Recently I made a self-deprecating joke among friends, when one of them said, “that’s so Jewish,” to which another quipped, “What do you expect? It’s in the genes.” The idea of a Jewish gene is not necessarily new, but it has become more popular and more concerning in recent years.  For example, today, direct-to-consumer genetic testing companies, like 23andMe and Ancestry.com, identify people with certain genetic markers as being a percentage Jewish, ...

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I am in the operating room working with an attending anesthesiologist I have known for years. "Tell me," I ask, "Do you and your colleagues talk about the difference between Des and Sevo?" He looks at me without responding. "You see," I continue, "There was a story on the radio about a hospital that has gotten rid of Desflurane because of the environmental impact. It is ...

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I am a primary care pediatrician. I am one of the thousands who serve our youngest and most vulnerable each day. Any pediatrician will tell you we are the underdogs of the medical hierarchy. But for me, it’s still the best calling on Earth. When I walk into an exam room, you will see my eyes lit up, my eyes bright, a happy lilt to my voice. You will sense the ...

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Recently, my mother waited for over an hour for what turned out to be a 5-minute visit with her primary care doctor. Her doctor seemed rushed and stressed, her questions perfunctory, the management plan hurried. And then she was gone. “It’s like she didn’t even know I was there,” my mom relayed to me. This is a physician who is thoughtful, intelligent, and kind, with excellent clinical instincts. After this visit, ...

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Physicians are excellent at floccinaucinihilipilification, which is seeing something as unimportant or worthless.  We engage in floccinaucinihilipilification every time we see a patient. We listen to their story and symptoms, and quickly filter, accept, or discard information until we arrive at our presumed diagnosis. The 18-second rule In 1984, Beckman and Frankel wrote in the Annals of Internal Medicine that the average time it takes a physician to interrupt ...

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Mr. O has a drinking problem. More specifically, Mr. O drinks far too much and far too often, and for reasons that can't be addressed with the tool he's chosen. I met him at what could be called the low point of his life, except I know better than to hope things will look up. On a night I covered the intensive care unit, this particular man ascended from the coma ...

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I once saw an older gentleman who was mentally impaired from birth. A hard enough blow, he had slowly, inexorably drifted into dementia.  He cut his head in a fall, suffering the ravages of gravity as so many do every day, every night. He was Caucasian.  His full-time care-giver was African-American.  That young man was the only person who could calm the angry, profane mood swings of his increasingly difficult, neurologically ...

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On my final day of work before beginning my self-imposed  burnout sabbatical, a colleague asked, "Why don't you just get on medication?" I remember thinking, "What am I medicating?  I feel nothing." I was in the vice grip of burnout, overwhelmed, and physically and emotionally exhausted.  But mostly, I was numb. But in reality, I have always self-medicated - with work.  As a professional ballet dancer turned doctor, my life has ...

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Calling. I am awakened by the loud, screeching sound of my pager. I feel my heart race. I look at the clock. It is 3:07 a.m. It’s cold in the room. I am shivering. I stand up quickly, instinctively. I feel the soreness of my feet for a brief moment, but push that thought aside and look quickly at my pager. It reads, “room 2309, death pronouncement”. My heart sinks. She is mine—my ...

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As clinicians, our medical training teaches us to categorize and diagnose. But caring for people can sometimes be gray – it’s not always black or white. In 2017, my colleague Dr. Kyle Christiason launched our health system’s first clinic dedicated to providing compassionate and affirming care to lesbian, gay, bisexual, transgender, queer, and questioning communities. As the Waterloo clinic got underway, we saw a growing need for services in central Iowa ...

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