Physicians have long been seen as superhuman -- able to jump the academic hurdles required to gain entrance to medical school, willingly delaying many of the gratifications associated with young adulthood, surviving long hours during training and later when in practice, keeping a cool head amidst crisis. In many ways, we physicians thrive on this image. Personally, I was unaware of how much I enjoyed the mantle of hero until I ...

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Sir William Osler wasn’t exactly wrong when he said, “Listen to your patient, he is telling you the diagnosis." But he didn’t mean it literally. His patients did not offer up esoteric and complete medical diagnoses on a silver platter. They left him clues in plain language that he listened to carefully in order to make the correct diagnosis. He penned his words in an era when medical information was scarce ...

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Medicine has become increasingly stressful for all levels of health care providers. Every year, nearly 400 physicians commit suicide, and in a study published in the Journal of Academic Medicine, researchers found that almost 10 percent of final year medical students and first-year residents (called interns) reported having suicidal thoughts. Previous studies from the National Institutes of Health found that physicians were twice as likely to ...

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When I started medical school, my classmates and I attended a special ceremony where we stood in front of our friends, family, and professors and recited some modern version of the Hippocratic Oath. For years afterward, I only remembered the “do no harm” bit, which is a lazy approximation of the actual words. I recently reread the oath, and even though I’d completely forgotten, it also said this: “I will ...

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I was about 13 years old. I heard that she had cancer and I went to the hospital to visit her.  Her name was Sister Pat, and she was my former principal and my favorite teacher from elementary school. I don’t think she had reached her fortieth birthday.  I was too young and uninformed to ask about any of the details.  However what stuck with me and I remember so ...

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The medical assistant swabbed my nose and my throat multiple times. Pricked my finger too. Then, the phlebotomist (or vampire?) drew bottles and bottles of my blood. Along with the physical discomfort, there was emotional discomfort too. What would the test results show? If they were all negative, would I be satisfied without having an answer? Being a patient can be extremely vulnerable. Not only do you often divulge to a ...

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I spent the evening of the 2016 presidential election and the morning after on an emotional rollercoaster. It began high and then descended into shock, disbelief and grave concern about the future of our country. Now that we have selected a candidate who intends to take the country in a radically different direction, and I worry about the consequences of reversing the Affordable Care Act, reversing economic assistance programs, and ...

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For a century, the white coat has been the symbol of the medical doctor. Today, the vast majority of medical schools in the U.S. begin with a white coat ceremony. There, the fledgling, future doctors stand together and recite a modified version of the Hippocratic Oath before being called up one-by-one to receive the white coats that they will wear throughout the upcoming trials and adventures of medical school. The ...

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Physician burnout has received a lot of well-deserved attention lately. Characterized by emotional exhaustion and professional frustration, it's tied to an array of adverse consequences, from physician suicide to poor patient outcomes. Organizations are waking up to the need to measure its prevalence and ameliorate its impact. There seems to be two broad schools of thought about the causes — and by extension, the fixes — of physician burnout. The first focuses ...

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On November 1973, I had an epiphany.  My first week on my internal medicine clerkship, I realized that I had found my specialty: internal medicine. Prior to medical school, I had worked with emotionally disturbed children in an inpatient hospital.  I really enjoyed the experience, and learned a great deal.  During my first two miserable years in medical school (I disliked how they taught the basic sciences and even more how ...

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