Category: Conditions

MKSAP: 52-year-old woman with chest pressure

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old woman is evaluated for a 6-week history of chest pressure. The symptom occurs when she walks up an incline on her daily 2-mile …

Health care facilities are difficult to navigate for older adults

A month ago, during a visit to her doctor’s office in Sequim, Wash., Sue Christensen fell to her knees in the bathroom when her legs suddenly gave out. The 74-year-old was in an accessible stall with her walker, an older model that doesn’t have brakes….

My patients teach me, guide me, and remind me that I am here

It’s an odd thing doing what I do sometimes.  Dichotomies of highs and lows, life and death, joy and sorrow.  In the past 15 years that I have been in health care — a nurse’s assistant, to registered nurse, to now pediatric nurse practitioner &#8…

Overcoming the challenges prosperity can bring to teens and young adults

They received a call that their 19-year-old son had been transported to the local hospital, extremely agitated and intoxicated, with a blood alcohol level of .245. What they learned over the next few days was that this wasn’t the first time their son h…

The randomness of cancer: bad luck or something else?

Randomness in life is inevitable because the universe is a pretty random place, although the extent to which you believe that depends upon your own value system. This notion comes into play almost every day of my practice in the PICU because many of th…

An ophthalmologist analyzes Joe Biden’s red eye

Four years ago, there was legitimate concern over Hillary Clinton’s health. Between her coughing spells, facial tics, stumbles and falls, not to mention her prism glasses and inability to hold more than a few campaign events per week, it wasn’t at all …

This is grief. This is life.

I had a brief, quiet, intense conversation with a friend today. She had just lost another friend, a close one, to a sudden and tragic accident. “How are you doing?” I asked. “OK,” she replied as she turned to go up the hallway. In a second, I knew bett…

The fraught history of the word, “teratology”

The field of teratology (also known as dysmorphology) is rapidly growing with daily innovations in prenatal medicine, genetics and preventive care that show its uniquely intersectional nature. But, the term teratology, and its derivatives teratoma and …

Clinical practice guidelines have problems, but they’re not broken

A Health Affairs blog post titled “Fixing Clinical Practice Guidelines” echoed several concerns I’ve discussed previously: practice guidelines are being produced in abundance but often have variable methodological quality, financial c…

Clinical trials advance medicine in the future. And help patients right now.

If you’ve ever used a medication to treat an illness, you have a clinical trial to thank for it. Every standard therapy used in medicine today once started as a clinical trial. And it is commonly understood that today’s clinical trials are shaping trea…