"Forty-two-year old male, chronic pain syndrome," the chart reads. I'm a third-year medical student doing an elective at a physical medicine and rehabilitation clinic, and this is my first time seeing Joe. Sitting expectantly in the exam-room chair, he's a gaunt man with a long face and dark tattoos down his arms. Wire-rimmed glasses, stringy ponytail, faded jeans and leather jacket complete the look. "Nice to meet you," I say. "I'm Angela, a ...

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Sometimes, it really does take one to know one.  Not every counselor can work well with every patient.  It is hard to understand how people can presume to know bereavement and grief when they have lost no one of significance in their lives.  Surely everyone has experienced loss at some time.  However, the death of a tame woods animal is usually, qualitatively, very different from the death ...

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We all know that physician-patient communication is important. Poor communication, not deficient clinical skill, is the primary driver of malpractice suits; conversely, good clinical communication alone can improve patient outcomes. For example, patients of physicians with superior communication skills have been shown to have superior blood pressure control.  Fortunately, physicians generally recognize the significance of good communication, and often take the time to ensure that it happens.  Yet there ...

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It wasn't so much the side effects -- nausea and belly pain that had once kept me from enjoying my aunt’s home cooking. I didn't fill my prescription for the malaria prophylactic Malarone before a family trip to India because the $50 co-pay seemed outlandishly expensive to a medical-student-in-debt. Years later, I find that my patients skip crucial medications to treat diabetes and depression because of the reality or even ...

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A recent Wall Street Journal article about how post-traumatic stress syndrome can be caused by cancer and stroke brought to mind the variety of responses many people experience in response to cancer diagnosis and treatment. The lingering intensity of those responses – physical, psychological, social and behavioral – can affect whether and how we attend to the tasks of survivorship; that is, monitoring and addressing the unique health challenges that follow treatment ...

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It was the beginning of my third year of medical school. I had just started my first clinical rotation. My very first patient was Ray, a middle-aged man with pancreatitis. I presented his case to the team. “What are Ranson’s criteria?” the attending physician asked. My mind went blank. “Uh, I’m not sure,” I said. “Next time, you’d better be sure,” the attending said. He turned to my colleague, who promptly gave the ...

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Make the difficult journey of cancer patients a bit easiernewspaper story recently caught my eye when it headlined: "Senators Revive Push for End-of-Life-Care Planning." It reported on new legislation making the rounds in Washington to address care planning for those with advanced illnesses. You remember "end of life care planning," don't you? It was part of the Affordable Care Act debate several years ago, and quickly became translated into
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In the past few years, I've observed an epidemic of sorts: patient after patient suffering from the same condition. The symptoms of this condition include fatigue, irritability, insomnia, anxiety, headaches, heartburn, bowel disturbances, back pain, and weight gain. There are no blood tests or x-rays diagnostic of this condition, and yet it's easy to recognize. The condition is excessive busyness. It's one with which, as a fellow sufferer, I empathize ...

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Have you ever felt that claims about the effects of our access to new and more health information overshoot the mark? For example, you may be searching for help in understanding some ambiguous findings from diagnostic tests. Perhaps you think you are having troubling side effects from your new medication but then it may just be a reaction to something you ate last night. You may be hunting high and ...

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6 tips to prevent being intimidated at the doctors office I’ve had my share of unsuccessful experiences with doctors and at medical clinics, including being intimidated by them. But after twelve years of chronic illness, I’m happy to report that I’m doing better in this uncomfortable setting. Here are six strategies to help minimize the odds you’ll be intimidated and to help ensure you make the most of the short time allotted ...

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