A plain X-ray film appeared on the computer screen—a humerus, a radius and an ulna were all visible. My pupils zoomed around the screen, and on initial inspection, everything looked fine. However, this X-ray was unlike any film I had ever reviewed. You see, it was for my then 4-year-old puppy, Lexi. My sweet little…
Revisiting Our Assumptions & Preconceptions
Admittedly, there’s not much to see on a country road 100 miles southwest of Iowa City, Iowa. It’s especially true in winter, when a blanket of white snow obscures any and all features of the seemingly endless fields of corn and soy. In the radiance of fresh snow on a bright winter day, even the…
Janusian Thinking in Rheumatology
Happy New Year, readers of The Rheumatologist! As the incoming editor, I want to welcome you back in this new year and hope that you’ll stick around, month after month, as we journey together through 2023. As the year progresses, you may notice some departures from what we have previously done, but I also wish…
The Secret to Happiness
Are you happy? This may be a question born of the pandemic. Pre-pandemic, I used to quote William Osler, MD, who simultaneously founded the Department of Medicine at the Johns Hopkins Hospital and created the modern system of medical education. He opined: The practice of medicine will be very much as you make it—to one,…
Exploring the Role of Artificial Intelligence in Rheumatology
I looked at the joints. They spoke back to me—”I need more humanism,” they whispered. To longtime readers, those two sentences may sound both familiar and alien, perhaps even a little humorous. That’s because those sentences were generated entirely by a computer using artificial intelligence (AI). It was simple, too: I just copied the text…
License to Cure: Greed, Politics & Medical Licensure in the U.S.
William Osler, MD, had an idea. Many institutions lay claim to the legacy of Osler, and by the time he arrived at Johns Hopkins Hospital in 1889 to become the first physician in chief of the institution, he was already widely acknowledged for his clinical acumen. He now wanted to spread that clinical acumen around.1…
Cliff Diving: Evergreening & Other Oddities
The glassblowers were in revolt. The island of Murano, in the 13th century, was a perfect home for the glassblowing industry. Connected to Venice through a system of bridges, Murano was surrounded by waters that protected the city from the furnaces that fueled the glassblowers’ craft. The Republic of Venice dominated trade throughout the Mediterranean,…
Evidence of Things Not Seen: The Match, Vienna & Unknown Unknowns
It is better to be feared than loved. The associate dean of student affairs at my medical school embraced this motto. Although the dean of the medical school was titularly in charge, it was the associate dean who kept the school running. And we all feared her, just a little bit. Without ever raising her…
Ignorant of Ignorance: Medical Education & the Dunning-Kruger Effect
I just didn’t understand. I was an excellent student. I know this is true of most of you. Given the nature of this publication, most of our readership have graduate degrees. This means that collectively, after completing four years of college, we all made the financially dubious decision to pursue post-graduate education, like lemmings jumping…
Concierge Care: Basketball, Hotels & the Future of Rheumatology
I wouldn’t normally look to professional basketball as a model for healthcare, but sometimes answers come from unexpected places. The observation that elite athletes are not like you and me—medically speaking—is not new. In the second century AD, the pontifex maximus in Pergamum recognized this fact and appointed Claudius Galen physician to the gladiators, making…
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