School is back in full swing.  The kids are packed up, scheduled and loaded with notebooks, pens, pencils, computers, and calculators.  Long lines form outside school drop-off areas.  Tired, pajama-clad parents drop off bleary-eyed children, accustomed to sleeping and playing all day, now headed off to fill their little brains with knowledge. Of course, it isn’t just the little ones.  All of our children were home over the Summer.  Now our daughter is a high school ...

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There’s an ugly undercurrent that sometimes shows up in the emergency department: indeed all over the world of medicine. I’ve seen it in doctors and nurses alike. It’s a meanness, a smallness, a kind of moral judgment that can lead us to make poor medical decisions. Or it can simply make us poorer in spirit. I remember the day I had a young man who was in custody. He was 18, ...

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So let’s get down to it.  Everyone is tired of shooting sprees.  If you’re a gun owner, you’re tired of seeing weapons abused and misused to harm the innocent.  If you’re a gun opponent, you feel the same way but can’t imagine why anyone has these weapons in the first place.  I get it.  I hope both sides get it. I’ve thought about this a lot.  I’m a gun owner.  I ...

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This summer, new resident physicians begin their training all across the United States. Today, our future family physicians and pediatricians, neurosurgeons and emergency physicians, plastic surgeons and laser tattoo removal specialists (OK, not really a specialty, just a sideline) will begin learning how to be physicians, having completed four years of expensive college and four years of even more expensive medical school. Anxiety-filled and debt-ridden, they will embark on four ...

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It’s peculiar, I think, that we live in a time of physician shortage and yet some things remain abundantly clear: 1. Physicians can’t work together to fight, either for their own good or the good of their patients. 2. Like hostages, or abused spouses, they just keep going back for more of whatever bad policies they endure. 3. They are devalued. Now, this isn’t about money. I’m not enough of a medical economics expert ...

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I have met, in the emergency department, some fierce individuals. Sometimes they can be terrifying.  Their clothes, their manner, their demeanor, the way they pace, all suggest potential danger.  They seem clearly capable of violence.  They look at me with distrust, expecting to be disrespected, dismissed, treated harshly. Sometimes, they are covered in piercings; a thing alien to me.  Other times, the symbology on their clothes speaks volumes.  My colleagues in ...

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It’s easy to be excited about facts when they support our own opinions. It’s nice to believe that uncomfortable facts are fake. Likewise, it’s comforting to believe that everyone who disagrees with us is ignorant. When the truth is so obvious, we say, "How could anyone but an uneducated bumpkin deny it?" And yet, it seems that much of our knowledge is incomplete and that our deeply held beliefs may be ...

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I know a bit about the opioid epidemic ravaging America. My wife and I grew up in West Virginia and follow the news from home. I practice emergency medicine in rural South Carolina, and have worked in Georgia, North Carolina, Kentucky, and Indiana. I have seen the enemy, and it is terrible to behold. The genesis of the epidemic has been covered over and over. It is a complex problem with ...

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I am convinced that I have one of the best jobs a writer can possibly have. I practice medicine, in an emergency department. My life, every day, is filled with conversation with humans. I see their faces and touch their hands. They bring me their children, their very children (!) and trust this stranger to make their precious ones well. I hear their stories! Such stories. Of sorrow and sadness. Loss ...

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Without doubt, the future of medicine will include mandatory education for physicians on their conscious and unconscious biases. The politically and culturally progressive nature of medical education and graduate medical education almost ensure that this will eventually be a deeply-ingrained part of our training and our continuing certification. I’m sure that as our culture purports to discover ever new and egregious forms of bias, we will be endlessly reminded, in ...

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