Let’s begin with a quiz question: Patients may be allergic to: A. oxygen B. carbon C. iodine D. none of the above If you answered anything but “D,” better keep reading. Consider this scenario: If a patient is allergic to penicillin, you would document “penicillin” in the medical records. It would never occur to you […]
Category: Conditions
MKSAP: 57-year-old man with type 2 diabetes mellitus
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old man with a 15-year history of type 2 diabetes mellitus is evaluated for bilateral burning sensation in his feet for the last 6 to 12 months. The sensation worsens at night. His HbA1c levels have remained less than 7.0% […]
MKSAP: 57-year-old man with type 2 diabetes mellitus
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old man with a 15-year history of type 2 diabetes mellitus is evaluated for bilateral burning sensation in his feet for the last 6 to 12 months. The sensation worsens at night. His HbA1c levels have remained less than 7.0% […]
How to improve the care of in-flight emergencies
“If there is a physician on the plane, please press your call light!” The vast majority of doctors who have flown on airplanes have heard this, and most of us are willing, if not entirely eager, to respond. What follows is usually a far from ideal encounter with inadequate information, too much noise, a cramped […]
The human hand: not really that good for anything
Long ago primitive sharks had ridges running down their sides from gill to tail. Later, muscles grew into the folds, and eventually, the central portion of each ridge receded while the ends enlarged to form fins both fore and aft. All was well. Then one day several hundred million years ago, a fish was swimming blissfully […]
Physicians don’t just suffer burnout. They suffer moral injuries.
Physicians on the front lines of health care today are sometimes described as going to battle. It’s an apt metaphor. Physicians, like combat soldiers, often face a profound and unrecognized threat to their well-being: moral injury. Moral injury is frequently mischaracterized. In combat veterans it is diagnosed as post-traumatic stress; among physicians it’s portrayed as […]
MKSAP: 38-year-old woman with endometrial cancer
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old woman is evaluated in follow-up after recent surgery for endometrial cancer. Her family history is significant for colon cancer in her sister (diagnosed at age 45 years) and her mother (diagnosed at age 65 years). Her maternal grandfather was […]
The secret life of a nurse
This is based on a true story. The name and some details of the events have been changed. She was the smarter nurse who floated to ICU, to CVRU, to CCU. She could handle any crisis: balloon pumps, CRRT, open-heart patients, respiratory distress, code blues — anything. Sandy was quiet. She didn’t really have any […]