I have a breathtakingly difficult confession to make. A confession that on its face seems rather innocuous but in many ways shakes the foundations of who I always thought I was, and how I identify myself. I no longer love being a physician. There — I said it. I winced even as I strung the words together to write the sentence. You see, to admit this is almost inconceivable. So much of ...

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I bought my first house a few days before starting my second year of residency in St Louis. It was a townhome: two bedrooms, one and a half baths, hardwood floors and lots of wall space. So much wall space, in fact, that I immediately began to look for ways to adorn all those barren surfaces. After visiting some local art galleries, I came to two conclusions. I knew exactly what ...

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Dear Mrs. J, I would like to express my deepest condolences on the passing of your mother. She was a magnificent woman, and I had the pleasure of being her doctor for almost a decade. It was a pleasure. During our short visits, she regaled me with stories of childhood and often gently sprinkled in advice gleaned from years of experience. Even as she began to decline, we would sit together ...

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Mathew preferred using the more biblical term "shepherd." After all, he labored his flock through pastoral pastures and meandering meadows. His parishioners, of course, were sheep and not people. After years of leading them, he could discern subtle differences: the slope of a forehead, the stutter of a step or the variation in bleat. He had a distinct name for every animal in his flock of thousands. Although Mathew preferred isolation, he ...

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The notion began early in computer science class during Jason's freshman year. The professor had noticed a certain elegance and zeal in his work and suggested medicine. That was in the days of the giants when clinicians were tied to such clunky programs as meaningful use and PQRS. In this antiquated milieu, Jason cut his teeth on basic health care architecture. In those prehistoric years, there still remained a bias toward ...

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I both look forward to and despise Sunday mornings.  I awake just before the sun and am on the road by 5:15 a.m.  Although I dread being upright so early on the weekend, I rejoice because it is the only trip to work, all week, at a leisurely pace.  I see the new admits at the nursing home, run by the hospital if necessary, and return just as my family ...

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Behind every doctor is a child who once watched helplessly. Maybe it was her father or grandfather who suffered under the weight of a disease that was deemed all but incurable. Perhaps her own skin was battered and bruised by the repeated trauma of an unrelenting tourniquet. She swore that when (if) she got older she would protect the innocent from such things. Her vow was the light that guided ...

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Sometimes before I go on a run, I take the laces of my jogging shoes and tie them together in a knot.  I wear the pair around my neck with each shoe falling to opposite sides.  The heels clunk against my chest as I make my last minute rounds.  It's as if running is my job and the shoes are the instrument I use to perform that job.  Eventually, I ...

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We are born with arms wide open, and we die in much the same way.  It is that which we carry, in the time between, that defines us. The newborn, caught in the primordial stew of beginnings, is unable to recognize the difference between self and other.  She grasps and roots at inanimate objects with the same voracity she reaches for her mother.  It is a time of differentiation, a time ...

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Joe had one of the best geriatricians in the city.  So when he got a call from the pharmacist saying his new prescription was ready, he assumed that it had to do with his recent annual visit and blood draw. His suspicions were confirmed, a few minutes later, when he got through to the nurse at the office. Joe was politely informed that he had high cholesterol and was being put ...

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I felt like the stack of charts rose past my head and all the way to the ceiling.  I pulled out my pen, opened the first, and started charting.  I took a moment before each note to collect my thoughts.  The patients were complex, the problems sometimes insurmountable.  The nursing station at the facility was buzzing with activity around me.  Phones were ringing, alarms were crying for attention. On the desk ...

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It was never his intention that the name would stick.  A decade ago, when he first began working in the restaurant, some of his fellow employees knew that he was formerly a practicing physician and started to call him "Doc."  Although many of his coworkers had since moved on, taking the knowledge of his previous profession with them, his moniker persisted. Doc liked the simplicity and tedium of his bartending job. ...

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Walter was far older than his chronological age.  A mere thirteen years, he kept company with a much older crew.  Doctors, nurses, and CNAs were his constant companions.  The other kids on his floor were either too sick to interact, or came and left within a matter of days.  But not Walter.  His heart was too weak to allow his departure, but too strong to be first in line for ...

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The daughter of the patient walked out of the room livid.  She was convinced that the nurse had no business taking care of patients.  She seethed as she recounted all the supposed injuries and mistakes that had occurred.  I took a deep breath and paused for a moment, trying to collect my thoughts. The daughter didn't know that I had watched this same nurse successfully perform CPR on a man the ...

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It hit me today while on hold with an insurance company to get a preauthorization. The call took thirty minutes. The medication was denied. And I knew that I was going to get an earful from the patient when I delivered the bad news. As I dialed the phone number, a disturbing, and yet all to familiar, feeling overtook me. Helplessness, powerlessness, impotence. I struggle with these feelings daily. In the beginning ...

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I have two refrigerators. The full size, expensive version, sits in the usual location in the kitchen.  The small black one rests idly in the basement.  Excluding this morning, of course, when I dragged it up the steps and begrudgingly coaxed it back into action.  Let me explain. Six months ago my old refrigerator started acting up.  Somewhere around year five, it’s motors groaned, its coolers moaned, and all the sudden the ...

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It was a little game we played. My shoes squeaked quietly down the hallway of the nursing home as I approached her room.  I knocked gently trying to avoid any particular rhythm or dissonance. Go away! Her voice was at once stern, and then followed by peels of laughter.  She only saved such greetings for me.  And I tried to trip her up.  I varied my visits by time and pattern.  Sometimes I ...

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It all started with the tip of my tongue.  Really.  I was chewing on dark chocolate chips with a vigor that was maybe a touch inappropriate for such a snack.  I bit down firmly and felt immediate pain sear through my mouth where the tooth overzealously punctured the soft tissue. I bit my tongue. Which wouldn't have seemed so calamitous if it had not been one of many bodily malfunctions that had ...

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He squeezed into the elevator just as the door was closing.  There was a lightness about him, an excitement.  His jacket was newly pressed and uncomfortably free of nicks or stains.   He stood at attention with perfect posture.  There was no sign that working at this early hour on a Sunday morning, nor even being awake, was something out of the ordinary.  Extraordinary. He glanced over at my tattered lab ...

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He had been educated at the finest universities.  He had graduated cum laude, or whatever the term is they use nowadays to signify distinction.  His pedigree was squeaky-clean. But as he haltingly entered the dark building at the end of an otherwise unexceptional suburban street, he felt more like a criminal than a scholar.  His office was drab.  Each room was glowing with the artificial light provided by an incandescent bulb. ...

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