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Last Build Date: Sat, 16 Dec 2017 16:00:36 PST


To this physician, thankfulness is his lifeline

Sat, 16 Dec 2017 16:00:36 PST

The complaint was constipation. In the exam room, a quiet girl stood in a too big johnny, her eyes staring down at the floor. The 13-year-old was here with her “aunt.” Like over 50,000 children before her, she’d made the fifteen hundred mile plus journey from El Salvador to escape the violence of government and […]

Is this is why women so often settle?

Sat, 16 Dec 2017 12:00:33 PST

Being 100 percent, authentically you is extremely freeing. It is awesome, brave, and takes courage and strength. It is also completely exhausting at times. Like, I-think-I-have-Influenza tired. The more I age, the more I advance. The more I advance, the more I realize how living my life in the constraints of other’s opinions or wants […]

#MeToo in medicine. This is one physician’s story.

Sat, 16 Dec 2017 08:00:23 PST

The senior psychiatry resident at the University of Washington School of Medicine warned me ahead of time. She laughed as she said, “He’s weird. You’ll get used to him.” When I first met with him, the psychiatrist lazily spun in his chair, his left hand tucked into his pants, his thumb hanging out. After he […]

MKSAP: 48-year-old man with knee pain and swelling

Sat, 16 Dec 2017 04:00:09 PST

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 48-year-old man is evaluated for a 2-day history of right anterior knee pain and swelling. The pain began suddenly and has increased in intensity. He currently rates his pain as an 8 on a 10-point scale. He has no knee […]

Is autonomy really better for patients?

Fri, 15 Dec 2017 16:00:02 PST

It used to be that doctors knew best. We told you what to do, and you obediently complied. The world has changed, and the paternalistic system of yore has given way to the shared decision model where patient autonomy is respected. The old way: “Well, I’ll be setting you up for surgery soon.” The new […]

The myth of multitasking in primary care

Fri, 15 Dec 2017 12:00:30 PST

Primary care doctors don’t usually have scheduled blocks of time to read incoming reports, refill prescriptions, answer messages or, what we are told the future will entail, manage their chronic disease populations. Instead, we are generally expected to do all those things “between patients.” This involves doing a little bit of all those things in […]

Psychiatrists should not be involved in presidential politics. Here’s why.

Fri, 15 Dec 2017 10:00:33 PST

The media, politicians, celebrities, athletes and other groups have questioned the fitness and mental health of the president, but one group has largely refrained: mental health professionals. This recently changed. One of the latest efforts is a book, a collection of assessments by 27 psychiatrists and mental health providers, called “The Dangerous Case of Donald […]

Youth football and concussions: some good news?

Fri, 15 Dec 2017 08:00:55 PST

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 […]

Patients made this doctor care about politics

Fri, 15 Dec 2017 06:00:22 PST

Before I went to medical school, I had little interest in politics. It wasn’t that I didn’t care about my country; I spent seven years serving in the United States Navy and have always taken pride in being an American. I suppose the reason for my political apathy was because things had always gone pretty […]

Did medical school desensitize doctors to debt?

Fri, 15 Dec 2017 04:00:17 PST

The high-pitched wail of the pneumatic saw cutting through the tibia, and the little bits of tissue the blade flung onto the surgeon’s gown were not enough to get to me the first time I saw a surgery, during my senior year in high school. It was the smell. Sliding down the wall in the […]

The first rule of medical school interviews: Don’t talk about cost

Thu, 14 Dec 2017 16:00:21 PST

The fall is over, and winter has come, which means I have just wrapped up a busy season of medical school interviews. Most interviews are conducted in a similar fashion with an hour of introduction, speeches by the dean, presentations of facts I already knew from the website, and finally the interviews. Within the first […]

Going skin deep: Is a tattoo ethically binding?

Thu, 14 Dec 2017 12:00:04 PST

There’s currently an image in heavy circulation making its way around the internet of a hospital patient’s chest tattooed with the words “Do **not** resuscitate,” accompanied by what is assumed to be the man’s signature. This 70-year-old patient arrived at an emergency department unconscious with elevated blood alcohol levels. He did not have any form […]

How do you tell a 24 year old that she is dying?

Thu, 14 Dec 2017 10:00:03 PST

Physicians are no strangers to death. We are baptized into medicine with cadavers as first-year medical students. We learn to break bad news. We lose patients, some that are expected and some we never see coming. Through it all, we maintain a distance, an emotional reserve that enables us to shoulder these losses but still […]

Both markets and the government are needed to fix health care

Thu, 14 Dec 2017 08:00:07 PST

The most common dividing lines in the national discourse on health care reform simply miss the mark. If one looks beyond the partisan posturing, each side has valid points, but also glaring weaknesses. We may need to work together to get health care right. I was recently invited to a political gathering to discuss health […]

The patient who was a former bowling champion

Thu, 14 Dec 2017 06:00:15 PST

My new patient was having trouble breathing and had lost his ability to swallow; despite this, he had been too proud to call either friends or family for help. He had lost thirty pounds and his clothes hung loosely. His belt was far too long. The day I met him, I thought, “This man could […]