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…
Where Do Rules End & Compassion Begin?
My long-standing patient with CRST syndrome (i.e., calcinosis cutis, Raynaud’s phenomenon, sclerodactyly and telangiectasia) had been losing ground over the past 18 months. BL was 54 and had developed restrictive pulmonary disease without radiographic pulmonary infiltrates. Her mean right heart pressures were moderately elevated by ultrasonography. But the greatest impact on her quality of life…
Dermatologist, Rheumatologist Discuss Refractory Cutaneous Lupus Case
As a dermatologist/internist with a career-long subspecialty interest in the cutaneous manifestations of the rheumatic diseases, I found the case of refractory acute cutaneous lupus by Samantha C. Shapiro, MD, in the June 2022 issue of The Rheumatologist intriguing in several ways, and I felt my perspectives on this case might provide additional educational value…
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…
Letter to the Editor: Weathering Storms
We read the article, “Rheumatologists Share Lessons Learned in the Wake of Hurricane Ida” (July 2022, The Rheumatologist), with great interest. This poignant account of the impacted patients and rheumatologists provides invaluable planning tips regarding medication loss, access to pharmacies and medical records, and strategies to avoid practice losses. The critical lessons presented in this…
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…
Set Up to Fail: The Criminalization of Clinical Practice
On Dec. 27, 2017, RaDonda Vaught killed Charlene Murphey, allegedly. Ms. Murphey was a lifelong resident of Gallatin, a suburb of Nashville, Tenn. She was well known from having worked at the local Walmart for 24 years, before she retired in 2012, when she was 65 years old.1 On Dec. 24, 2017, she was helping…
Stronger Together: The Future of Physician Unions
If you ever want to be depressed, turn to the internet. This might strike some of you as a truism. Certainly, between the pandemic and the war in Ukraine, it is difficult to open your browser without being smacked in the face by a dismally depressing piece of news. In this particular case, however, I’m…
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