Who Was Michael Balint and Why Should We Care?: Introduction

For a brief biography see: Michael Balint – An outstanding medical life.1 Balint’s son, John, was a distinguished professor of gastroenterologist and medical ethicist at Albany Medical College. I attended a lecture by him, and it was there that I first heard about Michael Balint and became interested in his opus magnum, The Doctor, His Patient and the Illness.2 The Sawyer Library at Williams College has a copy and I checked it out periodically over two decades, but found it hard going. Finally, in 2016, I bought a second-hand copy and decided to wade through it. Early in the book Balint asks: “Why does it happen so often that in … Continue reading

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Granulomatous Rosacea

Granulomatous Rosacea H.S. 2018 Case Presentation Presented by David Elpern August 17, 2018 A 34-year-old sociologist presented for evaluation of forehead lesions, which have been present for about 2 years.  These began about a year after her daughter’s birth.  Before that, she was on oral contraceptives and was fine, but she has not been on any hormonal birth control since then.  She saw another dermatologist and was treated with topicals, a SilkPeel, Tretinoin.  She also took doxycycline for 2 – 4 weeks. Nothing helped.  She is anxious about her appearance. O/E: The examination shows a pleasant, outgoing woman.  She has a somewhat pebbly appearance to the forehead with many, mostly … Continue reading

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Hot Spots 2018 Faculty Emails

Claypoole, Lauren Claypoole.lauren@gmail.com Dann, Frank zitdoc@hotmail.com Elpern, David djelpern@gmail.com Esaki, Paul paulesaki@gmail.com Glamb, Roman rglamb@straub.net Goo-Frazier, Alana alanagoo@hawaii.edu Ing, Malcolm malcolmingmd@hotmail.com Johnson, Douglas dwj808@gmail.com Kamm, Lindsay lindsay.kamm@gmail.com Karewicz, Marianna marianna.karewicz@gmail.com Kumar, Bhushan kumarbhushan@hotmail.com Rademaker, Marius marius.rademaker@gmail.com Reese, Vail drvcr@earthlink.net Reizner, George greizner@dermatology.wisc.edu Schoenfeld, Michael mjschoenfeld@gmail.com Webster, Michael michaelrwebster@bigpond.com      

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What Matters To Me Questionnaire

To view the questionnaire we used, click What Matters To Me Questionnaire We are trying to create a tool to help patients communicate with their physicians and other care providers about what really matters to them in their relationships with the health care system. Although one may not always get everything wishes for, this is a chance to share your preferences and values with regards to the healthcare you receive. When answering the questions it may be helpful to think of times you felt that your medical care needs were not met. Please rate choices in the order of importance to you. All information is confidential. No one’s identity will … Continue reading

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Marius Rademaker Hot Spots 2018 Low Dose Isotretinoin,

Marius Rademaker- Bio August 2018 Dr Marius Rademaker BM FRCP(Edin) FRACP DM is an Honorary Associate Professor at Waikato Clinical School (Auckland University School of Medicine), research director of Clinical Trial NZ, and a clinical dermatologist (Tristram clinic and MoleMap NZ – a national teledermatology service). Until recently he was Clinical Director and Head of the Dermatology Department, Waikato Hospital District Health Board and Chairman of DermNetNZ.org Trust. As well as being Regional Advisor of the Royal College of Physicians of Edinburgh, he is a Fellow of the Royal Australasian College of Physicians, the New Zealand Dermatological Society and member of the International Society of Dermatology, the European Academy of … Continue reading

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Metastatic Basal Cell Carcinoma

Case Presentation Metastatic BCC 2018 Hot Spots in Dermatology Presenters: Marianna F. Karewicz, NP Roman W. Glamb, MD Straub Medical Center Abstract Basal Cell Carcinoma (BCC) is deemed as one of the most frequent types of skin cancer. Typically, it is regarded as localized in nature and there is a tendency to view the condition as non-malignant because the tumor rarely metastasizes (Habif, 2016). However, what if the condition became aggressive? If left untreated, BCC has the capability to spread through direct extension, destroying normal tissue and large portions of the body; even penetrating the subcutaneous tissue to bone and/or the brain. This case presentation will explore the aggressive nature … Continue reading

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Illness Narrative – Long Form

My Illness Narrative: the Autopathography Project (If you want this in a printable form, please email D.J. Elpern djelpern@gmail.com) You may have a complex health problem that doctors have not solved. When you enter the new doctor’s office, a perky young person asks who referred you and then requests your insurance cards. Next, there are numerous forms to fill out. Then, you are seen by an assistant who records your weight, blood pressure, pulse, and even the oxygen saturation from a fingertip. Finally, the physician or his “extender” sees you for 10 – 15 minutes, at least half of which time he is focused on your electronic medical record. After … Continue reading

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Darkness Visible: A Life of Chaos

a chaos of hard clay. Byron, Darkness Darkness Visible: A Life in Chaos It takes almost a decade to train a physician: at least seven years for a family practitioner and up to ten for cardiac- and neurosurgeons. We become technically proficient in treating diseases, but are not as adept at treating the illnesses that people present with. How often do we get, or make, the time to really get to know our patients? Physicians are comfortable with disorders that are clear-cut: diabetes, skin cancer, hypertension, and on and on. Yet, there is a subset of humanity with medically unexplained symptoms (MUS). Thirty to 50% of people seen by primary … Continue reading

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Medical Nemesis: The Expropriation of Health (1975)

From the Introduction: full notes at:Medical Nemesis Illich Ivan Illich, 1926-2002 (http://en.wikipedia.org/wiki/Ivan_Illich) Introduction: The medical establishment has become a major threat to health.  The disabling impact of professional control over medicine has reached the proportions of an epidemic. Thoughtful public discussion of the iatrogenic [“physician caused”, iatros=physician & genus=birth] pandemic, beginning with an insistence upon demystification of all medical matters, will not be dangerous to the commonweal.  Indeed, what is dangerous is a passive public that has come to rely on superficial medical housecleaning. My argument is that the layman, not the physician, has the potential perspective and effective power to stop the current iatrogenic pandemic. During the last generations … Continue reading

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Notes on Pathographies

Notes on Pathographies: An Arabian Nights’ Experience David J. Elpern* * The Skin Clinic, Williamstown, Massachusetts Email          A few years ago, a group of us gathered in the Osler Library at McGill. Osler guided us with his words: The practice of medicine is an art, not a trade: a calling not a business; a calling in which your heart will be exercised equally with your head. Often the best part of your work will have nothing to do with powders or potions, but with the exercise of an influence of the strong upon the weak, of the righteous upon the wicked, the wise upon the foolish… Courage and cheerfulness … Continue reading

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