Category: Conditions

A rare condition that often happens to people with very poor eyesight

I have known him for over thirty years. He has been legally blind for the past five. He tends to be a practical, no-nonsense man. The other day, he seemed restless and very concerned as he lowered his voice and said: “I don’t want you to come to the co…

MKSAP: 56-year-old woman pulmonary hypertension

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 56-year-old woman is evaluated during an appointment to establish care. She has a developmental delay, and she is known to have pulmonary h…

Break the reaction to high pain scores

Pain usually cannot be “treated” like a standard ear infection. Treating patients in pain requires setting realistic expectations, using a variety of approaches, and patience. One patient I treated months ago highlights these points. At 6 a.m., I was r…

The antibiotics arms race must end

“Cha-ching!” goes urgent care. For your rhinovirus, adenovirus, or seasonal allergies you get a strep screen, flu swab, CBC, and chest X-ray. You get a steroid shot, Rocephin, and Z-Pak. A week later, you present for medical care again, because your vi…

A lesson in never giving up

Jim Henson, creator of the Muppets and Sesame Street, died at the age of 53. His diagnosis was toxic shock syndrome/streptococcus pneumonia — a deadly bacterial infection. We were on vacation when we heard the news: The genius who opened the imaginatio…

Peanut allergies: What is the best policy for schools?

Peanut allergies can be a serious problem, and many exposures happen when our kids are at school. On average, there are probably about 5 peanut-allergic children in each of our nation’s 100,000 school buildings. What’s the best policy for schools to us…

Horrific decisions that no parent should ever have to make

“Is she in pain?” I asked quietly as the pearlescent baby-shaped image on the screen folded its legs and then extended them. The radiologist doing my ultrasound had just finished pointing out a cluster of alarming abnormalities in our devel…

New year, new thinking about treating obesity

Eat less, exercise more is a common refrain heard by millions of people with obesity. If only it were that simple. Decades of research shows obesity is a disease that is caused by a combination of genetic, environmental, biological, and behavioral fact…

MKSAP: 55-year-old man with mild nausea and dyspepsia

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is evaluated in the emergency department for a 2-day history of mild nausea and dyspepsia that is worse with fasting and im…

The lesson every medical student can learn from emergencies

ing my ER shift for the day, I waited for the shuttle at a busy intersection. Within a minute of drowning myself in music, I saw an obese man at the bus stop suddenly collapse to the ground. I removed my backpack and ran the fastest I have ever run in …