I once had a patient in whom I found a small breast lump. She was only thirty-two, and the lump was soft, non-tender, and mobile. But it was new. She examined her breasts monthly and was certain that she hadn’t felt it the month before. And she had a family history of […]
Just two weeks ago, my hospital went live with a full ambulatory electronic medical record. Though the roll out wasn’t without its challenges, the software is simply outstanding. There is almost nothing about a patient’s medical history I can’t now access with a few clicks of a mouse button. Not only do […]
Photo: Nathan Reading
One hundred fifty million prescriptions for antibiotics are written each year in the United States. By some estimates, one third of them are unnecessary. One of the most common diagnoses for which antibiotics are inappropriately prescribed is upper respiratory tract infections (URIs). The overwhelming majority of these infections are viral—infections for […]
One of the earliest memories I have is of my father teaching me how to shake hands. He would always comment to me whenever he received what he considered to be the hallmark of a quality handshake, a firm grip. Handshakes, he taught me, were important. The indicated something about the character […]
The notion that dying is a right seems nonsensical to argue: death is given to all of us equally without the need of anyone’s sanction. The right to die well, on the other hand—well, that’s another matter entirely. A good death is, in many cases, something our fellow human beings have great […]
I recently had a patient of mine undergo surgery to remove his gallbladder due to acute cholecystitis. He’d been out to dinner with some friends and had started to feel nauseated, then developed some right upper quadrant abdominal pain that necessitated ending the evening early. After a sleepless night, a morning episode […]
When I was a resident working in the intensive care unit (the ICU) at the University of Iowa, one of my responsibilities was to communicate with the family members of my patients. However, an intensive care unit, as its name suggests, is an intensely busy place, and I often observed among my […]
Photo: stars alive
Four years ago, I was driving home from work when I began to experience mild chest pain. It was located slightly to the right of my sternum and felt like a muscle strain. My chest was slightly tender when I pressed on it, but so slightly that I felt unsure with […]
“When do we stop?” my patient’s son asked me.
“That’s really hard to know,” I answered.
We were discussing when to stop making interventions in hopes of trying to save his father’s life. He’d been diagnosed with a severe gastrointestinal bleed from a stomach ulcer.
Years ago, a longtime patient of mine came to see me with an odd complaint: he’d developed spontaneous bruising on the top of his penis. “I honestly don’t know how this could have happened,” he said. “I certainly didn’t bang it on anything,” he added with a nervous chuckle.
He went on […]