A Good Death?

“I’ve lived with this for 10 years. I’m hoping for another 2, to make it to my 85th birthday so I can have a big party.” My patient’s voice was weak, but his goals were clear. He had been transferred

Cool Water

This man is dying, I think. That is my assessment. But I know by now that such thoughts are not welcomed here. “Plan,” says the Resident, “plan.” Dutifully, I prattle, “Well, he has some fluid to give, let’s aim for

A Good Death?

“I’ve lived with this for 10 years. I’m hoping for another 2, to make it to my 85th birthday so I can have a big party.” My patient’s voice was weak, but his goals were clear. He had been transferred

Cool Water

This man is dying, I think. That is my assessment. But I know by now that such thoughts are not welcomed here. “Plan,” says the Resident, “plan.” Dutifully, I prattle, “Well, he has some fluid to give, let’s aim for

Merging Mortalities

I recently recalled a patient who was admitted to the hospital during my first medical school rotation in the late 1970s. He was a 25-year-old man with Hodgkin’s lymphoma. Typically, medical students on call would eagerly divide up the newly

Through the Fog

“You still haven’t figured out why?” my patient asked calmly. He was lucid for the first time in days. “No, but we’ve ruled out many diagnoses.” He sighed deeply and shook his head. “This is a hell of a thing.”

We Shall See?

Our empirical experience of the world teaches us that time cannot be taken back. We may perhaps slow it down, but we cannot reverse it. This notion becomes very obvious with aging. Once time passes, there is no way to

Nanima

“You are leaving?” she asked. “When will you come again?” “Soon,” I said. “I’ll be back soon, Nanima.” In my heart, I knew it wouldn’t be soon. In truth, I could only bear to visit her once every few months

Nanima

“You are leaving?” she asked. “When will you come again?” “Soon,” I said. “I’ll be back soon, Nanima.” In my heart, I knew it wouldn’t be soon. In truth, I could only bear to visit her once every few months

Nanima

“You are leaving?” she asked. “When will you come again?” “Soon,” I said. “I’ll be back soon, Nanima.” In my heart, I knew it wouldn’t be soon. In truth, I could only bear to visit her once every few months

Circadian Mechanisms in Medicine

In addition to the sleep–wake cycle and cognitive functions such as learning and memory, intrinsic clocks determine nearly all circadian cycles in physiology, such as daily variation in blood pressure, heart rate, hormone levels, respiratory and exercise capacity, and coagulation.

Circadian Mechanisms in Medicine

In addition to the sleep–wake cycle and cognitive functions such as learning and memory, intrinsic clocks determine nearly all circadian cycles in physiology, such as daily variation in blood pressure, heart rate, hormone levels, respiratory and exercise capacity, and coagulation.

Circadian Mechanisms in Medicine

In addition to the sleep–wake cycle and cognitive functions such as learning and memory, intrinsic clocks determine nearly all circadian cycles in physiology, such as daily variation in blood pressure, heart rate, hormone levels, respiratory and exercise capacity, and coagulation.

Circadian Mechanisms in Medicine

In addition to the sleep–wake cycle and cognitive functions such as learning and memory, intrinsic clocks determine nearly all circadian cycles in physiology, such as daily variation in blood pressure, heart rate, hormone levels, respiratory and exercise capacity, and coagulation.

Circadian Mechanisms in Medicine

In addition to the sleep–wake cycle and cognitive functions such as learning and memory, intrinsic clocks determine nearly all circadian cycles in physiology, such as daily variation in blood pressure, heart rate, hormone levels, respiratory and exercise capacity, and coagulation.

Osteoarthritis of the Knee

Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author’s clinical recommendations. Stage.

Whiteout

In the winter of my intern year, I took care of a man in the final stages of lymphoma. He’d exhausted all therapy and finally, in those pre–palliative care days, he had been readmitted to the general medicine service essentially

Nanima

“You are leaving?” she asked. “When will you come again?” “Soon,” I said. “I’ll be back soon, Nanima.” In my heart, I knew it wouldn’t be soon. In truth, I could only bear to visit her once every few months

Am I Racist?

R. was a teenager when his osteosarcoma came roaring back, with vertebral metastases that left him paralyzed and bed-bound. He’d been told he was going to die, but his mother, a tower of strength, was determined to keep things positive.

Am I Racist?

R. was a teenager when his osteosarcoma came roaring back, with vertebral metastases that left him paralyzed and bed-bound. He’d been told he was going to die, but his mother, a tower of strength, was determined to keep things positive.

Telephone

As a child, you probably played the game “Telephone”: you whispered a message into the ear of the person next to you, who whispered it to the next person, and so forth down the line. When revealed at the end

Salicylate Toxicity

On presentation to the emergency department, patients with fever, tachypnea, rales on lung examination, and acid–base disturbances are often given a suspected diagnosis of viral infection, yet persons with salicylate toxicity may present with similar symptoms. This article highlights the

Salicylate Toxicity

On presentation to the emergency department, patients with fever, tachypnea, rales on lung examination, and acid–base disturbances are often given a suspected diagnosis of viral infection, yet persons with salicylate toxicity may present with similar symptoms. This article highlights the

Heatstroke

Heatstroke is the most hazardous condition in a spectrum of illnesses progressing from heat exhaustion to heatstroke, in which a shared finding is hyperthermia (i.e. the rise in core body temperature when heat accumulation overrides heat dissipation during exercise or

The Devil Is in the Details

Foreword. In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information by sharing relevant background and reasoning with the reader (regular type). The authors’ commentary follows.

Rehabbed to Death

Ms. P. was an 87-year-old woman with moderate dementia who lived alone in an apartment before being admitted to the hospital with pneumonia. During her hospitalization, she became deconditioned and could no longer walk without assistance. Friends and family were

Cancer Survivorship

Advances in cancer screening and early detection, improvements in therapeutics, and supportive care all contribute to decreasing cancer mortality. Figure 1 shows the changing demographic characteristics of the cancer population from 1975 through 2040. There will be an estimated 26

A Seat at the Table

The sheer speed with which end-stage liver failure can consume a patient is what makes the disease so devastating. Unfortunately, Ms. S.’s family had never been informed about that reality. When they brought her in for a mere urinary tract

WhatsApp WhatsApp'tan Bize Yazın