Medicine fulfils three basic needs in the physician: the puzzle need, the fix-it need and the soap opera need. The puzzle need is our desire to figure things out, unravel the mystery of differential diagnosis, and apply our knowledge of physiology and “illness scripts” to the cases in front of us. However, if we only had a puzzle need, we… Read More »The Soap Opera Need
The ongoing grind of COVID medicine is starting to wear, although the promise of reopening is tantalizingly just out of reach. The everyday aggravation of life in pandemic times feels like we are all walking around with nerves exposed, as if a protective layer of resilience has rubbed off over the past year and a half. Yet, sometimes something good… Read More »Pits and Promise
People are complicated. Everyone is a mix of good and bad. I have been reading about and watching the television biography of Oliver Sacks. I have also been preparing a podcast on the history of obstetrics, which made me confront J. Marion Sims’ racism in the context of his important contribution to women’s health through perineal repair. Both were complex… Read More »The Incredible Hulk in L&D?
Last week I worked at a vaccine clinic in Montreal. I volunteered as a vaccinator when the director of Professional Services of our hospital and the head of the regional health authority asked for help in the Quebec campaign to get the population vaccinated as quickly and efficiently as possible. I am supposed to be semi-retired, working two and a… Read More »A Day in the Life at the Vaccine Clinic
When I interview medical students for positions in the family medicine residency, I often ask them to tell me a story of a patient who has been meaningful to them or taught them something. It is remarkable how often these stories have to do with death and their first or early encounters with the dying. In our culture, we have… Read More »A Good Death
“Now dear,” said the school nurse. “You seem to be sick. I will call your mummy to come to get you.” “You should call my dad,” Ali replied. “But dear,” insisted the nurse, “I don’t want to bother your daddy at work. I’m sure that your mummy will come.” “Listen,” said Ali with the eye roll of incipient adolescence. “My… Read More »Can I Please Speak to Mrs. Glaser
For much of my career, I have cared for patients who need interpreters when they come to see a doctor. Now at the site where I practice and teach, most of the patients speak Punjabi and Bengali. The elderly people are mostly Greek and Italian. Working with interpreters is an everyday occurrence and has its own challenges. Family interpreters will… Read More »Open to Interpretation
“Your family doc is very clever,” said the Cardiologist that I was seeing. “Yes, I know she is,” I said, “but why do you say so?” “Well, because she sent me this excellent letter about you, outlining her concerns and asking very clear and pertinent questions. I really like this, it recognizes my expertise and it doesn’t feel like a… Read More »The gentle art of the consult
I love Christmas parties in the same way that my Presbyterian raised son-in-law loves matzah and gefilte fish at Passover. They seem exotic and exciting. I love the lights and the smell of Christmas trees. I also really like that I am not obligated to do any heavy prep or be responsible for everyone’s good time. I just show up,… Read More »Ghosts of Christmas epidemics past
Melanie was one of the first patients we met when we opened a family medicine teaching unit at the Pointe St. Charles Clinic. In those days, the Pointe wasn’t the up and coming hipster haven it is now, but rather a struggling working-class area where the major industries had mostly closed. The clinic had proud roots in community action, having… Read More »Melanie: A portrait of patient progress