The Doctor vs The Computer

The Doctor vs The Computer

While I’ve been typing, the character number has been counting backward from 1,000, and now I’ve hit zero. The computer will not permit me to say anything more about my patient.

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Patient 1, Society 0

Patient 1, Society 0

A young, healthy patient called me recently requesting a CT scan of his head because of his headaches. He described his symptoms, and they sounded to me like migraines. His clinical picture was not suggestive of a brain tumor and I told him so, but he was persistent. “What if I’m the one 35-year-old who…

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Chaperones for Patients?

Chaperones for Patients?

The airline passenger who refused to allow a security pat-down made national headlines quickly. The idea of a stranger touching a person’s intimate areas makes most people cringe. But something like this occurs every day in the doctor’s office.

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Gifts of the Magi: For a young doctor far from home, an unexpected present

Gifts of the Magi: For a young doctor far from home, an unexpected present

"Bitter winds churned up First Avenue and tore through the pathetically thin scrubs that Bellevue doled out to its interns. The December sky glowered the same leaden-green color of the bile that Dr. Kamal Singh was siphoning from the gut of Mr. Bill Porter, a homeless alcoholic with a Southern accent, a jauntily curled mustache…

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Solving the Health Care Crisis

Solving the Health Care Crisis

Status quo is a powerful determinant of both belief and behavior. Many of the things we do and the things we believe in transpire because they are what we have always done or believed. This is why incumbents win elections, why we always choose the same flavor of yogurt, why we take the same route…

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One-Dollar Roses

One-Dollar Roses

“One-dollar roses?” She says it with a slight inflection at the end, so that it sounds like a question. “One-dollar roses?” There is a waif-like tenderness to her throaty voice. Is she a shrewd businesswoman, or is that just the way she speaks? Either way, you can’t help but look at her. It would be…

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Merced

Merced

“This is a case of a 23 year-old Hispanic female...” The speaker droned on with the details of the case that I knew so well. I leaned back in my chair, anticipating and savoring the accolades that were going to come. After all, in a roundabout way, I’d made the diagnosis. I was the one…

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A Day in the Clinic

A Day in the Clinic

8:30 a.m. Doing intakes—interviews with new patients to the clinic. First one is Carola Castaña, a petite thirty-five-year-old Brazilian who immigrated to the United States three months ago. She folds her hands in her lap as I begin to take her history. She understands my questions better if I ask in Spanish rather than English,…

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Neuron Overload

Neuron Overload

Sometimes it feels as though my brain is juggling so many competing details, that one stray request from a patient—even one that is quite relevant—might send the delicately balanced three-ring circus tumbling down. One day, I tried to work out how many details a doctor needs to keep spinning in her head in order to…

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Voice Mail: Blessing and Curse

Voice Mail: Blessing and Curse

Voice mail is both a blessing and a curse. When we were first given voice mail in our clinic, it was a revolution--patients could actually get in contact with their doctors. But sometimes voice mail is a ball and chain.

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Miscommunication

Miscommunication

The sun was already setting on Thursday when Diallo Amadou called me. “I not feeling well,” he said. “I need to see you, Dr. Ofri.” I already had one foot out of the clinic door, and I knew that Mr. Amadou lived 45 minutes away. The whine in his voice was apparent even through his…

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Swine Flu and You

Swine Flu and You

The only preventative medicine that actually prevents disease are vaccinations. Our world is an immeasurably better place since the advent of vaccines. Yet there is a complicated psychology that hovers like a fog around the idea of vaccination.

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Drowning in a Sea of Health Complaints

Drowning in a Sea of Health Complaints

The patient was a classic “worried-well” type of patient. When she unfolded a sheet of paper with a brisk snap, my heart sank as I saw 30 lines of hand-printed concerns.

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Rx: Writing

Rx: Writing

Writing has always been a prominent part of medicine. Doctors write “histories” of their patients all the time. Increasingly there has been interest in writing by patients.

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The Debilitated Muse

The Debilitated Muse

Poetry is a supremely sensory art, both in the imagining and in the writing. What happens when the poet faces illness? How is the poetry affected by alterations of the body and mind?

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More on Mammograms

More on Mammograms

A monolithic message on mammogram screening for breast cancer sidesteps critical nuances.

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Multiculturalism Lecture

Danielle's lecture on multiculturalism in medicine--"Journeys With Our Patients."

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ERs for Primary Care

ERs for Primary Care

George Bush once famously (or infamously) commented that health care is indeed available for all: You just go to the emergency room.

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A Tale of Two Phone Calls

A Tale of Two Phone Calls

There’s a lot we can learn from animals in many facets of life — Lord knows, a nice massage behind the ears could do a lot of us some good — but I am consistently impressed by how much smoother veterinary medicine runs.

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Social Mission of Med Schools

Social Mission of Med Schools

What exactly is the mission of a medical school? Is it to train the best and smartest doctors? Is to tend to our nation’s health? Is it to further medical knowledge?

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Abortion: The View From Both Sides of the Street

Abortion: The View From Both Sides of the Street

A dispassionate discourse on the abortion wars in America?  Not something that seems possible, at least in the current polarized culture in the United States. order celebrex prescription Almost by definition, any analysis of the politics and practice of abortion is heavily partisan. Even the medical world—the last bastion of any possible objectivity— has been…

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Palliative Care: From the Get-Go

Palliative Care: From the Get-Go

The scientific world finally produced the data to support what seems so obvious: Palliative care belongs in the beginning of cancer treatment, not just at the end.

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Endorphins and Overeating

Endorphins and Overeating

As a primary care internist, my practice spans the common adult ailments—diabetes, hypertension, high cholesterol, coronary artery disease, arthritis. It is hard not to avoid the difficult truth that obesity, while perhaps not causing all of these illness, certainly exacerbates them greatly.

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The Patient’s Voice

The Patient’s Voice

Not long ago I learned that these side effects listed on the package insert are not the ones the patient actually complains of. No, they are the symptoms the patients’ doctors choose to report, the doctors’ impressions of what the patients are describing.

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Can We Measure a "Good Doctor?"

Can We Measure a "Good Doctor?"

What do quality measures actually measure? Can they tell us who is a good doctor, or what makes a good doctor?

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Owning Up to Medical Error

Owning Up to Medical Error

Precisely two weeks after completing my medical internship,I proceeded to nearly kill a patient. July marked the startof my second year of residency at New York City’s BellevueHospital, and it was my first time being fully in charge of a patient.

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When Unemployed Means Unhealthy Too

When Unemployed Means Unhealthy Too

Research confirms what physicians observe and what everyone seems to know in their gut: losing a job is bad for our health. Our crazy patchwork system that ties health insurance to our jobs means that the recession--and it's "jobless recovery"--are damaging our nation's health.

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Facing Our Prejudices

Facing Our Prejudices

I had to be honest—I was uncomfortable with my patient's “morbid obesity.” Perhaps in obese patients we see the feared reflections of ourselves, should we lose our carefully honed discipline. This reaction is entirely irrational, of course; but emotions were never billed as rational, and doctors are as susceptible as anyone else.

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Residency Regulators are Back!

Residency Regulators are Back!

How many hours can a doctor work? The residency regulators are back. About ten years ago, the national organization that accredits residency programs (ACGME) set out its first guidelines about how many hours a doctor-in-training can work. Interns and residents finally achieved the vaunted 80-hour workweek. (New York State was 15 years ahead on this,…

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A fascinating tapestry…

A fascinating tapestry…

“The threads of Danielle Ofri’s memoir, Medicine in Translation, come together in a fascinating tapestry, with shimmers of what it is to be a physician, a mother, a writer and musician, a person with opinions trying to open herself to a world full of differences. She writes well, and the stories she weaves here are…

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