Many physicians have become world famous writers, and in Greek mythology, Apollo was the god of both poetry and medicine. I can personally think of many prominent physician writers I have come across in my reading over the years: There was the 12th-century rabbi Maimonides, Copernicus in the 15th century and the poet John Keats in the 1700s. In the late 1800s to early 1900s, there were Anton Chekhov, Sir Arthur Conan ...

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It is not unusual to see a patient for a timely transition of care visit after a hospital admission and within a minute of entering the exam room know with all the bones in your body that this person needs to go back into the hospital. The funny thing is that when that happens, if the patient has Medicare, we may indirectly suffer financially from such “avoidable readmissions.” We belong to ...

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How would you like to double your chances of winning the lottery? Just buy two tickets! Statistically, this is true, but is that a reason to spend more money on something that most likely offers no return on investment? Yet, in medical research, study after study shows impressive improvement in relative risk for this, that and the other intervention but a small or even negligible effect on absolute risk. For example, I just ...

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I’ve finally found my groove with our EMR. Maybe I’m even starting to like it. A few weeks ago I got a new iPad, this time a Mini, which lets me type with two thumbs the way some people text on a smartphone, and the voice transcription is good enough as long as you avoid fancy jargon and unusual generic drug names. Yesterday as I sat next to a patient and ...

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“Jag ska bli doktor,” a four-year-old boy announced to his family sixty years ago. Somehow, everything he did after that moment seemed to move him in that direction, even when, on the surface, his path through life seemed to be meandering. As a student, he was just as interested in literature and philosophy as he was in scientific subjects. He even failed his first quiz in organic chemistry just after receiving the ...

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One cold winter night many years ago, someone dropped off a calico cat and her two kittens in our snowy driveway, and we went from a two cat family to a five cat household. I learned a few things from that. When I was a resident, two thirtysomething family docs had an office upstairs from the residency program. Ned and Peter precepted us, and they sometimes ran downstairs to ask the ...

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“The fool doth think he is wise, but the wise man knows himself to be a fool.” – William Shakespeare I learned about the Dunning-Kruger effect at a medical conference recently. It certainly seems to apply in medicine. So often, a novice thinks he or she has mastered a new skill or achieved full understanding of something complicated, but as time goes on, ...

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Something very interesting happened to my patient visits when I changed my office attire. My clean long cotton lab coats, hanging on the back of my office door, suddenly all seemed dingy when I set out to change lab coat about a week ago. I decided to pretend it was Saturday. On Saturdays, I usually wear a pocketed button-down shirt instead of one of my usual Jermyn Street ones. I skip the ...

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I missed a drug interaction warning the other day when I prescribed a sulfa antibiotic to Barton, a COPD patient who is also taking dofetilide, an uncommon antiarrhythmic. The pharmacy called me to question the prescription, and I quickly changed it to a cephalosporin. The big red warning had popped up on my computer screen, but I x-ed it away with my right thumb on the trackball without reading the warning. Quite ...

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It was late afternoon. The woman who had seen my colleague, Dr. Wilford Brown, a few days earlier was sitting in my exam room. Her chart note read like a typical unnameable virus: headache, body aches, fatigue, low grade fever. She had always seemed like a level-headed resolute woman, but she had called three days in a row for medical advice because she felt so poorly. And it all sounded ...

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