It was flu season. I was meeting the usual frustrations of trying to convince my patients to get the flu shot. The flu vaccine has such potential to save lives, yet its reputation is marred by misinformation, leading people to decline this simple, inexpensive, and effective way to limit disease and death. Day in and day out, I felt like I was beating my head against a wall. This particular day, I ...

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My wife is a teacher. Her passion is helping the Bart Simpsons of the education system. This past year the school district in the rural area where we live tasked her with the job of opening the community’s first alternative education school. Imagine taking 60 of some of the hardest kids in the area and creating a school just for them, so they have an opportunity to feel success, thrive, and ...

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During intern orientation a few months ago, they promised we would never be alone in the hospital. And they were right. Until they weren’t. It’s hard to see colors in the dark — that’s why he looks blue. That’s strange; it almost seems like his chest is not moving. I must be overreacting. Everything is fine. My right hand began flicking his foot. Yell for help. This baby is a healthy newborn. Call a code. Interns ...

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My first transgender patient was a teenager who said although he was born female, he'd protested his gender from the time he could talk. He told a story of being asked, "Well, if you are a boy, where is your penis?" and he pointed to his umbilicus (which was an "outie"). OK, no problem, we have a gender clinic I can refer you to. When he came back and asked for ...

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When children are diagnosed with attention deficit hyperactivity disorder, stimulant medications like Ritalin or Adderall are usually the first line of treatment. The American Academy of Pediatrics issued new guidelines Monday upholding that central role of medications accompanied by behavioral therapy in ADHD treatment. Some experts say, however, they are disappointed the new guidelines don’t recommend behavioral treatment first for more children, as that might lead to better outcomes, recent research suggests. When ...

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In his article, "Medical education needs to stop burning out students — now," Augustine Choi suggests the culture of medical education is responsible for increasing numbers of depression and burnout among medical students, and suggests that more programs are needed to address self-care and wellness in order to build resilience. While I agree that mental health treatment should be readily available and easily accessible to those in need, ...

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I pass by one of our local parochial schools on the way to clinic two mornings a week. With the school year in full swing, each Friday I see the children lining up outside to go to weekly Mass. With the girls in their grey tartan skirts and blue vests and the boys in their blue shirts and pants, they form a colorful, large nameless entity to which I don’t ...

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"I don't understand, and no one will explain why it happened." Jake, my adolescent patient, lamented his experience to me during his well-child visit. "Those boys say that people like me are the devil. They don't even know me. I'm a good person." Hours before seeing me in clinic that day, a group of minority teens had confronted Jake while at a local youth community center because he was "the ...

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It’s an odd thing doing what I do sometimes.  Dichotomies of highs and lows, life and death, joy and sorrow.  In the past 15 years that I have been in health care -- a nurse’s assistant, to registered nurse, to now pediatric nurse practitioner -- I have had the strange experience of all this emotion.  It wasn’t until recently, maybe because I have a family of my own now, that ...

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Gravel crunched beneath our feet as my co-residents, and I walked alongside one another. Our laughter filled the air as the shadow of our large white camper van stretched behind us, looming farther and farther away. We had escaped the warmth of a vehicle that had been our home all week; it was cold, and we were underdressed, not uncommon in Iceland. Surrounded by sea, the wind blew furiously, unforgivingly, ...

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