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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Mr. Fine is in for the eleventh time in less than a week. I work as a social worker in a hospital emergency psych unit. Mr. Fine is suicidal again. It is kind of late in the evening when I see him, although it is my first time, I am the only social worker on tonight. This is the usual situation, one social worker per shift. The psychiatrist takes me aside, quietly ...

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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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As I was finishing up with my doctor’s appointment for the required immunizations I needed for medical school, my doctor asked if he could give me some advice for my upcoming journey. Being the clueless pre-medical student I was at the time, I said, “Please do.”  He said something along the lines of “They’re going to try to rewire your way of thinking, but stay true to who you are.” ...

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1. Increase retirement investments. As young professionals who will eventually retire or cut back on work at some point, we need to start investing in our future. While many of us may already have started setting aside money for retirement, others of us may not have begun that process. In 2020, let’s strive to do even more. Let’s commit to increasing our retirement savings, even if it’s by a small ...

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"What do you want to be when you grow up?" It's a question I frequently hear from physicians on my clinical rotations. Phrased somewhat tongue-in-cheek, the wording allows me to answer either in jest or in earnest. "An astronaut," I sometimes say, hoping for laughs and no follow-up. Other times, I try out different responses like Halloween costumes: a critical care specialist, an emergency physician, a surgeon. If I want the questioner's ...

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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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The World Health Organization has designated 2020 as the Year of the Nurse and Midwife in honor of Florence Nightingale’s 200th birthday. We owe a lot to Florence Nightingale, but what about Harriet Tubman or Mary Seacole? Nursing – and society – has been changing since the days of these nursing pioneers. It’s way past time to catch up to their timeless insights and fearless activism. We owe to all these ...

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School has gotten back into full swing, and thus we begin another cycle. Will this cycle be better than the last? Every year we find ourselves in this same spot. Summer’s over, big vacations are in the bag, back to school shopping is complete, and we start recovering from our summer spending. We often haven’t yet recovered from the summer splurges before it’s time to start Christmas shopping. Then we begin ...

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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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The practice of medicine is limited by what we can control. As students, we are taught to believe in the power of science, the importance of hard work, and the momentum of technological advancement as prime determinants in our patients’ outcomes. However, as we get further along in our careers, we come to realize that many of the factors that contribute to poor health are beyond our control at ...

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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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Because everything around us usually works, it can be easy to forget how fragile some of the workings are. My patients see this with their bodies, as they fail, but not so apparent to them are the fragilities of the health care system that we doctors get to see. Despite what the if-it-bleeds-it-leads press might have you thinking, our health care system is pretty good. Good, however, is never good enough, ...

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Doctors dispense medical advice. That’s what we do. Folks come to our office with various medical issues. We talk to them. We poke around some of their body parts. Then, we exercise our medical judgment. We might order a CT scan. We might prescribe stuff. We might simply reassure them and send them on their way. This is a typical day in the life of a health care provider, formerly known ...

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There are certain paradoxes of life that are beyond the realm of rational explanation. To me, one of such is that a country that figured out how to defy gravity and conquered the cosmos has time and time again proven to be incapable of taking care of the most basic human need, namely: a commonsense health care delivery system. U.S. spending on health care in 2016 was estimated at about 17.2 ...

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