e Writing Medicine By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT My first glimpse into the craft of physician-writers did not come through Anton Chekhov, Walker Percy, or William Carlos Williams, whose works I only came to after medical school. As a schoolboy, I loved W. Somerset Maugham, although he never practiced medicine, and his craft had little to do with his medical degree. My introduction to physicians as writers came through my textbooks. Boyd’s Pathology made me aware of literary voice, the ability of authors to place themselves in the text, let their personality come through, and subtly become a character in the reading experience. On the topic of defining the moment of death, Boyd in his single-author text wrote, “It was the author of the book of Ecclesiastes who said, ‘There is a time to be born, and a time to die.’ Fortunately it is the clinician, not the pathologist, who has to make this difficult decision. Sometimes, however, the kindly doctor may find himself murmuring those moving lines from the last act of King Lear: O let him pass! He hates him/That would upon the rack of this tough world/Stretch him out longer.” Full Article
e Forty Years of A Piece of My Mind By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT Forty years ago, in 1980, Jimmy Carter was president. Pac-Man debuted. In medicine, smallpox was declared to be eradicated. Additionally, on May 9, 1980, A Piece of My Mind was inaugurated in JAMA. The first essay, “Tuna on Rye, 1984,” was written by then–senior editor Samuel Vaisrub under the pen name Sam Vee. He introduced the column with an editorial entitled “For the Peace of Your Mind.” Full Article
e For the Peace of Your Mind By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT We hasten to assure our readers that a piece of my mind...is not intended as a sounding board for peevish gripes, nit-picking beefs, or sundry assortments of righteous indignation, which are usually prefaced by an angry “let me give you a piece of my mind.” Nor is this section of The Journal meant to be a podium for pompous preachments and ex cathedra pronouncements. Nor again is it designed to be a forum for half-baked speculations and warmed-over hypotheses. Least of all is a piece of my mind envisaged as a jamboree of jokes and a shivaree of limericks. Full Article
e Tuna on Rye, 1984 By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT “Your medical clearance, sir?” Full Article
e The Environment: People Pollution By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT Meeting basic food and shelter needs of a growing population and catering to the insatiable consumer demands of people profoundly influences the quality of our environment. President Nixon observed that many of our present social problems may be related to the fact that we have had only 50 years in which to accommodate the second 100 million Americans. To provide for the increasing needs and demands of people, we are polluting our air, soil, and water. Unchecked population growth, people pollution, is not merely a problem, it is a paradox. It is an issue that is intimately private and yet inescapably public. Full Article
e My Friend Claims Her Second Round of Cancer By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT As my Italian father would say, since the house is burning let us warm ourselves, and so Full Article
e pasture By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT with a weak smile the rabbi Full Article
e The Changing of the Seasons By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a level-one trauma nurse compares Arizona’s 2 seasons with the waning and the waxing of patient admissions and with the cycle of grief for loss of her mother and son, realizing how much their deaths have affected her nursing. Full Article
e Doppelgänger—Parallel Struggles to Lose Weight By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a primary care physician describes his patient’s struggle with obesity, sees himself in his patient, and wonders if his own struggles with weight loss impede his patient’s efforts to lose weight. Full Article
e Miles Together—A Patient-Physician Journey By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a family physician shares the beginning and ending of a near 12-year journey with a patient, helping him reach sobriety that led to a full though short life and feeling humbled to have been so entrusted to travel with him. Full Article
e Of What Am I Afraid? Plumbing the Depths By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a psychologist peels back the layers of her reticence and comes to terms with working with transgender patients as a member of LGBT community. Full Article
e The Cost of Technology—Patient-Centered Care By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a primary care physician describes a drawing by a 7-year-old patient who is sitting on an examination table with her mother cradling her baby sister with the physician’s back to them entering data in the computer as an example of a system that is sacrificing human contact for electronics. Full Article
e To Isaiah, a Casualty of a Fractured System By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, Donald M. Berwick shares the story of his patient Isaiah with the 2012 Harvard Medical School graduating class as an example of a patient who deserved the treatment that cured him of leukemia but whose life was lost to poverty and exhorts them to regard health care as human right that must be preserved in the clinic and in public. Full Article
e Learning to Talk: Speaking the Language of Patients By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a resident physician recalls the joy she felt while learning the formal language of medicine as a student and anticipates the lifelong joy of learning to interpret that language in ways most helpful for her patients. Full Article
e John Lennon’s Elbow: The Long, Winding Road of the EMR Progress Note By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, an attending physician shares his observations of how the changing nature of electronic medical record (EMR) hospital progress notes—often entered out of sequence and becoming ever longer and more unreadable—can hamper interacting with patients and providing patient care. Full Article
e The Road Back to the Bedside By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a group of physicians from an academic program in bedside medicine offer their observations on deficiencies in the assessment of US medical residents’ clinical skills and suggest principles for enhancing the teaching and high-stakes assessment of these skills to improve diagnostic accuracy and achieve truly patient-centered care. Full Article
e Crossing Boundaries—Violation or Obligation? By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a physician reflects on the rise of professional boundaries; on the ways in which such boundaries can in some instances foster uncaring patient-physician relationships; and on ways physicians might balance providing objective medical care and addressing social and economic injustices in the lives of their patients. Full Article
e EBM’s Six Dangerous Words By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a physician shares his thoughts about how the phrase “there is no evidence to suggest,” commonly used in the medical literature, can lead to false inferences and suppression of clinical intuition, and suggests four alternative phrases for clarifying inferences and improving shared decision-making. Full Article
e Pimping Socrates By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a medical student reflects on individualized teaching practices in medicine, such as “the Socratic method,” in the context of her intervening course work related to a PhD in ancient history. Full Article
e The $50 000 Physical By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a physician reflects on his father’s experience, at the age of 85 years, of getting a physical examination from a new primary care physician that ended up setting off a cascade of examinations and treatments. Full Article
e The Nod By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, an African American physician reflects on her experience one day with a white member of her ward team made up of two interns, three medical students, and a senior resident that sparked cultural and racial discussions throughout their month together that usually do not occur in such a diverse group. Full Article
e Whose Autonomy? By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a physician reflects on an experience during his medical residency involving the family dynamics of a couple in an effort to treat the pain of the husband. Full Article
e What Gets Measured Gets (Micro)managed By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, an attending physician reflects on the evolution of the role of the attending physician from a supervisor in the background to a micromanaging supervisor to ensure that the proper steps are followed to meet the quality metrics in place in the current health system. Full Article
e A Silent Curriculum By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a medical student reflects on the ways in which she has seen racism and implicit bias affect clinical practice and emphasizes the importance of examining and challenging these biases to address health inequalities. Full Article
e Story as Evidence, Evidence as Story By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a physician describes the power of anecdotes and stories as tools for public communication, education, and advocacy. Full Article
e The Greatest Generation By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, the author discusses the inaccuracies of generational stereotypes and unfounded criticisms about trainees, and the problems that faculty members who voice these criticisms can cause among physicians. Full Article
e The Unreasonable Patient By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, the author describes his experience with a patient referred to as “unreasonable,” and what the experience taught him about the need for physicians to perhaps improve their communication skills with patients rather than jump to labelling them. Full Article
e My Name Is Not “Interpreter” By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this essay, the author relays his personal experience with ethnicity-based discrimination and discusses the “microaggressions” that medical trainees from underrepresented groups based on race/ethnicity, gender, or sexual orientation experience. Full Article
e The Quick Physical Exam By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a teaching physician uses the fictitious characters Holmes and Watson to dispell the belief held by many physicians—that a thorough physical examination is an unnecessary art of the past. His emphasis: taking time to gather data and observe can avoid unneeded tests and guide accurate diagnosis. Full Article
e Questioning a Taboo By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT This narrative medicine essay summarizes ways in which physicians can use polite and scripted interruption to help patients effectively communicate their medical concerns, encourage further details, improve accuracy of the diagnosis, and set the agenda for the medical visit. Full Article
e A Death in the Family By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, an anesthesia resident describes his feelings of loss and unease when a coresident is admitted as a patient and dies of an overdose of fentanyl; this article emphasizes the importance of prioritizing physician wellness programs to help avoid burnout and substance use disorder. Full Article
e Moral Choices for Today’s Physician By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this essay, Don Berwick considers moral choices physicians face personally, organizationally, and globally and exhorts them to understand that the health of humanity depends on their speaking out against the social injustice of overpricing drugs and services, mass incarceration, and the lack of environmental responsibility. Full Article
e Physician-Parents Whose Children Have Rare Diseases By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this essay, a critical care pediatric hospitalist finds herself on the other side of the office table advocating for the specific medical care needed to address her son’s rare skeletal dysplasia and her search for a pediatric specialist with whom to travel on this quest. Full Article
e A Medical Student Shares Her Struggle With Depression By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this essay, a young medical student describes her struggle with depression and how the experience of vulnerability has bred a deep compassion for her patients and peers. Full Article
e Mentoring in the #MeToo Era By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative essay, the author wonders what effect the #metoo phenomenon will have on mentoring between male mentors and junior female trainees and faculty and recalls male mentors who were supportive of her and other women colleagues’ professional development in a plea for diversity and inclusion among leaders in medicine that supports the entire academic medical community. Full Article
e How to Mentor Millennials By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medical essay, the authors present 3 scenarios exemplifying the collision between mentoring expectations among millennials and older generation faculty and proposes strategies to bridge generational divides and engage the next generation of physicians. Full Article
e Advice for Starting Medical School By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medical essay, an internist offers three basic lessons not taught in medical school that he learned about practicing medicine based on his experiences from a patient with whom he has built a trusting relationship over the years. Full Article
e Grief After Suicide By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, the author mourns the suicide of young adult of a friend and relives his brother’s suicide 30 years earlier in a stream of consciousness montage of grief and advice to succor for those left behind. Full Article
e Friendships Across Cultural Barriers—We Are All the Same By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a family practitioner tells the story of how her relationship with an old-order Mennonite woman whose newborn son she examined and took to the hospital for cardiac surgery one Christmas day turns to friendship and a relationship with her broader community when the woman stays with her during her newborn daughter’s cardiac surgery. Full Article
e Full Circle: How Medicine Enabled Avoidance and Acceptance By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a psychiatrist used her residency to avoid grieving the loss of her brother to suicide but through participation in a grief support group during training she began to thaw enough to remember her brother, watch videos of ephemeral moments like celebrating his fourth birthday, an act that allowed her to see him and her family again. Full Article
e Systole and Diastole: A Metaphor for Living By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a physician finds in the motion of diastole, the process of letting go and filling up, an apt metaphor for how to handle the burnout, anxiety, and depression of medical training. Full Article
e Reflections on Women in Leadership—Holding up Half By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a medical school dean talks about the reticence most women feel when considering leadership roles and urges women to work out of their comfort zones, seize diverse opportunities, and step into leadership roles. Full Article
e The Sound of Silence—When There Are No Words By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a surgeon and palliative care physician describes the isolating silence that she felt her after the slaying of her father in Egypt when she was 18 years old and how that lingering silence has come to guide her when sitting with patients, when there are no words. Full Article
e You Did Not Teach Me What You Thought You Did By jamanetwork.com Published On :: Tue, 05 May 2020 00:00:00 GMT In this narrative medicine essay, a clinical educator uses her experiences enduring the aftermath of treatment for acute myeloid leukemia to reflect on the difference between physician-teachers and patients’ experience of illness and to locate meaning in what she can offer her colleagues and trainees despite persistent disability. Full Article
e A paper-based SERS assay for sensitive duplex cytokine detection towards the atherosclerosis-associated disease diagnosis By pubs.rsc.org Published On :: J. Mater. Chem. B, 2020, 8,3582-3589DOI: 10.1039/C9TB02469G, PaperChunxia Li, Yuan Liu, Xiaoyan Zhou, Yuling WangNovel SERS based sensing assay was built by combining nanoporous membrane with sandwich immunoassay for duplex cytokines detection. It can be used as a promising candidate for clinical application due to its excellent performance in human serum.The content of this RSS Feed (c) The Royal Society of Chemistry Full Article
e An efficient strategy for circulating tumor cell detection: surface-enhanced Raman spectroscopy By pubs.rsc.org Published On :: J. Mater. Chem. B, 2020, 8,3316-3326DOI: 10.1039/C9TB02327E, Review ArticleJie Lin, Jianping Zheng, Aiguo WuCirculating tumor cells (CTCs) are circulating cancer cells that shed from tumor tissue into blood vessels and circulate in the blood to invade other organs, which results in fatal metastases. Surface-enhanced Raman scattering (SERS) has great potentials in CTCs detection.The content of this RSS Feed (c) The Royal Society of Chemistry Full Article
e A dual-targeted CeO2–DNA nanosensor for real-time imaging of H2O2 to assess atherosclerotic plaque vulnerability By pubs.rsc.org Published On :: J. Mater. Chem. B, 2020, 8,3502-3505DOI: 10.1039/C9TB02459J, CommunicationZhenhua Liu, Yujie Cao, Xiaona Zhang, Huazhen Yang, Yujie Zhao, Wen Gao, Bo TangA novel dual-targeted CeO2–DNA nanosensor by modifying with folic acid (FA) and CD36 antibody was designed.The content of this RSS Feed (c) The Royal Society of Chemistry Full Article
e Highly efficient electrochemiluminescence of ruthenium complex-functionalized CdS quantum dots and their analytical application By pubs.rsc.org Published On :: J. Mater. Chem. B, 2020, 8,3598-3605DOI: 10.1039/C9TB02463H, PaperXiaofei Wang, Huiwen Liu, Honglan Qi, Qiang Gao, Chengxiao ZhangHighly efficient electrochemiluminescence of ruthenium complex-functionalized CdS quantum dots via ECL resonance energy transfer (ECL-RET) and their analytical application.The content of this RSS Feed (c) The Royal Society of Chemistry Full Article
e Electrodeposition of nickel nanostructures using silica nanochannels as confinement for low-fouling enzyme-free glucose detection By pubs.rsc.org Published On :: J. Mater. Chem. B, 2020, 8,3616-3622DOI: 10.1039/C9TB02472G, PaperJialian Ding, Xinru Li, Lin Zhou, Rongjie Yang, Fei Yan, Bin SuThis work reports an enzyme-free glucose sensor based on nickel nanostructures electrodeposited on a fluorine-doped tin oxide (FTO) electrode modified with a silica nanochannel membrane (SNM).The content of this RSS Feed (c) The Royal Society of Chemistry Full Article
e Aggregation-induced emission luminogens for RONS sensing By pubs.rsc.org Published On :: J. Mater. Chem. B, 2020, 8,3357-3370DOI: 10.1039/C9TB02310K, Review ArticleJun Dai, Chong Duan, Yu Huang, Xiaoding Lou, Fan Xia, Shixuan WangThe development of AIE bioprobes for RONS sensing in living systems is now summarized. We discuss some representative examples of AIEgen based bioprobes in terms of their molecular design, sensing mechanism and sensitive sensing in vitro and in vivo.The content of this RSS Feed (c) The Royal Society of Chemistry Full Article