The Face and the Person

The importance of the face in human interactions from the day we are born cannot be overstated. Infants, even if they are blind, communicate their feelings to their parents in large part through facial expressions. For children and adults, so much of what we comprehend about people’s feelings involves interpreting a glance, a smirk, or...

How Doctors Choose a Specialty

People sometimes assume that every doctor feels a calling or has a special skill for one area of medicine or another. But the truth is very different for most doctors. Old operating theater in London Wikimedia Commons (Mike Peel, CC BY-SA 4.0) When students begin medical school they don’t actually know what medicine entails. Maybe...

The Distortion of “Death with Dignity”

I recently wrote a short essay for Public Discourse about the “death with dignity” movement. In the piece, titled “All Death is Death Without Dignity,” I compare the palliative-care movement — which seeks to alleviate the physical pain of death, often in the context of hospice care — to the physician-assisted suicide...

Should Computers Replace Physicians?

In 2012, at the Health Innovation Summit in San Francisco, Vinod Khosla, Sun Microsystems co-founder and venture capitalist, declared: “Health care is like witchcraft and just based on tradition.” Biased and fallible physicians, he continued, don’t use enough science or data — and thus machines will someday rightly replace 80...

Revisiting The House of God

Dr. Stephen Bergman, a psychiatrist, published his now-famous satirical novel The House of God under the pseudonym Samuel Shem in August 1978. The book’s protagonist, a young intern, describes the emotional and physical difficulties during the first year of residency. With more than two million copies sold, the work is something of a...

Managing Expectations

“Yes. But could I endure such a life for long?” the lady went on fervently, almost frantically. “That’s the chief question — that’s my most agonizing question. I shut my eyes and ask myself, “Would you persevere long on that path? And if the patient whose wounds you are washing did not meet you with gratitude, but worried...

Becoming Cynical, Part 4

I have written quite a bit about why physicians become cynical (see here, here, and here). What follows are some more thoughts on this topic that relate to my previous post on Parkinson’s Disease (PD). Recently, a sixty-three-year-old patient came to the neurology clinic for a left-handed tremor that had become worse. He and...

The Parkinson’s Patient

via Shutterstock In 1817, Dr. James Parkinson, an English surgeon, scientist, and political activist, wrote in An Essay on the Shaking Palsy about a new medical pathology. In this work, he describes the characteristics of what would later be called Parkinson’s Disease (PD). The essay is worth examining because it offers a perspective...

Beauty, Biology, Music, and Math

As physicians, we rarely consider the healthy human body. We learn about normal human physiology during our first year of medical school but soon afterwards are exposed solely to pathology. In the hospital we almost always inquire, “What is going wrong here?” but rarely ask, “What is going right here?” It is worth taking a moment...

The Problem with the New Patient Autonomy

The neurology team shuffled single-file into the patient’s small room. The patient, probably in his 30s, had black hair, brown eyes, and an unsettling demeanor. He glared icily at us from his bed, the blankets covering him up to the neck. His pale brow furrowed even more noticeably as all nine of us intruded on his privacy. In a scene...