Goodbye Jag: What a case-report will not tell. by Cornelis Kennedy Case reports (CRs) are considered an important tool in conveying information about unusual clinical cases. They serve an important purpose in sharing knowledge with colleagues about often unexpected outcomes. These clinical events are then chronologically presented, analyzed and at the end a conclusion is discussed. Often more is needed. Sometimes the information that is not presented in the CR provides insights that may have a bigger impact on us than the pure clinical data. Sometimes more needs to be said. Sometimes we find ourselves crying. It was late on a Wednesday morning when the resident called. My patient, Jag, … Continue reading
by Rosanne Trost At times in my life, I have had a vague feeling of being vulnerable and lonely. It comes and goes. I can best describe it as a sense of unrest. Fortunately, the episodes are infrequent, usually brief. Still I wonder what they mean, if anything. Is there a message I am missing? In my childhood, when these uneasy feelings would occur, I never shared them. I do not know why. Probably because I would have been misunderstood. The pensive thoughts would not have been validated. As a little girl I remember feeling guilty for these sad times. I should be more grateful. During my junior year in … Continue reading
by Steven Sobel, M.D.* Taking a medication generally connotes a positive means of maintaining one’s health. Using a substance, on the other hand, is a pejorative term, implying reliance on chemicals as a means of escape. Yet the boundary between substance and medication defies facile demarcation. Our labels can be arbitrary and even hypocritical. One person’s medication is another person’s substance. A chemical used as a substance in one situation is considered a medication when used somewhat differently. The distinction shifts along with cultural norms and the passage of time. We might reach a consensus that penicillin is a magic bullet medication, a specific, effective antidote to an identified pathogen … Continue reading
Deep multicolored hues emanating from its surface in all directions Voracious and cruel like a black hole, ripping the borders of lighter brown nearby Seeding and spreading through the crimson water Eventually arriving at the home of thought, pleasure, and personality Shutting it down like an ember drowned by the morning rain Pronounced dead shortly, his lifeless body calling my name Despite his protective pigment If only he had known If only he was told If only he wore the protective white paste He could have been saved from the black hole by Ajay Kailas, a third year medical student at University of Central Florida who is interested in dermatology, … Continue reading
Ruth Tapp, a patient in the U.K., describes what it feels like for the patient to be the subject of bedside teaching. Here is the BMJ article: bmj.i6190.full This was a useful (and short) essay that will be of help to physicians, students, patients and their families. Some things have changed since 1920 — but not all!
After great pain a formal feeling comes — The Nerves sit ceremonious, like Tombs — The stiff Heart questions was it, He, that bore, And Yesterday–or Centuries before? The Feet, mechanical, go round — Of Ground, or Air, or Ought — A Wooden way Regardless grown, A Quartz contentment, like a stone — This is the Hour of Lead — Remembered, if outlived, As Freezing persons, recollect the Snow — First — Chill — then Stupor — then the letting go — There are times when pain is the artist’s teacher. Emily Dickinson expresses that in her great poem, After Great Pain. Keats, having studied medicine for seven years at … Continue reading
by Allen Shih In the well-lit room, students bustled, Dressed in scrubs, holding scalpels, and clutching Netters. Not one spoke, but some did pray. Today was the day. With swift broad strokes of knives, we cut into the flesh. Like lawyers on cross-examination, sifting through layers of muscles, we tagged hidden nerves and camouflaged vessels. Beyond donning the white coat on stage, Beyond the first patient hailing “bye doc!” Beyond spending time alone with terminally-ill patients, Anatomy taught us our first patient. Enshrined in a place of learning, A still woman with prominent cheekbones lay, With slender hands as cold as ice. Her blue eyes squinted into the night. Author … Continue reading
Humanity and Medicine Conference Johns Hopkins School of Medicine December 10, 2016 submitted by DJ Elpern The Turner Auditorium. I haven’t been in this room for 37 years… Not much appears to have changed. It is an imposing amphitheater that suits the Oslerian tradition of Hopkins. What follows are some random notes I took. There was much more that I missed. It was a day of rich pickings and I wish I could have gorged on more that was offered. The following photo could be a key theme of this day at the Turner Auditorium. The physician (observing) not doing something to the patient. The meeting began with a stressing … Continue reading
In his book, The Health Gap, Michael Marmot discusses the effect income inequality has on well-being and longevity. He discusses how the income gap is less in Scandinavia than almost anywhere else and shows how this translates into a narrower health gab between the upper and lower income brackets. Finland is now starting “an experiment in the form of social welfare: universal basic income.” This holds promise to further narrow the health gap. The December 18th NY Times article about this does not mention “the social determinants of health” but some of what the article covers is straight out of Marmot’s book. See: Free Money for the Jobless.
by Marla Lukofsky Today I attended the funeral of my friend and neighbor of 35 years, Ms. Enid. No one knew her exact age except for her best friend Ruby, another neighbor here at The Burnside, our six-storey art deco apartment building that we all lived in. Enid was distinguished and healthy, but dementia grabbed her sensibilities in her last year. Because she was single and had no family, she was sent to a nursing home far away from The Burnside and her friends, a good forty-minutes drive on the highway. Her death has had a huge impact on me. I miss her tremendously, of course, and her passing has … Continue reading