My blog represents my personal experiences and perspectives. This includes many anecdotes from my medical practice. I have been scrupulous to anonymize these anecdotes and to avoid ever belittling or making fun of patients. (I often make fun of and criticize myself, my colleagues, and the institutions where I have worked.)
Winter is coming, and with it – snow. Some of us love it and some of us hate it. And some study it. Read this story about the life and work of Wilson Bentley, a self-educated farmer from a small American town who, by combining a bellows camera with a microscope, managed to photograph the dizzyingly intricate and diverse structures of the snow crystal.
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.
I am thankful for it all, both the bad and the good. For all the things that make the world what it is. I am thankful for the opportunity to participate, to try to make a difference. And I wish you all the best holiday you can have and the opportunity to be thankful, too.
There are limits in both music and medicine. Go beyond those limits, and disaster is inevitable.
Two quotes from Donald Berwick’s Escape Fire address sum it up quite nicely.
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.
Shortcuts, humorously defined as the longest path between two points, can be dangerous in clinical medicine.
The first of November is the official end of the trail running season and the first of December is the official start of the Nordic skiing season. November serves as a transition month.
Close calls and near misses are common terms for bad things that almost - but didn’t - happen.
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.