In the emergency room, the stress is palpable. The hairs on your neck rise up as you enter the resuscitation bay where the next unconscious patient has just arrived. You can almost feel death as it circulates through the air, like a vulture in the sky. The air tastes sterile, and you hear the crash cart and ultrasound being rolled over to the patient’s bed. The patient was fine 20 minutes ...

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“Wow, cool case,” was the response from the residents in continuity clinic on Monday morning as I told them about a patient I had seen over the weekend at our main campus urgent care. Ironically, or maybe more tellingly, I thought the same thing; “that was a cool case.” The “cool case” was a senior in high school who was eagerly looking forward to her college career but woke up with ...

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STAT_Logo When President Trump slurred his words during a news conference this week, some Trump watchers speculated that he was having a stroke. I watched the clip and, as a physician who specializes in brain function and disability, I don’t think a stroke was behind the slurred words. But having evaluated the chief executive’s remarkable behavior through my ...

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Concussions and football have come up before, and the news so far has been discouraging. We want kids to stay active, and football is one of the most popular boys’ sports out there. But we know that some prominent professional athletes have had serious, cumulative brain damage from years of football – sometimes brain damage that has destroyed their lives. What about high school football, or football ...

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Humans evolved with the constant force of the earth’s gravity. This is relevant to several of our organs, but the brain’s anatomy makes it especially important. The brain floats in spinal fluid encased inside the closed box of the skull. Gravity would be expected to affect the details of that. Indeed, studies of people who spent prolonged periods of time in bed in a head down position indicate this abnormal ...

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The presidential symposium at this year’s Annual Meeting of the Child Neurology Society of America in early October in Kansas City raised many eyebrows. The first presentation of this symposium focused on burnout rates among neurologists around the country. Many of my colleagues felt that this was an inappropriate choice, especially with so many trainees and young child neurologists in the audience. Typically, the presidential symposium at a conference of such ...

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Recently, I was challenged by the mother of a trauma patient. She had read about traumatic spleen injuries online and was concerned about the risk a hematoma presented and wanted the ultrasound to look at the hematoma. I found myself floundering around trying to explain how this study was unnecessary. In frustration, I turned to my nurse practitioner and said, “Heather, can you translate for me?” This is a common problem. ...

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Part of a series. Cognitive decline is a normal process of aging; Alzheimer’s is a disease. Cognitive decline due to aging can be slowed but not halted with appropriate lifestyle approaches. The "big four" are equally important to slow cognitive decline: Don’t smoke. Reduce stress. Exercise often. And eat a quality diet in moderation. Good sleep and brain stimulation need to be added for maintaining good cognition. Some form of ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old man is seen for follow-up evaluation of Parkinson disease, which was diagnosed 10 years ago. Although his symptoms initially were well controlled with medications, he has experienced increasing fluctuations in motor symptoms, specifically tremor at rest and slowness, within the past 3 years. Medications are ...

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Two months into my pediatric residency, while working on an overnight call, I encountered my first medical mistake. We, fortunately, had had a very good night, and all patients had remained stable. It was an hour before sign-out to the morning team, that I received a page. I quickly held my pager and dialed the 4-digit number, only to find a busy dial tone. I was a little surprised and ...

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