysphagia requiring oral feeding with thickened liquids. Medical history is ...

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This presidential campaign has been alternately amusing and terrifying, courtesy of the antics of Donald Trump.  The prospect of someone who feels the need to boast about the size of his penis during a presidential debate having his small, small hands on the button to launch our nuclear arsenal does not inspire feelings of security. He is looking increasingly likely to be nominated by the Republican Party.  Many, however, ...

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My "aha" moment wouldn't come at the signing of my leave of absence contract. Nor would it awaken me at night with the chair-gripping dizziness I had come to expect. When the vertigo started in early December during my third block of clerkship, I chalked the symptoms up to stress. Over the December break, I met with my family doctor and casually recounted my symptoms. The vertigo had worsened, and seemed questionably ...

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There are several Tumblr sites where people submit their actual name and compare it to the name the Starbucks employee writes on the cup.  There’s “Starbucks Name Fail,” “The Starbucks Name Game,” “Starbucks Can’t Spell My Name,” and “That’s Not My Name, Starbucks.” There aren’t Tumblr sites for calling out Starbucks when they biff your drink.  “Starbucks F***** Up My Drink,” “Would You Just Look at This Beverage,” and “There’s No ...

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Medcomic-Multiple-Sclerosis This Medcomic highlights some of the main features of multiple sclerosis (MS).  Although the exact cause of MS is unknown, the disease is thought to occur as an immune-mediated attack on the central nervous system (CNS). As you can see in the illustration, the white blood cells are attacking the neuron and causing inflammation, demyelination, and axonal degeneration that can manifest through ...

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I walk up to the ICU. Ecstatic. I just placed a subclavian line, a chest tube, and performed a bronchoscopy on my patient. Intern year is going well, and today is a great day. For me. I have been learning so much, been trusted to do even more, and been a part of gratifying experiences. Successes. Life-changing procedures. Things that still make me sit in awe that we can transform the human body, ...

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