The common critique of surgeons from their medical colleagues is the scant amount of time spent with their patients. As the argument goes, surgery is more impersonal than other specialties and those who practice it see their patients in one dimension. In some sense, they aren’t wrong. For those who wield the scalpel, speed and efficiency are a priority. It's a philosophy perfectly illustrated during morning rounds, the daily tour of patients ...

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One late evening on pediatrics call, a frantic young couple brought in their few weeks old baby. She had spiked a fever which refused to go down and was fussier than normal. The cause of her symptoms could have been anything -- at best, a mild respiratory infection, in which case we would simply watch her and manage her symptoms, but at worst, it could be meningitis, an infection attacking ...

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In the mid-1800s, Ignaz Semmelweis, then a professor at Johns Hopkins, proposed something outrageous: Doctors and medical students working in the maternity ward should wash their hands before delivering babies because doing so could reduce infant mortality. For proof, he performed a rigorous experiment that showed babies delivered by midwives, who traditionally did wash their hands prior to deliveries, had rate of death that was five-fold lower than those ...

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My mind usually starts to wander around the third or fourth hour of retracting a fat flap or holding up a leg during a long operation. I start by guessing how many times the attending has done this particular procedure. Is it his hundredth time doing it? If he was one of the older attendings, perhaps it was his thousandth one. As a neophyte in the operating room, I still relish ...

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Running has been a constant in my life, and it always will be. I’ve gone on runs in snowstorms and 100-plus degree heat waves, Christmas mornings and birthdays. That hour or so dedicated to running is sacred, reserved for a few minutes to clear my head, a sort of reset button to each day. I’m surrounded by nothing but the sound of shoes hitting the pavement and gasps of heavy ...

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In an oft-cited psychology experiment from the 1960s done at Stanford, toddlers were isolated in a room with a table on which sat a single marshmallow. If they could resist the temptation to eat it, as they were told by the experimenters, they would be rewarded with two marshmallows later on. If we replaced these toddlers with medical students as the subjects, the experimenters would have run out of either marshmallows ...

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In medical training, each morning begins with pre-rounds, a sort of prologue to the work day that gives us a preview of our patients’ conditions. Like a daily ritual, we arrive in the hospital as the sun begins to peek over the horizon and proceed to visit each of their rooms. Some of them are still sleeping, but we wake them up anyway to needle them with questions. Any pain? ...

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I recently saw a patient who, against all odds, survived an aortic dissection. Miraculously, he was alive after the wall of his aorta -- the largest and most important vessel in the body -- began to rip apart. Aortic dissections are so violent and agonizing that a large portion of these patients don’t survive. Yet somehow, my patient was still able to sit upright in his chair and recount his ...

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A few weekends ago, I saw a patient with bloated shins at our school’s free clinic, and I marked in my notes that she exhibited “peripheral edema,” an esoteric phrase that means little to those outside of the medical community. That experience only highlighted the tendency in medicine to inflate common bodily functions into opaque medical jargon. Its use can be frustrating for patients who are trying to understand their ...

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