At the graveside, they still talk about judgment, intelligence, and the wisdom that is the practice of medicine. Deans and health care leaders wax poetic as they tell stories of great cures to lift in memoriam remarkable healers. Yet, though we bow to Hippocrates, Osler, and Salk, the time has come to mark a revolution in human history: The art of medicine is dead. It is not that doctors have fallen from ...

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Contrary to what my wife and colleagues think, it is not all about me. Well yes, I do get lonely sitting at my desk late at night, when my wife is busy, and the long-ago-moved-away kids are not available, and there is nothing running on NASCAR.  Nonetheless, it is not really about my needs.  I am talking, of course, about why I give patients my cell phone number. It is printed ...

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Her name is Joann. She has cancer. As that disease goes, it is not much, probably curable, one of those “if you have to get cancer, this a good one.” Still, she sits across from me, her skin pale, eyes tight and she rhythmically grasps her cold, moist hands. She fails to gain any comfort from the knowledge that she is going to be OK. Why? I have not told ...

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With thousands of cancers, thousands of families and thousands of deaths, I came to see deep time. I absorbed the finite nature of existence and gained a long view. Not just yesterday’s tests, today’s battle and tomorrow’s treatment, but the loss to come. I do not know when the reaper will arrive, but understand he will. I mourn each patient before we meet. I have learned not to cry. Call it ...

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When we think of pollution, we think of our planet: stripped forests paved asphalt black, sterile red rivers, brown-gray skies and creeping slums over once virgin land. We imagine massive dumps of civilized waste, the extermination of species and temperatures which bake the earth like a neglected oven. We mourn the global home in which we live, neglected, abused, in ruin. Do we ever think about ourselves? That is one of ...

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For soldiers, there are many fears.  Will I do my job?  Will I succeed in my mission?  Will my colleagues in arms be harmed?  Will I be injured?  Will I die?  For the American Muslim who volunteers to engage the enemies of the United States on foreign soil, there is a new worry.  What will my home country do to my family while I am gone? Recently, Dr. Ghazali A. Chaudry, ...

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Medicine is a paradox. To save, we cut with sharp knives. We ignore pain so that it will light the path to diagnosis. We give toxins to destroy toxic disease. We scold our neighbors when they neglect their health, even as we work ourselves to exhaustion, eat too much and evade exercise. We comfort the families of our patients while ignoring our own. There is one contradiction, which, by its very ...

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It was recently pointed out that one of my partners had made an error in a patient’s electronic hospital chart. Did I want to correct the mistake? Curious, I looked at the computer screen. There in 12-point-black-on-white Cambria was the culprit documentation. The words were: “Our therapy goal is palliative. Prognosis is good.” Now, this was clearly not what the author had intended. In common practice when someone is so sick that ...

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When patients and their families seek hospice care, they are thinking about how they will die. They want to be without pain, shortness of breath, loneliness and, above all, fear. They want to end their lives with those they love, in a place they know, with respect and support. They want control. They want dignity. We all know this, and try to provide it as friends, family and caregivers. Nonetheless, ...

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Not long ago, I overheard a frustrated hospital leader ranting about the poor performance of a physician. It was not that the doctor was screwing up surgeries, ordering the wrong drugs or missing obvious diagnoses. Actually, the physician was rather adept at healing his fellow man. The doctor’s failures concerned length of stay (far too long), sloppy medical records (incomplete, loaded with cut-and-paste) and a temper, which while not directly abusive ...

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