Conditions

The devastating opioid epidemic is one of the largest public health problems facing the U.S. Over 2.5 million people in the U.S. suffer from opioid use disorder. Four in five new heroin users started out misusing prescription painkillers. A 2015 analysis by the Centers for Disease Control and Prevention found people who are addicted to painkillers are 40 times more likely to ...

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My name is Lucy. I have stage IV liver cancer. I wanted everything done — even though the doctors told me this disease is terminal. My family, my church and my friends were praying for “the cure.” Though I believed in God and the hereafter, I wasn’t ready to go. 74-years-old with beautiful children, grandchildren, and a great-granddaughter. I woke up confused. In the background — wherever I was — I could hear ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 35-year-old woman is evaluated for intermittent fever, sweats, fatigue, and dull midchest pain of 2 weeks' duration. Medical history is significant for liver transplantation 6 months ago for primary biliary cirrhosis; she was seronegative for cytomegalovirus and Epstein-Barr virus, and her donor was positive for both. Results of ...

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The interviewees in my book talked about declining quality of health care. Do people even know or remember what it is like to get quality health care? Doctor visits are often too short to be adequately through. Psychotherapy is too often too brief,  with a focus on "quick fix." Psychotherapy isn't just about talking. It involves careful, thorough study and application of knowledge to the issues that patients bring with them. ...

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Whether to circumcise a newborn male child is not the simple, binary “yes/no” question it appears to be. Rather, the choice is affected by an astonishing array of issues: religion, culture, health and hygiene, sexually transmitted infections, expense, pain and medical recommendations. Some cite ethical concerns regarding usurpation of a child’s free choice. Others claim an equivalency between neonatal male circumcision and the practice of female genital mutilation. As a practicing ...

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A baby acutely ill with leukemia seems like the polar opposite of a woman with Alzheimer’s disease (AD), with her slow, insidious deterioration. Yet each disease can be progressive and fatal. I’ve cared for both, in different ways.  Can a childhood cancer doctor like me have insights about that other end of medicine, older adults with dementia? As a husband and caregiver, confronting my wife’s Alzheimer’s disease, I am appalled by the ...

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In Toronto on April 23, 2018, Alek Minassian intentionally drove a rented van into pedestrians, killing ten and injuring at least 15. Later the same day, Constable Ken Lam of the Toronto Police Service arrested Minassian after a brief, tense standoff. As seen in a widely circulated video, Minassian dared the officer to shoot, and feigned drawing a gun, most likely to commit “suicide by cop.” Constable Lam, however, ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old man is evaluated in follow-up after a diagnosis of ulcerative colitis. Ten days ago he was started on prednisone, 60 mg/d, but his symptoms have not improved. He has six to nine bloody bowel movements per day and moderate abdominal pain. He has decreased his oral intake ...

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Any debate as to whether chronic traumatic encephalopathy (CTE) is a legitimate neurological malady that affects football players is slowly being put to bed. Repetitive hits to the head resulting in sub-concussive trauma and that concussions are the culprit here. Clinical findings associated with CTE include memory loss, depression, anxiety, violent behavior, mood disorders and heightened suicidality, among other impairments. It tends to progress with time and can lead to ...

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