Declining autopsy rate, and how that impacts doctors
The role of autopsy in the medical profession is difficult to overestimate. Western medicine takes its roots from comparative studies between patient’s symptoms and the findings on autopsy....
View ArticlePatients who attempt suicide and withdrawal of medical care
If a person tries to commit suicide, could that be considered as a statement that this person wishes to die and does not want aggressive treatment to save his or her life? Not from a legal standpoint,...
View ArticleObese patients present challenges in the ICU
Obesity is a huge healthcare problem in the United States. It has reached the proportions of an epidemic and continues to get worse. Multiple medical problems including heart disease, hypertension,...
View ArticleGood medicine sometimes makes patients unhappy
As physicians, we all strive to practice good medicine. Good medicine means evidence based medicine in the patient’s best interests. In the ideal world this will make patients happy and satisfied. If...
View ArticleApplying the minimally invasive concept to patient management
Every time you subject the patient to an invasive procedure you take the risk of causing complication. I have done hundreds if not thousands of procedures which makes me even more aware of the risk I...
View ArticleKeeping the terminal patient comfortable is the purpose of comfort care
Dealing with an incurable illness or terminal condition is an inevitable reality of the practice of medicine. Not uncommonly, especially in the intensive care unit, we care for the patient with no...
View ArticleNeoplastic epidural spinal cord compression is an oncologic emergency
There are very few oncologic emergencies. Neoplastic epidural spinal cord compression is one of them. The delay in diagnosis and treatment is often explained by the non-specific nature of the...
View ArticleIntubating the combative patient
How many times have I been asked by the trauma surgeons to see a trauma patient for respiratory failure? The reason for intubation and ventilatory support – being combative and non-cooperative....
View ArticleDo Not Resuscitate and the need for a central line
Just the other day I was called to see a patient coming up to the Intensive Care Unit with a diagnosis of pneumonia. Upon my arrival the patient is “hanging in there” with the blood pressure in the 60’...
View ArticlePain control in a patient with rib fractures and a spinal cord transsection
When I was called to see the patient after a motorcycle accident I expected the worst. The patient sustained a thoracic spine injury with cord transsection at T5 level as well as significant chest wall...
View ArticleNavigating the path of contradictory medical opinions
With the advancement in healthcare and technology we are able to greatly extend the life expectancy of the population. For the healthcare provider that means that more elderly patients and patients...
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