As a pediatrician and future mother of black children, I am worried. I am worried about my patients who face possible death if they appear threatening to the wrong police officer, like Tamir Rice. I am worried about my patients who might be sleeping peacefully in their families’ home when law enforcement officials burst in with grenades like the ones that killed Aiyana Stanley-Jones. I am worried about my teenage ...

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There was a time within my professional lifetime when old records would arrive on the medical ward in a wheeled wire basket, multiple volumes with shabby pages. And in the VA of the 1980s, which still had veterans of World War I who never lived anywhere else the previous half century, the forklift could deliver not only the charts but the x-ray films that had not yet been sent to ...

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As the awareness and recognition of concussion in sports continue to increase and the frightening long-term outcomes for frequently and severely concussed athletes are realized, as a physician I cannot help but advocate drastic changes in football.  Of the major sports, it sees the highest rates of concussion, and for every highly publicized Greek tragedy of a broken NFL star (Jim McMahonJunior SeauDave ...

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Valley Medical Center was an iconic hospital and a great place to learn the craft of emergency medicine.  It was an old TB hospital that eventually became Fresno’s county hospital.  Sitting at the corner of Cedar and Kings Canyon avenues VMC was nothing to look at.  However, the combination of rampant poverty, violent gangs, and severe shortages of both doctors and nurses, made it an ideal place to do residency. In ...

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Incident reports are frequently submitted by hospital personnel. Did you ever wonder what happens to them? I have. Over the years, I estimate that I’ve heard of hundreds of such reports being filed, but rarely have I heard of a problem being solved or for that matter, any action being taken at all. In fact, I don’t even know where they went or who dealt with them. When I was a department ...

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Whenever I have the opportunity to suggest that good medicine is based on friendship, I usually get a nod of approval mixed with a quizzical look.  What’s that supposed to mean? At a recent meeting of an editorial board on which I serve,  the reaction to my suggestion was more forceful and perhaps more honest.  The topic of the day concerned patient education, and how hard it can be to move patients to do things ...

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"How many patients do you have?" I’m not sure what you mean. How many patients do I see on average each day? About twelve. "No. How many patients do you have?" Let’s see: Last week I saw about sixty patients altogether. Five of them were new patients. "No, no. How many patients do you have on your panel?" My panel? I don’t know what you mean by that. I don’t work as an employer in ...

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I’m struck, sometimes, by the vehement tone of some of the antivaccine comments you see out there. People who hate or distrust vaccines proudly proclaim that their Googling and life experiences have taught them that vaccines are bad. They don’t care what the science or the evidence shows. They know what they know. Me? I’m not so much into vehemence and dogmatism. I’ll follow the evidence. Show me solid science that ...

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IMG_0791 Dear Mr. Timberlake, I was not expecting to see you and I together. As a long-time fan, our names sharing space in the celebrity gossip column of In Touch Weekly was truly a surprise. Now, JT. Can I call you, JT? I know that you remember me from a few months back. We shared some time in a darkened auditorium with a few thousand of my friends ...

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I thoroughly enjoy my 65-year-old male with his horrendous diabetic foot ulcer.  But there’s not enough insulin in the state of Tennessee to cover the two bacon, egg, and cheese biscuits he eats every morning. And I adore my 57-year-old female with COPD.  But the inhalers won’t work until she stops smoking two packs of cigarettes per day.  I laugh every time I see that hilarious 32-year-old with hypertension.  But the ...

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