“It is not for me to judge another man's life. I must judge, I must choose, I must spurn, purely for myself. For myself, alone.” -Hermann Hesse, "Siddhartha" What does it mean to die with dignity? As a neurosurgeon who faces life and death decisions routinely, I ponder this question often. When a terminally ill person decides to choose death over suffering, we perhaps recognize the ensuing act as a dignified death. But ...

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Long ago, I represented a doctor who was … difficult. He was a phenomenal surgeon, world famous in his field, but he was not warm and fuzzy — not even close. Cold and hard were more his speed. We spent two weeks together, on trial in city hall. It takes about two years from the time a case is filed to the time the case goes to court. During that ...

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I remember the exact moment I realized the amazing power of women; that together, women can accomplish anything they put their minds to. I grew up in a household of women. I had no brothers to compete with, and my parents always encouraged us to learn and develop leadership skills. However, even growing up in an encouraging environment, I still developed an unconscious bias. In school and in college, I often ...

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Recently, Dr. Ashish K. Jha, a Harvard internist and health policy researcher, published an opinion piece in JAMA, advocating public reporting of individual surgeon outcomes. I have followed Dr. Jha for many years on Twitter and have enjoyed his blog posts and papers. However, I must respectfully disagree with much of what he wrote this time. He tries but fails to refute the arguments that critics of individual surgeon reporting ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 58-year-old man is evaluated in follow-up for hepatitis C-related cirrhosis that is complicated by nonbleeding small esophageal varices and ascites. His ascites has recently worsened and has required large-volume paracentesis three times per month. He has been on a low-salt diet, spironolactone, and furosemide. On physical examination, ...

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It’s 3 a.m., and I’m wide awake.  I’m giddy with excitement and scared.  I am 41 years old and tomorrow feels like the first day of school all over again.  Only it isn’t.  Tomorrow is my first day back at the hospital where I work as a surgeon.  Tomorrow is also my first day back at work after chemotherapy. Two months ago, I was diagnosed with breast cancer.  I underwent bilateral ...

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Replace like with like -- that is the basic principle of reconstructive surgery since its conception in the mid-1500s. Borrow from the healthy part of the body to rebuild the damaged part ... But what do you do when you have run out of places to borrow? What if there simply isn’t anything like it anywhere else on the body? How do you reconstruct something as complicated as the human ...

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What is a doctor? Technically speaking, a doctor is a person that dedicates his or her knowledge and skills to the prevention and treatment of diseases, while maintaining and even enhancing human health. The majority of physicians enter into the profession of medicine because they are committed to helping others. It is this mission-driven spirit and dedication that makes us grateful for the opportunity each to care for others during a ...

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We as women have to stop saying "I’m sorry" for things out of our control. When we apologize for things we are not responsible for, we take a step backwards in the advancement of women in the workplace. I am a cardiac anesthesiologist, which means I care for patients who are undergoing open-heart surgery. I work in an academic medical center and train doctors to become anesthesiologists. The operating room (OR) can ...

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Knee replacements are booming. Between 2005 and 2015, the number of knee replacement procedures in the U.S. doubled, to more than one million. Experts think the figure might rise another sixfold in the next couple of decades because of our aging population. Since many people receiving knee replacements are elderly, Medicare picks up most of the cost of such procedures. It shouldn’t be surprising, then, that ...

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