Every small community has a unique but similar cast of characters. Our small Southern Utah town was no different. From a young boy’s perspective, the cops and docs were feared but cautiously idolized, the mayor was respected, the athletic coaches were immortalized, and of course, we had the homeless man in town, whom we feared. We will call ours Stu. Stu had greasy disheveled hair and a gray beard. He wore ...

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I’ve been a doctor for one year. Two years of clinical rotations in medical school ill-prepared me for the reality of this job. Not that I went to bad medical school by any means; working in health care is simply something you can’t learn from a textbook or even on the sidelines as a marginally involved medical student. It is immersive. Working around death and dying individuals can be mentally and ...

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Since the two very sudden public suicide deaths of Kate Spade and Anthony Bourdain, society has again recognized that we never know what is under the surface of another’s façade. As physicians, these tragic occurrences emphasize that our caregiving requires seeing the entirety of an individual’s many parts. While we acknowledge that the façade is not fake -- it is but one true representation of an individual, well-curated, like pages on ...

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The recent prominence of the #MeToo movement has shined a light at many places in our society where insidious or even obvious sexism against women has long gone unremarked. Even when noticed it’s just shrugged off as the way things are. In honor of this, #MeToo was named Person of the Year for 2017 by Time Magazine. Medicine is no exception to this pervasive problem. A very interesting recent essay in the New ...

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Dear CVS, Please change your hold music. Please. Do the right thing. It’ll take you, or someone who works for you, or even a barely pubescent adolescent who nevertheless knows how to program music on his iPhone with more aplomb than anyone born before 1975, only about 48 seconds. And 48 seconds is substantially less than the amount of time I have listened to your never-changing hold music. I have researched the source of this ...

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We live in incredible times. A time when a millennial with a YouTube account clears six-figures a year (sometimes, seven figures!) with just a computer and a webcam. A time when a small-town girl with a love of fashion and an Instagram account can go from Nowheresville, America to front row at New York Fashion Week. A time when the shy girl in the back of the classroom amasses a following of hundreds ...

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Altruism is killing us. Take a second to let that sink in. Truly think about it. Resist your conditioning to refute this claim and try to apply it to your life. Still having trouble? Let me try to explain. In order to understand the truly destructive force of altruism on medicine, one must first define altruism. This can be difficult to do in the United States as any “good” or “charitable” ...

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It's a Sunday evening in a local South Texas emergency room with the expected ER traffic for a weekend evening. Lots of simple traumas: ankle sprains, abrasions, lacerations, falls, common URI symptoms, and fevers. The EMS radios in with a call of a five-year-old male who has altered mental status. The patient is brought in around five minutes later and placed in an open emergency room. The patient is accompanied by ...

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Why does she work? It’s a question that she must answer, for it begs itself every time she picks him up from daycare. She always finds him happy there. And yet that — selfishly? — is part of what tears at her. Shouldn’t she be the one making him happy at 11 months? It's more important to her than any other role that she plays – she wants to be everything that ...

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I am frequently asked what I do at social gatherings. My response, naturally, is that I am a physician. The individual then asks what your specialty is and I respond that I am a board-certified family physician. Then, I hear, “Oh, you are a GP.” Really! After all these 35 years, I am perceived as just a GP. "Just" is the key word at social gatherings — implied or stated. Well, ...

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