I practice in the rural, northwest corner of South Carolina, also known as “The Upstate.” It is a place of expansive lakes, white-water rivers and the mist covered foothills of the Blue Ridge Mountains. The area includes thousands of acres of Sumter National Forest. The natural beauty is breathtaking. Sumter National Forest and our various parks are laced with hiking trails, which are lined with unique plants and trees, some ...

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I recently cared for a patient who raised my heart-rate a bit. Of course, any emergency physician will tell you, the potentially difficult and complicated cases often come at the end of the shift, as you’re trying to clean up all of the paperwork and ‘head for the house.’ Nurse Ginger came to me and said, ‘we need a doctor in room 11.’ I snarled, snatched the paper, grumped and ...

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Does anyone realize that the chaos of modern American health-care is not a tragedy, but a triumph? We’re so busy trying to fix what isn’t broken and ignoring what is, so busy casting stones and casting doubts that we are blind to what we have. I have practiced medicine in this labyrinth for 16 years. I am an emergency physician. I practice in what may be considered the ‘epicenter’ of modern ...

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One of the many questions asked in the health-care reform debate is ‘how do we keep people out of emergency departments in order to reduce costs?’ Simply put, we probably can’t. And 16 years into my emergency medicine practice, I think I know why. Having taken my own children to the emergency department, even I have been surprised at the charges generated. But we should step back and remember that emergency ...

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It happens over and over. I call a surgeon about a patient with abdominal pain. ‘Well, what’s the white count?’ ‘Normal.’ ‘Did you get a CT Scan?’ ‘Yes, and it was normal. But they just look uncomfortable.’ ‘Sounds like nothing for me to do. Call the hospitalist.’ It happens in other specialties. Cardiologists who aren’t interested in a patient with a normal stress test, pediatricians unimpressed with negative chest x-rays and normal labs. ENT’s unconcerned if ...

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An emergency physician, like me, may be the worst possible person to discuss relationships with patients. I mean, one of the reasons I chose this specialty was that I didn’t want long-term relationships with my patients. I see, now, that God has a great sense of humor. See, the county I landed in after residency is small enough that I do know many of my patients, and I do see them ...

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My kids love to play Monopoly. They delight in acquiring properties, making money and crushing their siblings. They play with passion and savagery. That is, until recently. A couple of weeks ago I walked past the Monopoly board, spread on the floor between my children and their dear friend Tyler. "˜How's it going guys?' "˜Great game, but we all ran out of money. So, we just put some more money on the ...

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While I was driving my rental car a few days ago in another city, a man passed me on his chopper. He was covered in tattoos and his long hair was blowing wildly in the wind. He looked the very image of freedom, of unrestricted energy. Snug in my safe (boring) Chevy Cavalier, on the way to a meeting, with Mozart on the radio, I didn't give him another thought. ...

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I often joke that I'm not only an emergency medicine specialist; I'm an'alcoholologist.' It took quite a while for me to develop that expertise. See, I grew up in a home where no one used alcohol and none of our friends used alcohol. Consequently, other than some college and medical school exposure to the stuff, I was pretty naïve about alcohol. Now, 15 years into my practice, 18 years after medical ...

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I have read many articles about professionals who left their career fields after many years and decided to teach. Many of them go into the public school system to share their knowledge and experience with the next generation. In fact, it sounds like a grand idea. Qualified teachers are a commodity of inestimable value. But I have been stricken by a comment made by many of those who changed careers Almost ...

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