Newman’s Notions
Giving thanks
Colleagues, mentors, electronic records, and readers all make Dr. Newman grateful this month.
The ID of Dorian Gray: A tale of medical horror
The picture showed a bright-eyed, earnest young healer.
The transgender inpatient
Transgender and gender-nonbinary people face significant barriers to gender-affirming and high-quality health care.
On Her Majesty's hospital service
Read about the health care adventures of Spond, Dr. Jane Spond, pager number 00007.
Catastrophization
It seemed like the end of the world was coming and everything was out of control. Was it a collective Chicken Little moment? Or was the sky really falling?
Readmission impossible
A dedicated team strives to keep a complex patient out of the hospital.
A digestible problem
A young physician remembers army surgeon Dr. William Beaumont, his patient Alexis St. Martin, and the study of gastric secretions.
Rounding with the Bard
Shakespeare's words apply to hospital medicine, a fictional physician finds.
Monkey medicine
You may feel like you've entered a zoo and your ward has become the primate house, so here are the terms you will need to be a successful hominid hospitalist.
Morbid fascination
Obesity is only one of many conditions that could be called morbid.
Is there a doctor on board?
I heard the words you never want to hear on a plane, especially over the middle of an ocean: “Is there a doctor on board?”
Oh, what a night: The hospital playlist #2
Some songs to get through a tough night shift.
Canine colloquialisms
These will help anyone who works in the hospital get to the head of the pack.
Notes from the field: Hospital medicine in Japan
In Japan, hospital medicine may help to resolve several pressing issues, the biggest being the aging population.
Initial assessment
When you've spent as much time in a hospital as I have over the years, you tend to develop a sixth sense as to when something isn't quite right.
Hospital Servi-Sisyphus
It was that kind of morning: hypertensive patients who couldn't pay for their meds and little old ladies, sweet and otherwise, who kept on falling.
A newfangled column
The first stethoscope was created with a rolled-up sheaf of papers in 1816.
Physician biomarkers
Astounding differences have been found in the gene expression of the various archetypes of physicians haunting hospital halls.
Elevator pitch
A good pitch must be concise and clear, engaging and persuasive, well-rehearsed and actionable, and less than 30 seconds long.
Little's Law and you
To understand what's really happening in your hospital, you need to consider Little's Law.
Notes from the field: Hospital medicine in India
Last December, speakers from several countries joined their colleagues in Kochi, India, to discuss clinical administrative, and education issues during a multi-day conference.
Armadillo exposure, subsequent encounter
If there is no code for it in ICD-10, there is no way I could have an armadillo-related disease.
Apophenia
There is a black cloud hanging over your head; the universe is out to get you.
Sedimentation
One of the first descriptions of the erythrocyte sedimentation rate is detailed in a book by British surgeon and anatomist John Hunter.
The little brown bottle
The first documented recommendation of nitroglycerin for angina pectoris was described by Dr. William Murrell in 1877.
Magnificent maggots
Sometimes the best treatment plan can include an effective and simple intervention of antiquity.
Morpheus
For thousands of years, ancient civilizations in Asia Minor have been cultivating the opium poppy.
Choosing unwisely
A fictionalized ED visit for a simple cut spins wildly out of control.
Pott-y language
Tuberculosis with spinal involvement is often referred to as Pott's disease.
Newman's handy-dandy recommendation letter
A tongue-in-cheek template for handling recommendation requests.
The case of the undulant ungulate
A graduate student discovers the dangers of gourmet roadkill.
Simulation and reality
The author recounts his mother's career as a simulated patient.
Aphorism-based medicine
Analyzing medical truisms can help us understand how medicine has progressed over time.
Vital signs are vital: The history of pulse oximetry
It will likely surprise younger physicians to know that the modern pulse oximeter was not invented until the early 1970s and did not become commercially available until the 1980s.
Vital signs are vital: Sphygmology
There is much more to checking a pulse than noting its presence or absence.
Vital signs are vital: Focus on fever
Human body temperature must rank as one of the earliest "vital signs" recognized by our ancestors.
Vital signs are vital
Introducing a new series that highlights the importance of vital signs.
The new observation status
Here's the lowdown on the good, the bad and the ugly of the new CMS regulations.
The unusual occurrences in room 687
An earnest young doctor finds himself practicing medicine in a whole other dimension.
Quincke's legacy
This nineteenth-century physician described angioedema, invented diagnostic lumbar puncture and described a sign of aortic insufficiency, but was still rejected for a Nobel Prize.
How to stay safe
Safety--in the hospital and in life--is about more than following prescribed systems.
A palette of patients
When in the throes of illness, a patient can project one of a wide range of hues.
Yiddish for hospitalists
After our Latin primer for hospitalists, it only seems right to explore another language that's likely to be of great help.
A looney tenens
This month's column presents a fictional look at a very cartoonish hospital.
The one that got away
I was ready to reel in the diagnosis I was fishing for, only to feel it swim away on an emetic river of blood.
The center of your universe
You start your morning rounds. You will spend the next 12 hours here. This is your world. And you are the center of it.
Food for thought
Take a humorous look at a fictional doctor's quest to get some food during a busy day.
Latin for hospitalists
Here are the top 10 useful Latin phrases for hospitalists for 2012.
Quality time
What would happen if quality measures were applied to your personal life?
Generic discharge summary
What's lost in accuracy will be more than compensated with personal time saved.
Rounds in motion
Our goal was to round with precision, though it was more likely we would meander due to the effects of Brownian motion, bouncing randomly around the hospital, starting at one point and ending up somewhere else.
The apocalyptic hospitalist
A PubMed search for the phrase "end of the world" had no matches, so we must make certain assumptions in this report.
A jolly old locums
A locums assignment in a northern region leads to an unusual patient.
Life is sweet: An extremely brief history of diabetes
One thousand years before Hippocrates, healers knew that the passing of too much urine was a bad sign.
The wisdom of teens
Our editorial advisor learns a thing or two about diagnosis from an unusual source: his teenage son.
Top 10 reasons not to discharge your patient
Our editorial advisor examines length of stay.
Hospital failure
Like a conscientious physician, hospitalists must play doctor to their own facilities.
Stair wars
I came to an agreement with the medical students on service with me: We would spend our week "elevator-free."
A day in the life: The hospital playlist
A typical hospitalist's day if set to music would go a little something like this.
Safety first
I know I need to get up and get started, get my children ready for school... and I have an early morning meeting to which I just can't be late.
A lesson in serendipity
Sometimes after a hard morning of rounding, I hide in my office and distract myself by reading a tome from the past.
Day of the undead: The zombie intern
I didn't think my fellow first-years were really worried about my consuming them, but you never know about the strange prejudices of the living.
Hospital medicine in Chile
The international hospitalist movement continues to grow, especially in South America.
Hospital medicine in Portugal
Our editorial advisor reports from the 16th National Portuguese Congress of Internal Medicine.
Iatrogenica
A chance encounter with an old friend leads our editorial advisor to reminisce about patients past.
Ruppy: Teaching old dogs new tricks
By focusing on teamwork, communication, and strong relationships, successful collaboration between clinicians and other providers can be achieved.
The fascinating foxglove
We were rounding on the hospital service when one of our patients, already hypotensive, went into atrial fibrillation. The most appropriate drug wound up being one with a long and illustrious history.
Write it up
The source of my tension on this particular day was Karin, the incredibly intense fourth-year medical student rounding with me.
Going up, please
Every morning, our team faced the same difficult decision: going up the stairs or getting on the elevator.
The write stuff
Have you ever been given a prescription from your physician that was completely illegible?
Fight the noise
We all know the difficulty in functioning within a noisy hospital. But in hospitals we don't always have the option of suggesting that we move our discussion to a quiet coffee shop instead. Noise pollution in hospitals is an issue that confronts us all as hospital workers.
Locum terror
Here I was pulling into the staff parking lot of a funky old private sanitarium in the middle of stinking nowhere. I rang the bell and the creaky door swung open. A very pale and dusty nurse pointed to the staff lounge, but said nothing, though I seemed to detect the ghost of a smile.
A tick's tale
People have always been fascinated by medical comedies, medical dramas and medical reality shows. One of the most interesting of the current crop has to be "House, M.D." -- not because it is the most believable, but because it is by far the most inaccurate.
Hooked on mnemonics
Memory is elusive (and of course, it "lights the corners of my mind" -- or at least Barbra Streisand's mind). That's why there are so many tricks to remembering things, like acronyms, acrostics, rhyming keys, the image-name technique and the keyword method.
A leap forward
Life was fairly dull on Ganymede-13. I sat in my small bungalow on the edge of a vast forest of genetically engineered bamboo, looking at several foot-long segments of the plant.
Lunch with Lynch
Lunch with a former residency director leads to reflections on a career in medicine.
A very brief history of credentialing
While many may think of it as a modern concept, credentialing has been a part of physicians' careers since long before the Middle Ages.
Colombia, the new kid on the hospital medicine block
Hospitalists continue to gain exposure and acceptance in the U.S. as well as in other parts of the world, including Australia, Europe and Brazil. We are very excited that now the vibrant Andean country of Colombia is jumping on board.
Work hour limits: No gain without pain
Nobody would want their child riding on an icy road at 70 miles per hour in a school bus driven by someone whose head keeps nodding. Similarly, who would want to be cared for by a physician who is so fatigued he can’t remember the difference between the cranium and the cremaster?
Safety versus dignity: A balancing act
In the hospital, privacy is a scarce commodity often sacrificed in return for patient safety or our own convenience.
The final page
Medical editor Jamie S. Newman, FACP, remembers his first pager, and his next, and then wearing three at once....
The hospitalized hospitalist
Jamie S. Newman, FACP, recalls (somewhat fuzzily) his hip transplant.
The House of God revisited
Jamie S. Newman, FACP, offers a hospitalist’s perspective on a classic book.