I sometimes get messages from people who have lost physician colleagues and loved ones to suicide. It’s the specifics of these stories that wound me: a note left for an unexpected person; an insignificant fight at sign-out that in retrospect is full of meaning; the white coat that a woman wore when she jumped to her death. Each of these lives is complex, and each of these deaths ...

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When my friend was in her fourth year of medical school, she and her boyfriend sat down with their dean to discuss their residency applications. Both have since gone on to have successful academic medicine careers, but on that day in the dean’s office, they were nervous. My friend asked the dean for reassurance. “I’m sure it will all work out,” she recalled the dean saying. “After all, in 20 years ...

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Flu season is upon us, and with it a chance to test out my persuasion skills on a deeply skeptical public. Consider this recent patient of mine, a young man in college who came in for an ankle sprain. “While you’re here, why not get a flu shot?” I asked. He looked at me as if I were a car mechanic offering a few more add-ons to his maintenance exam. “Oh, I don’t ...

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As Harvey’s devastation raged through Houston recently, the city's mayor was compelled to address rumors that those seeking aid could be deported. In the wake of a statewide ban on “sanctuary cities,” the mayor sought to reassure the Houston area's more than 500,000 undocumented immigrants that they would not be targeted for deportation at emergency shelters. Nevertheless, out of the disaster ...

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To the graduating medical school class of 2017: Welcome to the profession. Many of you will be moving, planning long vacations, and preparing for your life as a medical resident. Right now, you're probably furiously reviewing handbooks on being a medical intern as you sit on a beach. (Or, like me, promising yourself you will — right after you finish "The Fault in Our Stars.") Forgive me, but I have something to add ...

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The middle-aged man in my exam room wasn’t an alcoholic. At least, that’s what he declared to me as I asked him questions about his drinking.

"I’m not like those people," he said, smiling nervously. "I go to work. I don’t fall down the stairs. I don’t embarrass myself."

As we spoke further about the consequences of drinking six to seven beers every night (and a few shots here and there), ...

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The young woman sat in the corner of my exam room, facing away from me as I asked her questions. Her answers were short. "I’m from El Salvador." Why did she come? "Because of the violence." Her voice was flat. Her hands trembled. I knew she had suffered terribly and I needed to ask her how. Slowly, quietly, she recounted the gang violence she had fled in El Salvador. The assault ...

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"I did a weekend of 72 hours in which I only got four hours of sleep. I would also secretly hope to get in a car accident and maybe break a leg so that I would be force to take off from work ... just so I could get some rest. Thank God, I never got in an accident, but I have had colleagues fall asleep at the wheel." - Dr. ...

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Several years ago, I was meeting a young woman in my clinic for the first time. She was healthy but had been obese most of her adult life, even though she had tried many methods of losing weight. We spoke for a few minutes about diet and exercise, and she agreed to see the nutritionist. A few months later, she came back to check her progress. She had lost weight, about ...

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By the end of my first year of residency, I knew I was in trouble. I was overwhelmed by the 15-hour days, the unbearable sadness of the tragedies I witnessed, my feelings of impotence and my fears of making a mistake. My life was my work, and everything else seemed to be falling apart: my physical health, my relationships, my ability to sleep after months of night shifts. Yet, I came to work ...

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