Many consider the novel the House of God, written by Samuel Shem (pen name for Stephen Bergman), to be a must-read for any physician or soon-to-be physician. A fictionalized account of his internship year, the book details how the accumulated stress, fatigue, and powerlessness of being a first-year doctor inexorably accumulates during that year — with sometimes hilarious, and but also disastrous, results. The survival strategies of the interns in ...

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When writing medical notes, some clinicians include an appreciation of their patient's personality and disposition in their opening line (the "chief complaint"), or when they're wrapping up (in the "assessment and plan"), or in both locations. You know — it goes like this: "CC:  Ms. Smith is a very pleasant 62-year-old woman admitted with …" or: "A/P:  To summarize, Mr. Jones is a delightful 89-year-old man presenting with …" or: "CC:  This lovely 74-year-old retired school teacher was in her usual state of health ...

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Forgive the autobiographical nature of this post, but here’s a recap on how I started down the path to becoming an infectious disease (ID) doctor. To begin, understand that my first year of medical school was rough going. In hindsight, this wasn’t surprising. After majoring in English during college (with a minor in the Harvard Lampoon to develop good study habits, ha ha ha), then spending a year abroad teaching, I found medical school’s unrelenting ...

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In the United States, any person who has tried getting their own (or their patient’s) radiology images from another hospital or practice will find the practice painful. Here are several obvious reasons why the CD-ROM — briefly the darling of large data transfer — is a truly terrible way to share radiology images in 2018: They require physical transfer. Remember the term “snail mail”? Do people still say that? They are slow. When you bring a ...

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Earlier this year, I wrote a piece about friends and colleagues of mine who have left HIV clinical practice. Something about it touched a nerve. Admittedly, it was kind of a downer — but it might have been slightly misinterpreted. A lot of the problems my friends cited could have easily applied to almost any area of clinical practice; these challenges were by no means limited to HIV care. They mentioned the ...

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As an infectious diseases specialist married to a pediatrician, I am going to propose, in most unhumble fashion, that I have the ideal perspective to assess the worthiness of vaccines. So when Robert F. Kennedy Jr., a notorious anti-vaccine crusader, announced that he was under consideration to head a government commission on vaccine safety and scientific integrity, and is planning to step away from his environmental job to take that post, I ...

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MD-Compensation-Report Now a median of $174,000 per year is hardly chump change, so I don’t expect much in the way of sympathy on these data. On the other hand, someone has to to be last, and note that our income hasn’t increased a bit since the last time I commented on this survey three years ago. So it’s worth taking a few moments listing ...

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As undoubtedly you’ve heard by now, there’s another person cured of HIV out there — this time, it’s a baby born to an HIV-infected mother. Here’s the story: The mother didn’t know she was HIV positive until delivery, and the baby was found to be infected by both HIV DNA and RNA right at birth. The doctors started combination antiretroviral therapy approximately one day later, essentially as soon as ...

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A flurry of coverage recently appeared about the U.S. Preventive Services Task Force’s recommendation for one-time HIV screening for all Americans, ages 15-64. Some might wonder why this is news — um, hasn’t this been recommended now for years? — and I think I’ve figured it out. Let me start by relaying that every ID/HIV specialists can tell some version of the following sad story, which is still repeated on a regular basis ...

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We specialists in infectious diseases love case conferences — especially those where the case is presented as an "unknown," and we try to figure out the diagnosis from the history. I suppose this isn’t very surprising, since ID cases in general are already among the most interesting in all of medicine. Those that are case-conference-worthy are particularly prime. “Funny bug in a funny place,” was how one of my colleagues characterized these ...

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