Genetic Testing
“If you want CVS, you’ll have to decide within the next three days,” the genetic counselor told us. My husband and I were sitting in the upscale office of the maternal fetal medicine (MFM) practice in downtown San Francisco. Our obstetrician had referred us here for genetic testing of our twins in addition to the … Continue reading
Post Hoc, Ergo Propter Hoc
We understand very little about the human body. Sometimes I think that the more we learn, the more we learn how much we don’t know. Occasionally, our patients show us. Take Jim*, for example. He came to me complaining of wheezing and shortness of breath. He had been newly diagnosed and treated for asthma over … Continue reading
Continuity of Care
“I would want you as my doctor. I just wouldn’t want your life,” I said to the thoracic surgeon. It was after midnight and we were standing in the intensive care unit. I, having urgently intubated a critically ill patient; he, having finished a surgery on a patient we shared. This particular patient had had a lung … Continue reading
Anxiety
Anxiety ranks among my least favorite diagnoses. In medicine, we have a long history of blaming a variety of diseases on anxiety. Even in the recent past we attributed gastric ulcers to stress until it was proven that a bacteria that lives in the gut is responsible. Indeed, who would have thought: a bacteria living … Continue reading
Doctors Can Only Give So Much
editorial in SLC Tribune I called it “The Depressed Doctor” in homage to David Foster Wallace and his short story, “The Depressed Person.” The SLC Tribune titled it: “Doctors Can Only Give So Much.” Here’s a link to the Schwartz foundation and more about Schwartz Rounds.
The Stories We Tell
Stories are at the heart of who we are as people. In medicine, patients tell their doctors the story of how their symptoms started and how they have progressed. They tell the story of how they feel now. We document this story in a note from the encounter that we call the “history and physical.” … Continue reading
Brain Transplant
When I was in Boston, I had a patient with a brain tumor and two adult sons. She had a malignant, progressive brain tumor and had been unresponsive for months. Her prognosis was poor. One son, I’ll call him Peter, thought she would have wanted to be DNR/DNI: if her heart stops, if her breathing … Continue reading
Girl Driver
“Mom, doctors are men and nurses are women,” one of my four-year-olds said to me cuddling up in my lap as the pediatric nurse walked in. He wasn’t trying to be inflammatory. At this age, he had been learning social norms, and his voice betrayed the pride he felt at finally figuring out this “rule.” … Continue reading
Air Pollution is Bad for You: What I learned at the Air Quality Retreat
What I learned at the University of Utah Air Quality Retreat March 4, 2013: From Particles to People: Air Quality, Health, and Society Retreat 1. Air Pollution is bad for you. One of the ground-breaking studies on evaluating the effects of air pollution compared the rate of hospitalizations in children living near a steel mill … Continue reading
What I Learned at the ATP Reunion Conference Feb 2012
Hi all, happy valentine’s day! I hope you’re all doing well. It was fun to meet up with some of our class for the reunion conference. While this conference was not the life-altering event our class was, I still found it useful and thought I’d share some of the things I learned at the conference. … Continue reading
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