When I was 20 years old, I boarded a flight from St. Louis, Missouri to Houston, Texas.  It was Fall and the temperature had begun dropping.  That being the case, I was dressed like a typical college student at that time of year: sweatpants and a hoodie.  After taking my seat, a middle-aged white woman sat next to me.  Little did I know what I was in for. Over the course ...

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There are so many things that I could tell you to be.  Be brave.  Because change and opportunity are scary and fear is a natural precursor to achievement.  Be kind.  Because there are fewer things in life that will bring such natural and unadulterated joy.  Be humble.  Because the first sign that you are plodding off in the wrong direction is the undying certainty you feel in the rightness of ...

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I just heard. A colleague, a man of integrity and warmth, a hard-working physician with ideals, ethics and many valued contributions, has taken his own life. His perspectives may have differed from mine at times, but every interaction was infused with respect. He was a good man. Much has been written about the rate of suicide of physicians. One million Americans lose their doctors to suicide each year. Normally I ...

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My patient The day I met you was early in my second year of internal medicine residency. After much of my internship had been spent on arduous inpatient rotations, I was finally ready to lead my own team of young doctors and students on a high-acuity wards service. Yet, in my continuity clinic, I was still fresh, insecure, and naive. The day I met you, your abdomen was swollen, your eyes ...

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When I’m working in a hospital setting as a physician, part of my everyday job duties involves going over consent forms with patients. I am of course a medical physician, rather than a surgeon, so generally don’t have to go over them as often. But I do have to take consent regularly for certain interventions including blood transfusions and minor procedures. The process of getting consent is something everybody is ...

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There’s an ugly undercurrent that sometimes shows up in the emergency department: indeed all over the world of medicine. I’ve seen it in doctors and nurses alike. It’s a meanness, a smallness, a kind of moral judgment that can lead us to make poor medical decisions. Or it can simply make us poorer in spirit. I remember the day I had a young man who was in custody. He was 18, ...

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How many physicians know how many visits they are approving when referring to a specialist? This was a germane question posed to me today. I first asked this question of myself as a junior faculty member, while busting the residents’ chops over the egregious numbers of referral visits they were approving. You see, as any good resident knows, being proactive in the referral department demonstrates skill in the art of “avoiding ...

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During my first pregnancy, I frequently dreamt of my baby. I couldn’t remember the details of facial features or hair color, but I always knew that I was going to have a girl. Three years passed after Claire was born, two more heartbeats were identified and then lost somewhere deep within my abdomen. On two occasions, I watched blood seep from my body and stain my clothing, realizing that I didn’t ...

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It was 4:30 a.m. on a freezing cold winter morning when I dragged myself to my car and started down the street to the hospital. I was working in the ICU for the month, and sleep had become a commodity I no longer enjoyed. I tried to shake my brain out of the dense fog it seemed to always be in lately. I looked up in time to see my car ...

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The process of setting up a new pain management clinic has allowed me to critically consider the role of patient intake forms, an area that has traditionally been ignored by technological advances and institutional innovation.

Health care must empower patients to conveniently complete intake forms digitally -- whether at home, en-route to our clinics, or in our waiting rooms.  When done correctly, the forms can greatly enhance the patient ...

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