I spent the summer between the first and second years of medical school in the emergency department at Cincinnati’s major trauma hospital. More specifically, I spent summer nights there, studying the effects of interpersonal violence. Cincinnati is both a friendly city and a violent city. People say “Hello” when you pass in a corridor. At […]
Category: Conditions
MKSAP: 34-year-old man with slow-growing lesions
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 34-year-old man is evaluated for several slow-growing lesions on his penis. He first noticed the wart-like growths 3 years ago, and they have progressively enlarged. He was treated with topical cryotherapy six times and topical imiquimod over the past year […]
Not so fast with joint MRIs
You wake up one morning, and your shoulder hurts. You’re not sure why, and blame it on your sleeping position. Perhaps you bend down to pick something up, and when you stand up your knee hurts. These are very common stories heard from patients in an orthopedic surgeon’s office. The onset of joint pain without […]
We have to deal with the trauma in veterans early on
My medical center recently cemented an agreement with the Veterans Administration to offer care to veterans who could not be accommodated at the VA. We need paying patients, they need doctors of our caliber — establishing mutual benefit. Military veterans have always been among our patients. During my professional lifetime that has included men of […]
Antibiotics vs. surgery for appendicitis: what one surgeon thinks
Here are a few thoughts about the latest chapter in the never-ending debate about antibiotics vs. surgery for the treatment of uncomplicated appendicitis. You will recall the randomized controlled trial from Finland published in 2015 that found a 27% rate of failure of antibiotics within the first year. Now that the patients have now been followed for […]
Best practices in head CT imaging: How are we doing?
Computed tomography, or CT scanning, is one of the most powerful diagnostic tools to emerge during my medical career. Just look at the detail in the brain images above, taken at 90-degree angles through the brain. And I was there at the beginning. I remember well when I was a medical student taking neurology, and […]
MKSAP: 36-year-old woman with refractory constipation
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 36-year-old woman is evaluated for a 12-year history of refractory constipation. Her symptoms began after a difficult childbirth. She has constipation marked by straining, bloating, and a constant sensation of incomplete emptying. She sometimes has 4 or more days between […]
Is there parity in mental health or are we still dealing with a paucity?
With the recent 10-year anniversary of the Mental Health Parity Act being signed into law, comes the reminder that we still have so much work to be done. Unfortunately, blatant discrimination in health insurance coverage for mental health and substance abuse has continued despite this legislation. The Parity Act required that dollar limits on mental […]
Evening eating: Are you a “light” eater?
An excerpt from Let Go of Emotional Overeating and Love Your Food: A Five-Point Plan for Success. Copyright © 2018 by Arlene B. Englander. Published by Rowman & Littlefield. All rights reserved. Anyone who has ever tried to lose weight or keep weight off realizes that evening can be the make or break time of […]
My brother, a physician, died. Could I have done more?
Healers, scientists, leaders — these are all terms that we equate with being a physician. As we spend our years if not decades in training, we strive to become all of these components. But when you miss something — the small details, the nuances of a history and these are the clues that could lead […]