Mea sententia...

Refractory eczema

Eczema had been her only real health problem, but what a problem it had been. 

My compass

As a physician for 35 years, I have strived to live up to a quote I first heard from my father: the goal in medicine is to cure sometimes, to relieve often, and to comfort always. During my more than three decades of practice, I have learned that one must combine a willingness to care and ability to hear with an offer to help in order to comfort – let alone occasionally heal. It has been - and continues to be - a glorious and fulfilling career. But it has not been easy or without pain, confusion, fear, or despair.

Smart phones. Stupid users.

The small balcony of our motel in Port Angeles afforded me a fine view. Sitting there, I enjoyed spectacular sunsets, a wide range of shore birds, and the ferries coming in and leaving from Victoria across the Strait of Juan de Fuca.

Left Upper Quadrant (LUQ) pain

The Grand Rounds presentation that week was in the form of a Clinical Pathological Conference (CPC), a medical tradition where a case is presented to an expert or panel of experts in front of an audience of clinicians. The presentation is usually done in the order the information became available during the patient’s hospital course and the experts ask questions, discuss what they think is going on and why, are given more data based on the questions they ask, and ultimately try to come to the diagnosis that was proved at surgery or autopsy.

Ode to the grumps

 

Long ago, in a distant land, in circumstances seeming dire, a dear friend penned this for me. It surfaced this week while I sorted papers. Like all truths and most good literature, it is timeless. I offer it, with thanks to Jill, for those in need.

Ode to the Grumps

 

Many a time it hath been stated

to the grumps we oft are fated

tho' such condition is rare to find

Discovery

“One does not discover new lands without consenting to lose sight of the shore for a very long time." 

André Gide (1869-1951)


 

Have you changed your mind lately?

If not, it doesn't mean you are smart.  Remember...

"Faced with the choice between changing one's mind and proving that there is no need to do so, almost everyone gets busy on the proof."

John Kenneth Galbraith, economist (1908-2006)


 

Dear (Patient) John letter

This imaginary letter, penned after attending a Quality Initiative meeting, is fictional today, but I suspect something like it will appear in the near future and be sadly common within five years. I hope I have retired by that time, because it would be truly shameful to actually sign and send such a letter.


Dear (computer generated patient name),

I am writing to express my deepest regret that I can no longer serve as your PCP.  I will continue to provide you with all appropriate care during the next sixty days while you arrange an alternative provider.

Let there be bureacracy

“And God created the organization and gave it dominion over man.“

(attributed to Peter Townsend)


 

How long will it take?

Rudiger Dorbusch, a German economist who spent much of his career at MIT, famously said:

“Things always take longer to happen than you expect – but once they happen, events unfold more quickly than you’d ever have imagined.”


 

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