A Doctor’s Responsibility
“Excuse me, sir,” I imagine the scenario playing out, “do you mind if I barge in on your life to see if I can save your life?” At what point does concern morph into presumption? The line between kindly interventions and condescending ones can be perilously thin. More
Child Separation Is a Medical Emergency
In adult medicine, we see daily the physical and psychological effects of early childhood trauma. Well into older age, patients retain the scars and setbacks from those early experiences. The list of effects of early childhood trauma is so expansive that it wasn’t surprising to see the president of the American Academy of Pediatrics refer to border agents’ removal of children from parents as “government-sanctioned child abuse.” More
Your Medical Chart Might be Biased
Medical charts are the primary means of communication among medical professionals. Coded language in the charts covertly signals to other members of the team which patients aren’t trustworthy or deserving. What does it mean when doctors and nurses–consciously or unconsciously–slip dog whistles into your medical chart? More
Medical Humanities
When your body threatens mutiny and you are peering into the abyss, you want a doctor who has contemplated mortality in a deep way. Being sick is indeed hell and every patient deserves a Virgil. Infusing the medical training with a bit more Virgil just might be the key. More
Art & Anatomy
The “art of medicine” is a term that is used—sometimes disparagingly—to refer to the non-technical skills of medicine. Artistic rendering enables us to appreciate the emotional grappling one must do in the world of anatomy and in the larger world of medicine. More
Mothers in Medicine
We in medicine are inculcated in the culture of deferred enjoyment, of sacrificing our lives now for some distant rose-colored, board-certified future. But here’s the breaking news: No chapter with unlimited time and resources is ever going to magically open up in our lives. No fairy godmother will miraculously graft 8 hours onto your day or stock your house with groceries or impress the 16 kinds of vasculitis into your cingulate gyrus. More
Doctor Visit Guide
Going to the doctor isn’t most people’s favorite activity. I often get asked by friends and family how to make the most of a medical visit. Here’s my advice, and it’s basically the same whether you are the patient, or a family member or a caregiver of the patient. More
In Search of a Beloved Teacher
“Written and Illustrated by…” These words were written on a blackboard in September, 1971, in crisp, authoritative chalk. This was practical magic, unfolding on our laminate pressboard desks every single day. Ms. Zive handed us power, and it was exhilarating. More
A Tax Plan that’s a Medical Emergency
Three members of the U.S. Congress are physicians. But they seem to share a collective amnesia about the Hippocratic Oath. The bill being proposed by Republicans is about taxes, but the toll on our health could be worse than the toll on our wallets. More
Patients vs Paperwork
Like some virulent bacteria doubling on the agar plate, the EMR grows more gargantuan with each passing month, requiring ever more (and ever more arduous) documentation to feed the beast. It’s time to take action. More
Medical Humanities: The Rx for Uncertainty?
A large part of our medical maturation is facing uncertainty and then accepting it into our fold. This is far harder than memorizing all those rare diseases. The humanities can offer doctors a paradigm for living with ambiguity and even for relishing it. More
One Last Visit to See My Patient
My 91-year-old patient and I had been together for some 20 years — honestly I’d lost count — so visiting her at home, even in the torrential rain, was the least I could do. More
Nothing Glamorous about Opioid Addiction
Pain stands nearly alone as a medical condition that not only can’t be measured but that patients might also have an ulterior motive to lie about. I never wonder if a patient is lying when she says she is constipated or has a vaginal itch. But the reality is that there’s not much street value for Metamucil, and there aren’t any rehabs filled with recovering Monistat addicts. More
How We Treat Our Fellow Americans
The blossoming truth of “No Apparent Distress” is that a segment of American society has been casually cast aside, left to scavenge on the meager scraps of volunteer health services, and failing that, left to die. Some politicians might call this “choice.” A more medically accurate term would be abandonment. More
Healthcare’s Biggest Conflict of Interest
The doctor-patient relationship is a one-on-one interaction, and so conflicts of interest are concrete and directly personal. Medical decisions can be swayed by money, even unconsciously, regardless of whether it’s from insurance companies or from industry. But the most basic conflict of interest is that health care access is tied to health insurance. Presence or absence or extent of health insurance is the most powerful influence on how doctors care for patients. More
