“Wait. I can explain.” One could imagine this phrase coming up under many conditions in daily life. When I first became a physician, however, I would never have expected to use this phrase in my clinic. In medical school, I was taught the importance of dialogue in establishing a relationship with a patient. Statistics indicate…
It started with an inhaler. Like many of you, I am a rheumatologist. And like you, I see some patients more often their own primary care provider. This is so often the case that I have gradually devolved into their backup, all-purpose doctor. I am the doc they notify when they get hospitalized for pneumonia…
There is an old adage that there are two types of people—lumpers and splitters. For some, people are easily categorized into liberal vs. conservative, Democrat vs. Republican, Donald Trump supporter vs. Hillary Clinton supporter. For others, everyone is a snowflake, and what makes us different is much more important than what makes us the same….
If you are a news junkie, then you know that a tick-tock is a story that relies heavily on chronology, counting down the events of the day, in order, as inexorably as the ticking clock. These types of timeline stories have become very popular in the fast-paced world of modern politics, in which readers eat…
4 Patients in 4 Weeks Baltimore is a little over two hours away from Richmond, Va., by car. I know this now because I recently drove to Richmond to attend a memorial service. I drove in silence. Music made me sleepy, and I could not bear to listen to another iteration of how we are…
Every year, my program goes through a ritual—I scrub my face, put on a smile and meet hordes of medical residents from across the country. And every year, I do my best to convince all of them that Baltimore would be an amazing place for them to complete their medical subspecialty training in rheumatology. Now…
Mysterious Ways The juxtaposition of the old and the new was readily evident that busy Wednesday morning. My first patient, a 94-year-old gentleman, Hal, arrived with a precise request. His rheumatologist for the past 40 years had just retired, and he was searching for a doctor with expertise in the use of gold sodium aurothioglucose,…
My dear electronic health records How do I dislike thee? Let me count the ways Adaptation of Sonnet 43 By Elizabeth Barrett Browning, 1806–1861 As my tenure as physician editor winds down, it’s worth reviewing some of the more nettlesome issues confronting clinicians that have been previously discussed in these pages and gauge their current…
An Unforgettable Story Her name was unforgettable. Not only did we share our given names—Simon and Simone, but her French-Canadian surname was based on this appellation, too. I was the junior resident working on our hospital’s nephrology service when she was admitted for evaluation of progressively worsening kidney disease and an overall failure to thrive….
Steady hands, nerves of steel: The endoscopic transphenoidal hypophysectomy is a delicate neurosurgical procedure. Using a three-dimensional microscope and a powerful magnetic resonance imaging machine to guide them, the surgeon must meticulously dissect the throat tissues, navigate through the palate and the sinuses to reach the base of the skull where the pea-sized master gland,…