Morbidity & Mortality Conference, a post mortem

When things go wrong in medicine, as they invariably do, we try to figure out what went wrong, and why.  We try to learn if there’s anything we could have done better and what we should do next time. It used to be, in the days of the Giants, that the physician responsible for the patient … Continue reading

A New Therapy for Asthma

I first met Carol* (name and identifying details have been changed) when she came to my clinic after a severe asthma attack had sent her to the Intensive Care Unit.  After a few days, she had been extubated and had acquired a new diagnosis, asthma.  When she saw me in clinic, she felt better than … Continue reading

What I Learned at the ATP Reunion Conference February 2014

I. Capitation is coming Although Brent was careful to stress that despite this being gospel among those who “have drunk the kool-aid” it is not universally accepted. Still, the alternative narrative is just more of the same – more efficient fee for service – or aspirations for competing as one of a handful of fee-for-service … Continue reading

Physician Compensation

Doctors are burned out and they don’t enjoy their job as much as they used to.  But looking broadly, physicians are still spared the economic difficulties and loss of autonomy that are present in most other sectors where people are still lucky enough to be employed.  There are issues that doctors rarely face: unemployment, inability … Continue reading

The State Fair

“I got run over by a golf cart at the State Fair,” my five-year-old cheerfully says to the Emergency Department technician who is checking us in. A utility cart knocked him down – he is a five-year-old running along the grass by the path, and some asshole wasn’t looking as he turned into my kid … Continue reading

Evidence-Free Pregnancy Advice

I know why the hoopla around Emily Oster‘s new book, Expecting Better, bothers me, it’s because she hasn’t let you in on obstetrics’ big bad secret… and here it is…. from a pulmonologist. What Ms. Oster points out, and where she is absolutely correct, is that the data to support most pregnancy advice, indeed, most … Continue reading

The Women’s Table

My latest post on mentoring women in medicine and science can be found at the Broad Side.  It’s called “The Women’s Table” and you can read it here.  http://www.the-broad-side.com/the-womens-table ————————————————————————— The Women’s Table at Yale (picture) Women’s Table The Women’s Table by renowned artist and architect Maya Lin (B.A. 1981, M. Arch 1986) lists the … Continue reading

Judging by the Source

“Mom, who made the first people?” he asks me sweetly. It is already nine o’clock and well past his bedtime. Blah, blah, blah, I stumble a bit then build up to “people came from monkeys.” “Nah,” he says and gives me a sly smile as if I’m trying to trick him. My “really, they do!” … Continue reading

Gorilla Glue and Heartbreak

“My friend said to tell you everything when I come,” she says as she opens a little zippered bag full of flakes. “My teeth are falling out and I can’t afford a dentist, so I use Gorilla Glue to glue back the pieces,” she says. She was referred to me for severe asthma, but she … Continue reading

Hubris

“I think he’s just anxious about it,” the medical student told me a few sentences into the presentation.  His patient had had a spontaneous pneumothorax, a leak of air between the lung and chest wall, a few years ago, and now he had some uncomfortable feeling and was worried about a recurrence.  I hadn’t heard the full story … Continue reading