What Makes a Great Physician?

At this blog’s inception nearly five years ago, I asked myself the following question: “When you watch impressive doctors at work, what is it that most impresses you?” In other words, what makes a great physician? I was a third-year medical student at the time and I couldn’t answer the question. At the beginning of training one...

Medicine as a Vocation

“Hey, doc, come over here!” the patient shouts at me and gestures with a quick wave of his hand as I walk by his room. “I need to show you something. Take a look at this.” Without waiting for me to ask him what is wrong, he takes out his member and testicles and points at them. “One of my testicles is swollen. Look! And it’s...

Bigotry, Medicine, and Pittsburgh

“You’re one of them wealthy people, from that wealthy family — what are they called? The Rothbergs?” “You mean the Rothschilds?” I asked. “Yeah they’re the ones. You’re related to them?” “No, sir. My last name is Rothstein — different family but same religion.” Most of the time I don’t hear about race or...

Is More Medical Testing Better?

“I think this patient needs a CT scan of her chest,” the consulting physician said to me over the phone. “Her lungs sound bad, and given her history, we need to make sure she isn’t developing pneumonia.” The patient, though only thirty-five, had been through a lot during her hospitalization. She came in a week prior with some...

Reflections on Treating the Poor

It is altogether curious your first contact with poverty. You have thought so much about poverty — it is the thing you have feared all your life, the thing you knew would happen sooner or later; and it is all so utterly and prosaically different. You thought it would be quite simple; it is extraordinarily complicated. You thought it...

Locked In: What It’s Like to Be Fully Paralyzed

On Friday, December 8th, 1995, Jean-Dominique Bauby, the 43-year-old French editor of the fashion magazine Elle, suffered a major stroke. He was behind the wheel of his BMW after picking up his son, and suddenly felt as though he were “functioning in slow motion.” His vision blurred and he broke out in a cold sweat. He barely managed...

When Doctors Are Wrong

As medical students and resident physicians gain experience they also gain knowledge and confidence. Consequently, young trainees eventually reach a level of comfort in speaking with families and patients about prognosis and disease course. This is part of the purpose of training, as these conversations happen so often that they are an...

A Biopsy

There are certain patients who never fade from a doctor’s memory — they make an indelible imprint on one’s training. Thinking back on these patients and their respective hospitalizations is like gazing through a pristine window pane on a clear, sunny day. Often they stick in our memories because one becomes emotionally invested in...

The Case for “Pimping” in Medical Education

Illustration by William Sharp (National Library of Medicine) “What are some common causes of pancreatitis?” The attending physician looked at me as we stood outside of the patient’s room. It was as if she had turned a stage light on over my head while medical students and residents silently waited at my flanks, watching with bated...

The Burden of Medicine on Mt. Kilimanjaro

The imposing mountain of Kilimanjaro in the East African country of Tanzania stands alone amidst the surrounding flatlands and swallows up the horizon with its snow-capped peaks. At once alluring and intimidating, its enormous size provides the kind of thrill and sense of wonder that a child must feel when it becomes conscious of the...