Hard time is here And ev’rywhere you go Hard times is harder Than th’ever been befo’
The opening lines of a century-old Delta blues song rings out among the stars and the dark of a rural Virginia night.  I sit tenuously awake atop an old wooden stump in front of a farmhouse, where four minds sleep peacefully inside. It is 3:00 am. From the window I hear the sound of the needle dragging ...

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My psych final was this morning, which I am 90% confident I did well enough on to pass the class (which is all I need to be satisfied).  Considering I counted watching “Girl, Interrupted” as studying, I say that’s not too bad. I felt like there were many necessary topics left out of our behavioral medicine and psychiatry course.  One of the many: sexual assault. For the past eight years I have ...

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It felt good to stuff the stethoscope back into my pocket and slip into the emergency department last night. The constant ringing of phones, beeping of cardiac monitors, and distant wail of inbound EMS units was a welcome cacophony compared to the isolated silence of the library study rooms. Sweeping the curtain back as we stepped into the first patient room, the hours of frustration with biochemical pathways and embryological derivatives ...

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“Um—Hi there, I’m a, uh, you know.  Medical student. First year. For, you know, the Patient-Doctor—err, Patient-Physician course—” The nurse smiled and turned to a woman of shorter stature with bony, scrunched- up shoulders. “Mary, do you want this first year to interview you?” Mary was about to set foot in the lounge when she heard this. She let out a sigh and faced me. Her eyes looked worn; I could tell ...

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I have been thinking a lot over the last few weeks about all the many ways that the experience of medical school has changed me. The most obvious is knowledge. I've drunk from the proverbial "firehose" of information that we experience in medical school, and apparently enough of the facts stuck with me to pass all my exams, and secure myself a residency program back in my home state of California. ...

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The lines of text on my laptop screen blurred together as I lost focus.  I knew there was at least one error on my medical school re-application I would regret later on.  My eyes scanned the familiar body of words but failed to connect the information to my brain.  Frustrated, I closed the application and shut my computer off. My bedroom door abruptly swung open, revealing my mother with the phone ...

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I recently wrote about the ways in which residents’ lives change dramatically during the transition to practice. For many, this transition feels like a complete 180. I’m going to devote today’s post to introducing the concept of a “Life After Residency Alliance,” which is a group of people you can rely on for support, guidance and direction as you transition to practice. The concept is taken from Napoleon Hill’s Mastermind Alliance, ...

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I was skeptical when a doctor casually mentioned that 2% of all pregnancies are ectopic pregnancies (in which the fertilized egg is implanted somewhere other than the uterus, usually the fallopian tube). Without treatment, a common outcome is fallopian tube rupture, which jeopardizes the life of the mother. It is a serious medical concern. I shot a confused look at a fellow first-year medical student. Two percent? It seemed way ...

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This morning started off like any other. I parked my car, walked into Starbucks and pulled up my iPhone app while waiting in line. The usual suspects were already there  -- the elderly fellow that always flirts with the baristas, the business man with his freshly pressed suit and the tired-looking mother. As I approached the counter, I ordered my usual summer morning beverage and went through the motions to ...

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As a teenager in the mid-late 1990s, my father, an engineering educator, and I would talk about the ills of the healthcare system and how physicians lost control of healthcare: primarily because they concentrated on medicine rather than the forces changing healthcare delivery. I realized this was due to an outdated medical education system and reforming it might actually improve healthcare in this country. That was my Sputnik Moment. Since graduating ...

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