An excerpt from Fallible: A Memoir of a Young Physician’s Struggle with Mental Illness. Jason had an entire group of voices in his head that he called “the committee.” They talked nearly constantly, sometimes in a flat roar but often escalating t…
Category: Conditions
The intern who knows everything
What seems like a tidal wave of pages washes over you. Drowning in a torrential sea of order clarification, bowel regimens, and vital sign deviations — you struggle to stay afloat. Medical school did not prepare you for this. Patients and nurses are ca…
A physician’s inaccurate cancer prognosis
Mr. G* was diagnosed with advanced prostate cancer two years ago and has been on a succession of medications to control a progressive cancer. His PSA never nadired after surgery, and adjuvant radiation only increased his urinary problems. Androgen depr…
Speaking to cancer as if it were a person
I’d known Ellis for years — he once hired me for a social work job. Yet when I think of Ellis Ledger, I remember him best the night I encountered him outside of his apartment building. I was out late walking my dog. Ellis stopped to talk. He clea…
We need more awareness of food-allergic kids
When my peanut-allergic son was five, he suddenly blurted out, “Mom, don’t worry about me, if I eat a peanut by mistake and it kills me, I can just hit the redo button and get another life, like in the video game.” I became really sca…
When a medical facility isn’t equipped to handle profound mental health issues
A person rolls into an outpatient clinic. A pleasant bleach smell emanates from freshly scrubbed chairs. Happy chatter about people’s lives, and this week’s health issues are dimmed by the local radio station playing in the background. The …
A nurse won’t let this patient die
The sun sets a cascade of pink and yellow in the window of an ICU room. The slow hum of ventilation dampens the buzzes and beeps from machines. I stand in a room inundated by equipment. A machine to monitor vital signs with purple, green, blue, and red…
MKSAP: 59-year-old man is evaluated during a routine examination
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 59-year-old man is evaluated during a routine examination. He feels well and has no symptoms. Medical history is significant for hypertensi…
10 things you need to know about strangulation and domestic violence
Having recently testified in several legal cases involving strangulation, here are some facts we all need to know about this extreme form of domestic violence (DV). I invite other subject matter experts to share their personal opinions on what is impor…
Getting pregnant may have saved her life
Mary Beth is a female in her early 30s, quite obese and mildly mentally repaired, as well as suffering from schizophrenia. She lives in a housing authority apartment, which is not a great place. But being highly subsidized, it is cheap! Her apartment i…
