An unusually calm morning in the ICU led our amiable attending start rounds by asking how we took care of ourselves so that we could look after others. While scrambling to gather patient details, we all struggled to answer them, except for my eccentric British-Canadian friend (who is still confused about his nationality since Brexit) who said he did so by reading Hemingway. In medical school, board scores seem to be ...

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Too often, residents want you to address something, so they don't have to — except for infectious problems where they putz around with antibiotics until lunchtime on Friday, then call ID. For me, one example seemed rather routine: a diabetic with another medical illness. It wasn't terribly well defined in the hospital records, but included atrial fibrillation and congestive failure at presentation. At day nine, with pressure from the DRG lady ...

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I frequently get asked how I balance my schedule as a physician who is also involved in lots of different things outside of clinical medicine. As any reader of my blog knows, I like to stay busy! As well as my work as a frontline physician (which I absolutely love and have no intention of ever leaving)- - doing a mixture of inpatient and outpatient work, I also am involved ...

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An excerpt from How to Raise a Doctor: Wisdom From Parents Who Did It! I know what you’re thinking, I thought this book was about how to raise a doctor, and now this guy is telling me not to raise a doctor! That’s exactly right. I’m telling you to not ...

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When you see your doctor, you want to know what’s wrong, follow the steps to recovery and get predictable results. Sadly, this is not always possible. Medicine is an art based on science that is constantly changing and full of things we don’t know. Here are four reasons why it seems like your doctors didn’t get it right — when we actually did:

  • Your symptoms or exam findings were not typical ...

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On a weekend night, I received a strange phone call from an emergency room resident. “This is an emergency,” he said, adding fragments of details, “… vaginal bleeding … her heart rate is in the 150s.” It was hard to figure out what was happening and his tone was oddly calm. “Is she in an exam room?” I asked. “No,” he replied, “we’re in the trauma bay.” I ran downstairs with ...

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CPR was first endorsed by the American Heart Association in 1963. When I took a Red Cross Life Saving Course in 1965, we learned about the “chest pressure arm lift” form of resuscitation which worked about as well as burning incense. I began working as an orderly in a community hospital in 1967. You probably remember that I was famous as the guy who first popularized wearing gloves when inserting ...

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Consider this hypothetical addendum to a hospital discharge summary: ”ADDENDUM @10:56 a.m: In considering the accurate billable discharge time involved in this case (as I have recently been instructed by hospital coders that I must record the exact time required for a patient discharge, rather than simply “greater than 30 minutes” or “less than 30 minutes”), I feel I have stumbled upon a troubling quandary, having failed to note the exact ...

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I’ve interviewed many doctors on my podcast The Doctor’s Life. They share their stories of how they came to medicine and how they developed into the physicians that they are today. There are three common themes in these “origin stories”: The first is that many of the doctors were mentored by a physician who inspired them to pursue medicine. The second is that they were “called” ...

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Humans need human touch Patients sometimes need a shoulder to cry on. When I say that, I normally mean it on a completely figurative level. However, at times, it needs to be interpreted differently. There are instances in a medical encounter where an actual shoulder could be of service — a physical crutch that takes off an emotional load — and that's when the popular adage can be beneficially carried out in ...

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