I yelled for the nurse as I wrapped my arms around Mr. John. He was suffering from a violent acute dystonic reaction from a dose of Haldol the night before. Severe muscle spasms overtook his entire body. I saw the whites of his eyes as his gaze shot to the ceiling. He had lost all control over his body — legs, torso, arms, neck, face, eyes. "I can't breathe, I can't ...

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I was an intern, doing a rotation in the coronary care unit (CCU) of a large urban hospital. It was very challenging: The patients had complex medical issues, and my fellow residents and I were given lots of responsibility for their care. Still, I felt I was finally getting the hang of residency. One of the first patients I saw was Mrs. Smith, a middle-aged woman who had come to the ...

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The money was so good in the beginning, and it seemed it might gush forever, right through tiny country hospitals in Missouri, Oklahoma, Tennessee and into the coffers of companies controlled by Jorge A. Perez, his family, and business partners. It was his “secret sauce,” the rotund Miami entrepreneur would smilingly tell people in their no-stoplight towns. The money-making ventures he proposed sounded complicated, sure, but he said they would bring ...

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For more than 30 minutes, Robert Findley lay unconscious in the back of an ambulance next to Mercy Hospital Fort Scott on a frigid February morning with paramedics hand-pumping oxygen into his lungs. A helipad sat just across the icy parking lot from the hospital’s emergency department, which had recently shuttered its doors, like hundreds of rural hospitals nationwide. Suspecting an intracerebral hemorrhage and knowing the ER was no longer ...

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Toward the end of my clinical rotations, I met Salma, a 34-year-old woman who came from Egypt with her family to the U.S. two years ago. Wearing a latte-colored hijab, she was here at the hospital to care for her father, who had a case of congestive heart failure exacerbation with pleural effusions. When deoxygenated blood comes to the right side of the heart, it gets pumped to the lungs to ...

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Imagine yourself spending two years of your life indoors with books. Sometimes the only person you speak to for a few days is yourself, as you memorize intricate details of bugs and drugs that you never imagined yourself knowing. And then after these two years, you're completely isolated from the world for about two months or so, studying for the exam that they tell you determines the rest of your ...

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A debate highlighting gender discrimination in medicine currently rages within the pediatric hospitalist medicine community. The debate centers on the board certification process for "grandfathering" for the new pediatric hospitalist subspecialty which effectively excludes women on the basis of motherhood. For those not familiar with "grandfathering in," this is the process by which a new subspecialty may grant board certification to physicians who have been practicing in the specialty. The alternative option ...

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It's often said that pediatricians and veterinarians have the hardest jobs in medicine because their patients can't tell them where it hurts. But the same is often true for the health care professionals treating older patients who can't communicate well or don't fully understand what's being explained to them. So, whose job is it to advocate for these patients? The answer is that everyone on the medical team must play a ...

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The only times I stood in Emily’s room without fear were the day I met her, and the day she died. These days were two long years apart, years of unhealthy snacking and spending most weekends away from my husband and son. When Emily’s name first appeared next to mine as an overnight admission, the resident physician providing the hand-off gave me a clear warning: “Good luck. She is the ...

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Colorado’s ski resort areas in Summit County have a high cost of living, among the highest in the country. The people who visit these places — Keystone, Breckenridge and Copper Mountain ­— can afford it. Many of those who live and work there can’t, especially when they get sick. In addition to expensive rent, they pay some of the steepest health insurance premiums in the nation. Hospital costs are ...

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While my forty-year parts warranty expired some time ago, leaving me with a snapped fibular styloid process not long after, the ensuing twenty-five years have not resulted in any serious medical encounters until last week.  Following a very pleasant early evening session with our Congresswoman and a sweet snack at home, abrupt abdominal pain progressed in under two hours to a clinical acute abdomen.  As I got dizzy and dependent ...

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When looking at the way medical education and patient care is delivered, there is no question that there is a culture of “knowing.” From the moment a pre-med enters high school, they are bombarded with tests that assess knowledge. This extends throughout medical training, where the development of an assessment and plan in residency is paramount in the transition to an attending physician who must make autonomous decisions for their ...

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The millennial generation is known for its desire and ability to change the status quo. As this group continues to enter and dominate the workforce, particularly as our current residents and medical students, employers are adjusting their long-held practices to reinvent their culture and ensure long-term access to young, top talent. Can you give this generation the same dress code as you did the baby boomers and expect the same result? ...

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People often compare internship to drinking from a fire hose. Overwhelmed by new information and workflow, interns (especially international) usually do not have a clear direction about how to optimize their working/learning experience. Here are some tips for interns to smooth their transition from a newbie into a high-functioning intern in the setting of medicine inpatient wards. Success leaves clues Don't explore yourself, specifically ask your upper-level resident about the most productive ...

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Let’s get right to it: This is an apology letter to frontline clinicians. And a call to action. I’m a patient advocate, and I’ve spent most of the last 20 years fighting for patient- and family-centered care in national laws and regulations, and in local practice. Prioritizing the needs of patients and families above all else. It is meaningful work to which I feel deeply called, and it is hard work ...

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Recently, my niece gingerly confided that she was going to study engineering rather than medicine. I was certain she’d become a doctor – so deep was her love for biology and her deference to our family tradition. But she calculated, as would anyone with common sense, that with an engineering degree and an MBA, she’d be working for a multinational company making a comfortable income by twenty-eight. If she stuck ...

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My classmate and I looked at each other with amusement and embarrassment as we learned that all medical students would now be required to launder their white coats at the hospital. After several complaints that medical student’s white coats did not appear as “white” as they should, the university decided to take matters into their own hands. I looked down at my own white coat, which was due for a ...

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As a law student, I recently was a legal extern at a hospital this summer. It’s a crazy thought because when I started medical school back in Fall 2015, my bus would pass through the pick-up/drop off zone at the hospital every single day at 7:43 a.m. I always saw physicians with their long white coats and coffees in hand walking through the automatic sliding doors. I too saw patients ...

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Did you know that the traditional doctor’s white coat that you probably associate with your physician actually was a look that doctors “borrowed” from another profession? Back in the early days of doctoring, to add some perceived legitimacy to the title physician, the white coat look was adopted from our colleagues in the hard sciences who did actual experiments in the lab. If you recall, what we doctors call a “white ...

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I shared my assessment and plan with the preceptor as she walked into the room. She cut me off, “You think this patient needs surgery?” she smirked. “He has no idea what he is talking about, don’t mind him,” she whispered loudly to the patient. I kept quiet until the patient left, and my preceptor began writing her note. I pulled up a recent research article I had found prior ...

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