It's the winter of 1993. A cold, snowy day. Windy. A blizzard. The phone rings. I'm not on call for my patients today — except for one. Daisy has been in my care since the early 1970s, and given the risk that she may suffer a serious downturn, I've instructed her nursing home to call me whenever necessary. This is that call. Daisy, my dear lady, the old artist, is dying. Throughout her ...

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As a doctor, there is an experience that all can relate to. It concerns that particular patient who comes in with not just one concern, but a litany of them. They require more than the prescribed 15 minutes of visit time, and we sit and listen, try our best to console and guide. Yet, for some patients, it never seems ...

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I read the recent article on KevinMD: “I’m sorry: Why I lost my love for medicine” with great sadness. My heart goes out to the author; many of their concerns echoed deeply within me. I am sorry that we, as physicians, haven’t effectively succeeded in solving the myriad of problems facing health care today. And the author is right: Health care as a system, in the ...

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I’m a pediatric hospitalist, and I know that most days in the hospital are routine. But every once in a while, a patient pierces through your armor, and touches your heart in totally unexpected ways. Willow did that to me. Willow was five days old and had been admitted because her breathing was not quite right. I first met her in her hospital room, with her dad hovering over her bassinet, ...

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Eighteen months out of residency and into outpatient psychiatry private practice, for the first time since before medical school, I'm coming home actually feeling a surplus of energy to put into my life outside of clinical practice. Sure, I did my best to maintain my interests and relationships during my training, but doing so felt like trying to wring blood from a stone. A slight sense of boredom in the evening, ...

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It is a busy time of year. I made my rounds to collect my skis after tuning, to pick up items for our Christmas guests, to get my haircut, and to claim my new eyeglasses.  I drove to my golf course and took a half-hour walk on snow-covered paths with my dog.  Dropped him at the groomers, then made stops for last-minute food shopping.  While my wife took on the masses at a megastore, ...

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It's 2 a.m. And I'm in the emergency room. There are beads of sweat dripping from my forehead. One of my nurses comments that I just don't look quite right. I can feel the urge to vomit and know where the nearest trash can is at all times. I'm clearly sick. Febrile. Shouldn't be working. But it's the middle of a night shift, and I've got patients to see. I place ...

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Throughout my career, I've contemplated what it means to be a good doctor. While I still cannot fully articulate it, I know a good doctor when I see one. She's the masterful diagnostician who can solve any medical mystery. He's the physician-scientist who spends countless hours on finding a cure for HIV. She's the colleague on my right, arguing on the phone with a patient's insurance company to get a ...

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I ran late the other morning. My first patient, an internal transfer, was already waiting. Booting up my laptop seemed to take forever. Usually, I try to poke around at least a little in the EMR before I enter the exam room, even when I know the patient well in order to remind myself of what we are supposed to do in today’s visit. I decided to walk in cold because I ...

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I wanted to go the extra mile for my patient. The resistance I found was unexpected. She was young. Her life — an incredible journey in diplomatic circles — was crippled too soon by a recurring disease that would ultimately prevail. Day after day, I'd round on her in what seemed like a pointless exercise, waiting for the inevitable to come. Another round of chemotherapy would have to wait for her ...

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