I spent an hour yesterday with a new patient who has complex repaired congenital heart disease. In our initial conversation, it became apparent she and I had differing agendas. I was on a mission to efficiently evaluate her heart, sort out any ongoing issues, document the visit, and then move on to the next patient. Her desire was to tell her story and be listened to. So, in the moment ...

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With any new illness comes metaphor. It is humanity’s attempt to incorporate the mystery of disease into our own stories. We like to personify illness, give it human characteristics as a way of visualizing it. We name its actions to help lessen its unpredictability. Tuberculosis consumed. Syphilis punished. AIDS invaded. Cancer grows. COVID-19 quarantines separate and spread fear. How long does it take for a disease or illness to become a ...

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The pandemic has revised the triple aim framework of health care. The simultaneous triple pursuit of improving the patient experience of care, improving the health of populations, and reducing the per capita cost of health care is currently not possible. With widespread forced lockdowns, we are unable to provide the optimal patient care experience, the health of the population is declining (limited access, postponed procedures, delayed vaccinations, etc.). And while ...

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I recently attended a cardiology conference where a dear friend of mine was presenting on the topic of hypertrophic cardiomyopathy. She discussed how fibrosis within the ventricle causes diastolic dysfunction, an inability of the myocardium to relax. My ears perked up. Just the week before, while on vacation, I personally experienced the inability to relax. Though I was free to lounge around New Orleans while my husband attended the annual CHEST ...

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Physicians are excellent at floccinaucinihilipilification, which is seeing something as unimportant or worthless.  We engage in floccinaucinihilipilification every time we see a patient. We listen to their story and symptoms, and quickly filter, accept, or discard information until we arrive at our presumed diagnosis. The 18-second rule In 1984, Beckman and Frankel wrote in the Annals of Internal Medicine that the average time it takes a physician to interrupt ...

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