There was a time when medical textbooks were the ultimate resource for information in the field. The modern age of the U.S. medical textbook began in the 1920s and was fully established by the 1960s. Internal medicine saw the appearance of textbooks by Russell Cecil (1927) and Tinsley Harrison (1950), with specialty textbooks by Goodman…
I am often asked by medical students, resident physicians and—especially—patients, what is rheumatology? When students ask me why I chose to be a rheumatologist, I answer that I have never been in love with pathologies, such as rheumatoid arthritis, spondyloarthritis, gout, osteoporosis, systemic lupus erythematosus or vasculitis. In fact, I chose rheumatology because I love…
I have been reading Yuval Harari’s thought-provoking and engaging book, Sapiens: A Brief History of Humankind, about our species’ struggles and the path that led to our emergence as the predominant species. I was captivated by the drawing of the hand of one of our ancestors and mused about what that forebear was thinking as…
You are a rheumatologist in Texas. You are very well trained. Your mentors included some of the leaders in rheumatology, and you are respected by your colleagues and your patients. You know the devastation of untreated rheumatoid arthritis and lupus. A young woman with recent onset of systemic lupus erythematosus is your new patient. You…
“I tell everyone who comes into her room now, ‘You will not disrespect my daughter again. No one will,’” recounts Sarah’s mother. “Every time a [provider] acts rude to her, Sarah tells me, ‘Ma, I’m used to it now,’ and I have to insist ‘No! Baby, you should never get used to that.’ … Dr….
I have been listening to The Fighter Pilot Podcast because my fantasy career would have been to fly a jet fighter plane (not even remotely possible, given my constitution). I learned that when an aircraft accident occurs, a mishap board is convened, not to assign blame but to try to learn what went wrong and…
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…
It was Christmas Eve, 1996. The pain had become excruciating—it had to be for Kerby to opt to go to the hospital on Christmas Eve because Kerby’s pain tolerance was high. At that point, he had been living with what had ultimately been diagnosed as psoriatic arthritis for about 30 years. That Christmas Eve, the…
The impressive progress of medical knowledge and technology reinforces our trust in the scientific methodology that made it all possible. However, that progress also creates risks related to the primary goal of medical care: to serve our patients’ interests and enjoyment of life in the best possible way. In this article we present our views…
Camelot allegedly existed once upon a time in South Wales. The name was evoked again in the 1960s, but perhaps it is also applicable to the character of rheumatology in the halcyon days of the 1970s and 80s. That’s not to belittle the world we now live in, with so many treatment options for our…