Looking through a glass darkly, then seeing face to face

April 17, 2012

How do you explain to a mother your concern that her child, whom you have seen repeatedly over years, might have an underlying genetic syndrome that will profoundly impact the rest of her life?
 

Midnight medicine: A time when difficult decisions must be made

February 28, 2012

Moral distress: when clinicians feel they cannot do the ethically appropriate thing. Midnight medicine: when difficult decisions must be made with no time for consultation and critique.
 

An unlikely afternoon hero: When being there is good enough

December 20, 2011

In the middle of a humdrum afternoon at the office, in between sobbing febrile toddlers and heartbroken adolescents, those patients whose suffering I can do little to alleviate, momentarily I become a hero to one family.
 

Transitional medicine: Patients
 who are just passing through

October 13, 2011

I watch them go—a new family I will most likely never see again. They've played by the rules, but got burned by the system. Lose your job, lose your health insurance, lose your doctor.
 

Growth and development: In 
pediatrics, everything starts small

August 24, 2011

Some things grow more quickly than others, and sometimes we have the chance to weed the garden before it's too late.
 

Generational medicine: The year of the great-grandmother

June 15, 2011

I watch them walk down the hallway, this woman I have known as a mother, now as a grandmother, whose grandson still has a great grandmother of his own.
 

The art of medicine: Having faith in the seeds we plant

April 13, 2011

A visit from an 8-year-old patient reminds the author that in medicine as in the natural world, every seed germinates in its own time.
 

Goethe's Erlköenig: A poetic 
drama at the close of day

February 09, 2011

On a day in late winter, an acutely ill 6-week-old infant reminds the author of a famous poem—and leaves him hoping for a different outcome.
 

Heartache: When the diagnosis is just a click away

December 15, 2010

After a trying week, a young patient with puzzling heart pain reminds this clinician to breathe easy—and let his own chest discomfort subside.
 

Out of season: Coping with 
an adolescent in crisis

October 20, 2010

An exchange with a troublesome adolescent girl incites contemplation about whether the teenage years are always a time for blooming.
 

Love's labors lost: Sexual dysfunction in an adolescent male

August 06, 2010

When a teen-age boy disguises his true intention to receive a Viagra prescription, the author reflects on relationships and reading between the lines.
 

House calls, homebodies: Remembering that you came

June 16, 2010

The comfort of a clinician's home visit is immeasurable to patients who wish to live their last days in their own home.
 

Telling it slant: Using poetry 
as a venue for healing

April 27, 2010

When the author is invited to speak to a local boy scout troop, he uses poetry to find a pathway in to a difficult subject.
 

A grief observed: A belated bill must finally be paid

February 25, 2010

An encounter with a patient last seen 6 years previously reminds the author that there's no escaping grief. It always catches up with us.
 

Evaluating the patient with a measure of equanimity

December 29, 2009

The author reflects that no matter how many times he has examined a child who has been abused, the experience doesn't get any easier.
 

A jaundiced view: More than meets the clinician's eye

October 28, 2009

The author reflects on just how much he has left to learn about how a disease can impact the lives of those who suffer from it.
 

Rhyme and reason: Searching for poems in medical practice

August 20, 2009

A teen-age patient presents with fatigue and malaise. Her vague symptoms do not lead to a diagnosis, but the poem gleaned from her care is a treasured gift.
 

Face to face: Glimpsing the man behind the mask

June 09, 2009

The author reflects on how deceiving outward appearances can be after watching the interaction between a little girl and her disfigured parent.
 

An early morning mist and the wing of a prayer

April 06, 2009

I take another sip of coffee and recall the words of yesterday's e-mail: "My father will be having heart surgery tomorrow morning to replace a damaged aortic valve and repair the mitral valve."
 

"Like a bridge over troubled water, I will lay me down"

February 20, 2009

"There is a land of the living and a land of the dead and the bridge is love."
 

The art of medicine: Using your heart and your head

December 01, 2008

"After the man told me his story, I sensed that he felt better. He needed to have someone listen."
 

The practice of medicine: Moving beyond the science

October 01, 2008

Nearly 3 decades ago, when I first stepped out into the field of clinical practice, the science of medicine was top priority.Like most PA students from that era, I spent the greater part of 2 years struggling to learn human anatomy and physiology, physical diagnosis, pathophysiology of disease, laboratory medicine, diagnostic radiology, and pharmacologic treatment.
 

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