Developing the COVID-19 vaccine was the first monumental milestone on a long and arduous journey to achieving the entire U.S. population's vaccination. One of the barriers to achieving this task is the absence of a reliable, scalable way to uniquely identify each individual before or after they receive the vaccine. Furthermore, in the absence of this unique identifier, it is extremely difficult to reliably use existing state or regional data repositories ...

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"I am overwhelmed right now. I know I am not alone. I hear it in the voices of my friends, family, colleagues, patients. We are all feeling it. I am overwhelmed by this virus. There is so much to learn, so much to teach. Every day the information changes. Who is credible? Who ...

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The highly anticipated A Promised Land was the first book I could not wait to crack open over my two-week break for the winter holidays. Former President Barack Obama explains in his introduction that this work is the first of two autobiographical accounts covering the period from his state legislature run in Illinois through his presidency. This masterwork takes you through every decision he makes and helps illustrate just how ...

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Canadians breathed a huge sigh of relief when the federal government approved the first COVID-19 vaccine and saw the first immunizations take place. The end of the pandemic and the prospect of a return to normal, whatever that means, became a real possibility.

Rolling out a national vaccination program will be no small feat. In addition to the basic logistical challenges of moving volatile product throughout the ...

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With this third surge and our ICUs at zero capacity in Los Angeles, I spent  New Year’s Eve alone at my apartment, recovering from a wards rotation I had completed the night before. No revelry or celebration for me this year.  For months, this virus has been wreaking havoc on our lives and slowly,   then rapidly chipping away at our health care systems. I’ve seen the ...

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Family lore recalls that my grandfather, succumbing to stomach cancer in the mid-1960s, “died addicted to morphine.” Decades before the AIDS crisis sparked the hospice and palliative care movements, the confluences of pain, dependence, and addiction were confused and regrettably moralized. Since then, the science has excelled, but our clinical understanding of how pain and addiction intertwine remains limited by stigma, assumptions, and the separation of the underlying science ...

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I am at a loss.  While trying to explain the events to my children since January 6, I feel profound sadness and fear.  Our country is built on freedom, yet the latest in a parade of crisis’ is being used by those in power to remove our freedoms at an alarming pace and divide our country further. Less than one percent of the people who went to Washington, DC for a ...

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"Each year, medical students across the country prepare to start the long-anticipated core clinical rotations. Suddenly, we’re thrust into a world of constant adaptation and evaluation, with many highs and many lows. As I finish up the year and new students get ready to start, I’ve been asked time and time again for ...

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She shook her head no, eyes brimming with tears, chin quivering with emotion. Again, I told her that without further care, her son would never have use of his arm and possibly would die. Her voice trembling, she told me her husband would beat her if she returned home without the boy. She placed her son on their horse, his newly bandaged arm in a make-shift sling. I gave her ...

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December is typically busy in the ICU. Flu and respiratory viral pneumonia cases start trickling into the ICU, interspersed with cardiac arrests, strokes, pulmonary emboli, septic shock, and COPD exacerbations. The ICU census starts creeping up. December 2020 has been unique and challenging. There were seemingly endless days of patients coming to the ICU, only to die. People with COVID-19 and the usual ICU ailments seemed sicker than usual. Patients have ...

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This is not what I signed up for. Have you ever said this when you are rushing home 1.5 hours after the last patient left and you still haven’t finished all your charting? You grab a handful of forms to take home with you with the hopeful expectation that you will get them done tonight too. After you have done “enough” to appear to be a present parent and prepared supper ...

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"Doctor, how are you doing?" I’m really so grateful when people take the time to ask this. But when I respond, candidly, that it’s been tough and I’m definitely not doing great, I often hear, “But you haven’t had any patients who have died from COVID, have you? And you got the vaccine, didn’t you?” Fortunately, no (not yet) and yes. My heart goes out to our ICU, inpatient, and ER teams ...

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Being an internist, the day is filled with problem-solving.  The problems are often not straightforward and require thinking, rethinking, reevaluating, and reading up and researching before the problem can be solved.  However, when a sixth sense, an intuition kicks in that warns us that something needs to be addressed urgently even when we cannot specify or articulate why. Once I had a patient come in for shortness of breath that is ...

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"We in medicine are experts in delayed gratification. We’ve been in school for what, about 21 years before residency? Then we finally become an attending.  Then we can splurge a little. But still, we were told to hold back. Live like a resident. This is a great skill to have as an entrepreneur. ...

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She was rather calm during her visit.  It was the first time we’d met, and she was establishing primary care with our office and me.  We were both delighted to learn she was from a small Georgia town not too far from where I previously practiced, and we quickly reminisced about the slow pace, lack of certain resources, and genuinely good, devout people that often stem from and still reside ...

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Dear colleague, Sorry for my delayed response. I didn't know if I was going to follow up with you on this issue.  When you initially messaged on LinkedIn, on New Year's Eve, I was holding my daughter.  She's five, and she was desperately trying to stay awake for the ball drop.  She was determined to ring in the New Year.  Which, unfortunately for me, meant that I had to keep my ...

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Sometimes structural racism surfaces in a way that even those of us who would like to be “color-blind” cannot help but see. In the spring of 2020, the video-recorded death of George Floyd (who was Black) at the hands of a law enforcement officer (who was white) brought millions of witnesses to the kind of hostility that is all-too-familiar to individuals of color.  Individuals, many non-white, took to our nation’s capital ...

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Vince Hamilton has no legs. For that matter, he has lost the tips to most of his fingers as well.  It made opening soda cans almost impossible.  So when I saw him for the first time, my immediate reaction was one of sympathy. He had been admitted from a nursing home with a swollen red finger nubbin.  It wasn’t hard to figure out it wasn’t his first time around this rodeo from ...

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Experts have taken to social media to quell misinformation and address common concerns about Pfizer’s messenger RNA (mRNA) COVID-19 vaccine, performing an important public service in support of robust vaccine uptake. However, some scientific information is being oversimplified to the point that it is misleading. The public’s decision to take a vaccine whose long-term risks are unclear should be a well-informed one. Clear communication is crucial to the process of ...

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"What has become of medicine today? What has become of the sacred patient-physician relationship? What has become of medical offices- aren’t they supposed to be healing places? Who goes to a medical clinic (no matter how Big the Name) to be insulted and diminished and hurt? What has become of physicians as ...

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