I know you want to. I know you would rather have anything other than dementia—even cancer. I know you are happy with your life and want it to continue as it is. If it has to change, I bet you’d like to slowly become more frail until one night you just die in your sleep. You do not want to slowly become more confused. You don’t want to live ...

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Happiness doesn’t always come easily. Some people seem naturally happy, like they inherited the right gene or were born into the right circumstances. Many other people struggle to find happiness. Perhaps even more people hope to become happier than they already are. But what kind of plan should people follow if they are hoping to become happier? Or will any kind of plan merely make it harder to thrive?

It ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old woman undergoes perioperative evaluation. She has osteoarthritis of the right hip since sustaining injuries in a motor vehicle accident 15 years ago and is scheduled for elective hip arthroplasty in the next few months. Medical history is otherwise notable for type 2 diabetes mellitus. She ...

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You’re at the top of your game. And you are perhaps thinking that this is not how you envisioned life at this stage in your career. Many successful physicians are frustrated that they can’t find the time or energy to be present with their family and friends. They haven’t even thought about activities just for fun and creativity. Taking a vacation seems impossible without the practice coming to a screeching halt. You ...

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One of the most important things to understand about heart health is that a woman’s needs change over time. Risk factors for heart disease like high blood pressure and high cholesterol can become more important as a woman ages.  Hypertension and high cholesterol are not things we may feel. This is why hypertension is called the silent killer. Even women who have always maintained normal cholesterol and blood pressure levels could ...

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The fertility clinic waiting room is a space where many people will find themselves at some point in their lives. In spite of cheery music, shared success stories, infertility awareness weeks, and positive media campaigns, this can be a challenging and sensitive time. About one in six Canadians experience fertility problems — these range from difficulties getting pregnant to difficulties staying pregnant and experiencing pregnancy loss. As fertility specialists, we know that ...

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The front-desk clerk, Ruth, comes to me and says Rose Henderson wants a cab voucher signed — which guaranteed payment. Rose could not be made to understand, Ruth tells me, that we are not permitted to sign vouchers when the person, the client, comes to our offices solely for the purpose of picking up cash ... which is Rose's purpose. We are Rose's payee, which means we handle her money. I ...

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In my very first job as a doctor — working in a London hospital in the 1980s. I always took a ridiculously detailed past medical history for every patient I saw. I started to notice how many elderly women had had septicemia, a life-threatening infection in which enormous amounts of bacteria enter the bloodstream. The neighborhood surrounding the hospital had once been the worst slum in London. And it didn't take ...

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Recently we had a patient admitted for a diagnosis that did not really fit his problem representation. The diagnosis was a convenient one, and easily treated. He initially responded to treatment, and we discharged him. The diagnosis assumption nagged at me, but I did not push forward with a test that my mind wanted. A week later he returned (the dreaded readmission), with the same symptoms. The admitting resident expanded the ...

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I am a critical care RN, and I violated my patients’ rights. For decades, every day that I worked in the emergency department or the intensive care unit, I violated my patients’ federally protected rights to participate in their plan of care. I didn’t mean to, or want to, but my tasks to maintain their life took priority over the obstacles to hearing them when they could not speak. Almost every day ...

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