“Doctor, are you SURE?”

Hubris is a killer. Fight it with humility! In medicine, we often don't know why things happen as they do, and it can be hard to say "I don't know" when faced with certain questions.  Some patients view uncertainty very unfavorably and want total confidence by their doctor all the time. How do you feel when your doctor says "I don't know"?

Breaking news: FDA expected to approve di Michelangelo® System for robotic fecal disimpaction.

MILAN, Italy: Gastroenterologists rejoice! Innuendo Technologies has announced that FDA approval of the di Michelangelo robot is expected early this spring...the first robotic platform designed specifically to perform fecal disimpaction! Dr. Hans Enyuanus was one of the pioneers of robotic fecal disimpaction using the di Michelangelo® System, having performed over 2000 procedures...

I wonder if they have a white coat ceremony in care management school?

Now, I don't want to offend anyone with this post (it's already too late), but it seems these days that the only qualification that one needs to don a long white coat is to work in some patient care area of a hospital. The long white coat used to be the way patients, families, and other hospital medical staff could instantly tell who was a full-fledged attending physician. In fact, the emphasis on the white coat starts on the first day of medical school with something aptly called a "white coat ceremony."

“Badness” is a spectrum

"Is it bad" is an honest question. "Is that bad" is usually also an honest question, but one that is much more difficult to answer. Patients usually ask "is that bad" without actually having a diagnosis yet. At the end of our visit I try to summarize the pertinent issues and I will usually list a few of the possible diagnoses that may explain the symptoms. Then we will come up with a plan to test for these diagnoses. I might say "This is probably irritable bowel syndrome, however some of the symptoms could be consistent with Crohn's disease or ulcerative colitis. We need to do further testing to figure out which one it is."

The Chef.

Small beads of sweat were already forming on his forehead before he entered the kitchen.  He walked into the back where the chef, who was working furiously, didn’t even notice him. “Excuse me, Chef?” the waiter managed to peep out, barely audible above the kitchen clamor.  There was no answer.  “Um, excuse me, Chef?” the  … Read more

“When can I go home?”

Most patients want to get out of the hospital as soon as possible.  No one wants to sleep in a loud hospital room with constant interruptions for rounding, vital sign checks, blood work, etc.  Hospitals are a place for people when they’re sick, and if you aren’t sick you shouldn’t be in a hospital. I  … Read more

The wrong messenger

Bad news is always hard to break.  I would like to think that I get better at breaking bad news after doing it over and over, but it doesn’t make it easier.  Some experiences stick with you and this is one of them: Several years ago I was making rounds in the hospital and my  … Read more

Speaking in codes

“Hi, it’s Dr. Smith…are you taking consults today?” the voice on the other side of my short-range hospital phone said.  I recognized the callers name as one of the new hospital doctors, known as hospitalists. “Of course,” I said, “what have you got?” I guess some groups have a specific doctor for the day “take”  … Read more

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