Audio Element Research Articles

Intensive Care.

Ad Libitum4 July 2017Intensive CareBrenda Butka, MDBrenda Butka, MDFrom Nashville, Tennessee.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-0257 Audio Reading - “Intensive Care” Audio. Virginia L. Hood, MD, reads "Intensive Care," by B. Butka. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Mr. Jones stands outside the glass, looks inat his foreign wife. Alien,her only language numbers, her only songvariations on an oscilloscope. The audiencerecognizes wild new rhythms:she is pushing back frontiers, shemarches forward.In this cool light,eight floors above the parking lot,she transforms.A bag of bone and water,flesh becomes irrelevant, she becomeswhat she was not.A silent grotesque, she sings her song.The room sighs, is more alive than this centerpiece.Her chest rises and falls in time with machines.As the sun warms an aqua morning sky,a hidden crescendo.Mr. Jones tells Mrs. Jones good-bye. Author, Article, and Disclosure InformationAffiliations: From Nashville, Tennessee.Current Author Address: Brenda Butka, MD; e-mail, brenda.[email protected]edu. PreviousarticleNextarticle Advertisement Audio Reading - “Intensive Care” Audio. Virginia L. Hood, MD, reads "Intensive Care," by B. Butka. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 4 July 2017Volume 167, Issue 1Page: 65KeywordsBoneFallsThorax ePublished: 4 July 2017 Issue Published: 4 July 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Counterclockwise.

Ad Libitum4 July 2017CounterclockwiseVenetta Masson, RN, MAVenetta Masson, RN, MAFrom Washington, DC.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-0373 Audio Reading - “Counterclockwise” Audio. Virginia L. Hood, MD, reads "Counterclockwise," by V. Masson. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Lost in timeand the fog of bereavementI'm startled to see the handsof the clock by our bedrunning backwards.I confront it face to face,shake it, but resist unplugging.For days we track back(the clock and I)from now to then till suddenly I seewhat Zen and physics say is true—we live in a block universe,all things in all time.And with that, I unplug.I no longer use the clockbut keep it closeted—prophet in a cave—silent reminder thatthere's no such thing as a raceagainst time, no finish lineonly this human finitude. Author, Article, and Disclosure InformationAffiliations: From Washington, DC.Current Author Address: Veneta Masson, RN, MA; e-mail, veneta.[email protected]com. PreviousarticleNextarticle Advertisement Audio Reading - “Counterclockwise” Audio. Virginia L. Hood, MD, reads "Counterclockwise," by V. Masson. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 4 July 2017Volume 167, Issue 1Page: 16KeywordsRacial and ethnic issuesRunning ePublished: 4 July 2017 Issue Published: 4 July 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Krebs Cycle.

Ad Libitum20 June 2017Krebs CycleVeneta Masson, RN, MAVeneta Masson, RN, MAFrom Washington, DC.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-0374 Audio Reading - “Krebs Cycle” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Krebs Cycle," by V. Masson. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail the sequence of reactions by whichliving cells generate energyI remember as if it were yesterdaycramming in the libraryhours before the examwhen, in a Zen-like flashthe Krebs cycle manifested itselfin stunning clarity.I rushed into classspilled out what I knewenergized, euphoriconly half-believing that a revelationof this magnitudehad been entrusted to me.I couldn't contain it for long.A curtain fellmy understanding cloudedonce again blurring the border ofscienceand mystery.Every few years I've cycled backtrying to recapture that thingI once grasped—... Author, Article, and Disclosure InformationAffiliations: From Washington, DC.Current Author Address: Veneta Masson, RN, MA; e-mail, veneta.[email protected]com. PreviousarticleNextarticle Advertisement Audio Reading - “Krebs Cycle” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Krebs Cycle," by V. Masson. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 20 June 2017Volume 166, Issue 12Page: 911KeywordsBlindnessCellsLibraries ePublished: 20 June 2017 Issue Published: 20 June 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

This Is Why.

On Being a Doctor16 May 2017This Is WhyCassandraCassandraSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-1745 Audio Reading - “This Is Why” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "This Is Why," by Anonymous. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I write this because I am afraid to write this.I write this because I am a fourth-year medical student typing on a small laptop in my closet in the dark. Because I am sitting on the floor with my back against the wall. Because to my left lies a pile of unsorted clothes and underneath a silver knife. Because in my senior year of college, I sat on the corner of my bed—on my bed, because back then my closet was overfull of skeletons and nightmares seeped in under door cracks and through the walls and there was nowhere ...

Precision Medicine.

Ad Libitum3 May 2016Precision MedicineVeneta Masson, RN, MAVeneta Masson, RN, MAFrom Washington, DC.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-0222 Audio Reading - “Precision Medicine” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Precision Medicine," by V. Masson. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The latest way to make the luckiest humans in history anxious during their short stay on Earth.—Richard Lehman, BMJOh yes, I say,this is what I want,precision medicine.Let the data flow.Mine my genomefor glitches and clues.Retrofit what you can andwhat you can't, wellat least I'll knowthe condition I fearcan't be fixedprecisely.My anxiety's highbut knowledge is prizedand much has been gainedwith my help.I might do fine.Not all genes expressand mistakes can be madein labs and trialsand the non-coding genomeis massive, complexand, for all I know, the placewhere luck is transcribed. Author, Article, and Disclosure InformationAffiliations: From Washington, DC.Current Author Address: Vaneta Massonm RN, MA; e-mail, veneta.[email protected]com. PreviousarticleNextarticle Advertisement Audio Reading - “Precision Medicine” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Precision Medicine," by V. Masson. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 3 May 2016Volume 164, Issue 9Page: 610KeywordsAnxietyFearPrecision medicine ePublished: 3 May 2016 Issue Published: 3 May 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

There's a Time Bomb in Your Chest.

Ad Libitum3 May 2016There's a Time Bomb in Your ChestJack Coulehan, MD, MPHJack Coulehan, MD, MPHFrom Coram, New York.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-0331 Audio Reading - “There's a Time Bomb in Your Chest” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "There's a Time Bomb in Your Chest," by J. Coulehan. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Walking to your office, my bodythrummed basso continuo belowcompeting fragments and motifsin my consciousness. Some dissonant,some sweet—each theme comfortablymine. My organs contributed nothing.My pancreas, silent. My spleen, mute.Body parts played pantomime behindmy back, until I discovereda time bomb was ticking in my chest.Normality went up in smokeat the thought the device might tripat any minute. How could treacherylike this have taken place inside me?Should I have listened more carefullyto the contrabassoon? No tellingthe second it's set for, no tellinghow stable its components. My dreadis deafening. They often eruptwithout warning, you repeatas you swivel to study the report. Author, Article, and Disclosure InformationAffiliations: From Coram, New York.Current Author Address: Jack Coulehan, MD, MPH; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement Audio Reading - “There's a Time Bomb in Your Chest” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "There's a Time Bomb in Your Chest," by J. Coulehan. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 3 May 2016Volume 164, Issue 9Page: 632KeywordsConsciousnessPancreasSpleenThoraxWalking ePublished: 3 May 2016 Issue Published: 3 May 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

The Last Day.

On Being a Doctor3 May 2016The Last DayWilliam Lynes, MDWilliam Lynes, MDFrom Temecula, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2341 Audio Reading - “The Last Day” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Last Day," by W. Lynes. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The room was cold and dark as I entered my office that last day. My diploma shone as a damaged image as I pondered the tragic plan, one of a burnt-out physician who could not practice anymore. I loathed that likeness; pathetic, weak, a failure at medicine, my lifelong goal. I had a family to take care of and a loving wife, but I was incapacitated and paralyzed with fear.Twenty-four hours later, miraculously I was alive, blood covering the floor of my office from the grim sacrifice. My choice to die at my own hands had failed. I informed ... Author, Article, and Disclosure InformationAffiliations: From Temecula, California.Corresponding Author: William Lynes, MD; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement Audio Reading - “The Last Day” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Last Day," by W. Lynes. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 3 May 2016Volume 164, Issue 9Page: 631KeywordsAlcoholicsAnxietyEmotionsIntensive care unitsShockSuicideSurgeryThoraxTracheostomyWeight loss ePublished: 3 May 2016 Issue Published: 3 May 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

A Few Good Words.

On Being a Doctor19 April 2016A Few Good WordsChristopher Moriates, MDChristopher Moriates, MDFrom University of California, San Francisco, San Francisco, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2198 Audio Reading - “A Few Good Words” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "A Few Good Words," by C. Moriates. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail “Do you have any questions?” I asked. My team of residents and medical students standing around the bed began to slump a bit. We had 10 more patients to see this morning, and we were already falling behind. As I asked the question, my brain immediately began chanting, “Please don't, please don't, please don't.” I thought the chant was quiet enough that only I could hear it, but my patient seemed to read my mind. She was an elderly woman with cancer, admitted with shortness of breath due to fluid that had built up around her lung. This stubbornly progressive ... Author, Article, and Disclosure InformationAffiliations: From University of California, San Francisco, San Francisco, California.Corresponding Author: Christopher Moriates, MD, University of California, San Francisco, 505 Parnassus Avenue, M1287, San Francisco, CA 94143-0131; e-mail, [email protected]ucsf.edu. PreviousarticleNextarticle Advertisement Audio Reading - “A Few Good Words” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "A Few Good Words," by C. Moriates. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics Cited byTrust-Based Partnerships Are Essential — and Achievable — in Health Care ServiceRole of Kindness in Cancer CareWhen Patients and Their Families Feel Like Hostages to Health CareWhat Adult Cancer Care Can Learn From Pediatrics 19 April 2016Volume 164, Issue 8Page: 566-567KeywordsArmed forcesBrainDyspneaElderlyHabitsLung and intrathoracic tumorsPatientsPerceptionPleural effusionShoulders ePublished: 19 April 2016 Issue Published: 19 April 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Insufficient Reflection

Ad Libitum19 April 2016Insufficient ReflectionLaura Sherwood, BS, BALaura Sherwood, BS, BAFrom Ooltewah, Tennessee.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2224 Audio Reading - “Insufficient Reflection” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Insufficient Reflection," by L. Sherwood. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail the boy on the screen lying lifeless ... Author, Article, and Disclosure InformationAffiliations: From Ooltewah, Tennessee.Current Author Address: Laura Sherwood, BS, BA; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement Audio Reading - “Insufficient Reflection” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Insufficient Reflection," by L. Sherwood. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 19 April 2016Volume 164, Issue 8Page: 552KeywordsDeceptionEmotionsFloodingIntensive care unitsMusclesPancreatic cancer ePublished: 19 April 2016 Issue Published: 19 April 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Alms

Ad Libitum1 March 2016AlmsStephen T. Harvey, MDStephen T. Harvey, MDFrom Nashville, Tennessee.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2103 Audio Reading - “Alms” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Alms," by S.T. Harvey. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail No one with youno record to tell us yourhistory medicationswhen you last had something to eatwe have only scars to go bysome of themno doubt madeby your own handwhich the attendinghas raised into the airto demonstratewaxy flexibilityit has stayed there all nightsomeone has lefta pennyin your cupped palm Author, Article, and Disclosure InformationAffiliations: From Nashville, Tennessee.Current Author Address: Stephen T. Harvey, MD; e-mail, [email protected]com PreviousarticleNextarticle Advertisement Audio Reading - “Alms” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Alms," by S.T. Harvey. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 1 March 2016Volume 164, Issue 5Page: 341KeywordsScars ePublished: 1 March 2016 Issue Published: 1 March 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Far Too Often

Ad Libitum2 February 2016Far Too OftenStanley Cohen, MDStanley Cohen, MDFrom Atlanta, Georgia.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2105 Audio Reading - “Far Too Often” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Far Too Often," by S. Cohen. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail (Idiopathic thrombocytopenic purpura)Too often purple saturates your skinfar too many places, playinga twisted game, connecting dotsalong the path of edges and elbowsthat left their memory on yours.Too often tears drain your eyes.Those war wounds from everykitchen you enter, some doorclosing, a child's ill manners,a moment misspent, a hand mislaid.Too often you wear long sleeves,high collars, pants instead of skirts,hoping to hide the ripe or fadingcolors from eyes that questionand contend—perhaps your own.from running your ... Author, Article, and Disclosure InformationAffiliations: From Atlanta, Georgia.Current Author Address: Stanley Cohen, MD, Children's Center for Digestive Health Care, 993D Johnson Ferry Road, #440, Atlanta, GA 30342; e-mail, [email protected]com PreviousarticleNextarticle Advertisement Audio Reading - “Far Too Often” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Far Too Often," by S. Cohen. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 2 February 2016Volume 164, Issue 3Page: 183KeywordsElbowGamesHealth careHeartIdiopathic thrombocytopenic purpuraMemoryRiversRunningSaltsTaste ePublished: 2 February 2016 Issue Published: 2 February 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Album

Ad Libitum19 January 2016AlbumStanley Cohen, MDStanley Cohen, MDFrom Atlanta, Georgia.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2108 Audio Reading - “Album” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Album," by S. Cohen. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Do I see my childrenor their photos in my memorythrough unmeasured momentssleeping on the dockwalking home after schoolcaptured on silvered film.I thought he was taller thenthough perhaps I was instead.The fictions are now altereda contrivance for the spiritthat said I would know should know would always rememberconstantly rerecordedwondering what's editedknowing another somethingmust have been erasedfor its replacement Author, Article, and Disclosure InformationAffiliations: From Atlanta, Georgia.Current Author Address: Stanley Cohen, MD, Children's Center for Digestive Health Care, 993D Johnson Ferry Road, #440, Atlanta, GA 30342; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement Audio Reading - “Album” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Album," by S. Cohen. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 19 January 2016Volume 164, Issue 2Page: 119KeywordsChild healthChildrenHealth careMemoryWalking ePublished: 19 January 2016 Issue Published: 19 January 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Reverse Amortization

Ad Libitum19 January 2016Reverse AmortizationSylvia S. Villarreal, Med, MPHSylvia S. Villarreal, Med, MPHFrom Houston, Texas.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2060 Audio Reading - “Reverse Amortization” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Reverse Amortization," by S.S. Villarreal. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In memory of DSJI enter her home's palpable emptiness—so unlike your usual bearish embrace.Your boyish smile punctuated seven decadesof full engagement. Terry—smaller, conscriptedas widow—is surrounded by remnants of a tandem life.Two sets of golf clubs slumped against the wallbear hushed witness to the abrupt cessation of sharedpleasures. Our conversation circles aroundyour sudden departure—an accounting of the final hours.in ... Author, Article, and Disclosure InformationAffiliations: From Houston, Texas.Current Author Address: Sylvia S. Villarreal, MEd, MPH, McGovern Center for Humanities and Ethics, 6431 Fannin Street, Suite JJL 410, Houston, TX 77030; e-mail, Sylvia.S.[email protected]tmc.edu. PreviousarticleNextarticle Advertisement Audio Reading - “Reverse Amortization” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Reverse Amortization," by S.S. Villarreal. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 19 January 2016Volume 164, Issue 2Page: 124KeywordsMemory ePublished: 19 January 2016 Issue Published: 19 January 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Deescalation

Ad Libitum5 January 2016DeescalationStanley Cohen, MDStanley Cohen, MDFrom Atlanta, Georgia.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2106 Audio Reading - “Deescalation” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Deescalation," by S. Cohen. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail What do you do when you come from the hospital when the ventilator has stoppedall the miles of polyethylenepulling and pushing fluids before,now hang limp, to no avail?The kitchen, the mirrors, the bedwhere you both rested headsG-d, not his pillowNo, not his closet and the clotheshe'll never wear.Only a shroud covering his face hovering over the rest of lifemay as well drape over the house,house that was once collectively yours that now seems so much hisHow do you cook and contend answer the phone look at the mail pray for an endNeed you bother?What do you do when you come from the ... Author, Article, and Disclosure InformationAffiliations: From Atlanta, Georgia.Current Author Address: Stanley Cohen, MD, Children's Center for Digestive Health Care, 993D Johnson Ferry Road, #440, Atlanta, GA 30342; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement Audio Reading - “Deescalation” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Deescalation," by S. Cohen. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 5 January 2016Volume 164, Issue 1Page: 61KeywordsChild healthChildrenCombined antiretroviral therapyHealth careOintmentsStainingVentilators ePublished: 5 January 2016 Issue Published: 5 January 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

The Mammoth in the Room

Ad Libitum1 December 2015The Mammoth in the RoomDaniel Goodenberger, MDDaniel Goodenberger, MDFrom St. Louis, Missouri.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-1586 Audio Reading - “The Mammoth in the Room” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Mammoth in the Room," by D. Goodenberger. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail At the elevator, waiting, aged hip unquiet, urging patience. He approaches—didn'tI see you in the GI lab when I had my colonoscopy, talking to Dr. D?Ah—probably about shared ultrasound, uncovering cancer high and low, between us. Here to see him?No, my first chemo. Colon? Lung, in the center of my chest, like my fist, they can't remove it.Testing—Alk1 negative, awaiting … EGFR? Hope the side effects are not too bad.Buttercups froze in my mouth as Berezovska's malignant chill embraced us;Freezing the smile upon my face, making solid his brittle hope, and erasing my arthritic pain. Author, Article, and Disclosure InformationAffiliations: From St. Louis, Missouri.Current Author Address: Daniel Goodenberger, MD; e-mail, daniel.[email protected]gov. PreviousarticleNextarticle Advertisement Audio Reading - “The Mammoth in the Room” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Mammoth in the Room," by D. Goodenberger. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 1 December 2015Volume 163, Issue 11Page: 835KeywordsColonColonoscopyEstimated glomerular filtration rateHipLungsMouthThoraxUltrasound imaging ePublished: 1 December 2015 Issue Published: 1 December 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Errant gull

Ad Libitum17 November 2015errant gullD.A. Frater, MDD.A. Frater, MDFrom Dallas, Texas.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-0239 Audio Reading - “errant gull” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "errant gull," by D.A. Frater. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail the sun is once again behind me and Ihave come a long way to see you as Ithought I had once before and again theday is ending with you hidden from mysightstanding by the sea wall arms elbowstucked in tightly scanning thebrightening waves the light ready todepart lifts from the ground around meand cuts slowly through thetrees behind before it catches the tallerwaves the further breaches warm breaks inthe gray as your dancing brethren wheellike golden kites hoping to hide you frommy sweeping gazehad actually seen you the telltale ... Author, Article, and Disclosure InformationAffiliations: From Dallas, Texas.Current Author Address: D.A. Frater, MD; e-mail, [email protected]md. PreviousarticleNextarticle Advertisement Audio Reading - “errant gull” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "errant gull," by D.A. Frater. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 17 November 2015Volume 163, Issue 10Page: 746KeywordsElbowHand strengthVision ePublished: 17 November 2015 Issue Published: 17 November 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

The quiet room

Ad Libitum17 November 2015the quiet roomD.A. Frater, MDD.A. Frater, MDFrom Dallas, Texas.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-0591 Audio Reading - “the quiet room” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "the quiet room," by D.A. Frater. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In the quietquiet roomwhere she diedI looked forclues shemight haveleft beforesucceedingat whatonce beforeshe hadonly triedI found stillrestingin her bedan imprinther questionmark bodycurledat the kneesthe hips bentthe elbow thepoint of hershoulder ahint incloth ofher faceto onesideI sat atthe edge ofthat finalempty momenteyes closedto see hercurled insomethingelsebesidesthe endand laidmy handto herphantom hipwantingto softenso thehard sadconfusionand gentlyrub toolate Iknowa softtouchupon herheartand yetstilltriedto fathomthe depthof herspiritsinkingprayingthat shetouchedbottomfinallyupon ahoped forcalmandwas notalone inher restingplacethat theeaseupon herface wastherefair andsincereand despitemy hidingfears didnot hersecretdreadbelie(For PMF) Author, Article, and Disclosure InformationAffiliations: From Dallas, Texas.Current Author Address: D.A. Frater, MD; e-mail, [email protected]md. PreviousarticleNextarticle Advertisement Audio Reading - “the quiet room” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "the quiet room," by D.A. Frater. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 17 November 2015Volume 163, Issue 10Page: 808KeywordsElbowFearHeartHipKneesShouldersTouch ePublished: 17 November 2015 Issue Published: 17 November 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Special Delivery

Ad Libitum20 October 2015Special DeliveryAdam Possner, MDAdam Possner, MDFrom George Washington University, Washington, DC.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-1651 Audio Reading - “Special Delivery” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Special Delivery," by A. Possner. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail One day, my child, when you aremuch older, you'll want to knowwhere babies come from, to whichI'm not sure what your motherand I will say, probablywe won't tell you storks, althoughI will always remembersix months before you were bornthe day your mother and Iopened our front door to findsitting on the stoop a whiteenvelope, graceful, wings closed,carrying beneath its beaka sleeping letter conceivedfrom a feather of blood pluckedfrom your mother's arm, swaddledin disclaimers, a letterbearing the news of your sex.Adam Possner, MDGeorge Washington UniversityWashington, DC Author, Article, and Disclosure InformationAffiliations: From George Washington University, Washington, DC.Current Author Address: Adam Possner, MD, Assistant Professor, General Internal Medicine, Medical Faculty Associates, George Washington University, 2150 Pennsylvania Ave NW, Suite 5-516 North, Washington, DC 20037; e-mail, [email protected]gwu.edu. PreviousarticleNextarticle Advertisement Audio Reading - “Special Delivery” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Special Delivery," by A. Possner. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics Cited byBacteriophage Treatment before Chemical Disinfection Can Enhance Removal of Plastic-Surface-Associated Pseudomonas aeruginosa 20 October 2015Volume 163, Issue 8Page: 607KeywordsBlood ePublished: 20 October 2015 Issue Published: 20 October 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

The Biopsy Room: Prostate

Ad Libitum6 October 2015The Biopsy Room: ProstateJack Coulehan, MD, MPHJack Coulehan, MD, MPHFrom Setauket, New York.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-1467 Audio Reading - “The Biopsy Room: Prostate” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Biopsy Room: Prostate," by J. Coulehan. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Each punch of the devicethuds in my boggy braina fraction of a secondafter its teeth bitea sliver of prostate—a miniature dragonattacks my rectum,a white-clad assistantslips fragments of tissueinto labeled containers.Twelve punches, a dozenvicious bites, the twelvegreat labors of Hercules,especially his captureof Cerberus, three-headedsentry of the underworld,the twelve apostles of Christ,especially the last, Jude,patron of impossiblecauses, the twelve Knightsof Camelot, especiallyGawain, the purest of heartwho lopped off the headof the Green Knight,but found forgiveness,the twelve Olympian gods,especially Apollo,my protector, the zodiac'stwelve constellations,including Libra, whichaugurs balance and grace—The last punch reminds meof Cancer, its sharp pincerswon't let go.Jack Coulehan, MD, MPHSetauket, ... Author, Article, and Disclosure InformationAffiliations: From Setauket, New York.Current Author Address: Jack Coulehan, MD, MPH; e-mail, John.[email protected]edu PreviousarticleNextarticle Advertisement Audio Reading - “The Biopsy Room: Prostate” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Biopsy Room: Prostate," by J. Coulehan. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 6 October 2015Volume 163, Issue 7Page: 536KeywordsBiopsyBrainHead and neck cancersHeartRectum ePublished: 6 October 2015 Issue Published: 6 October 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Predictive Value

Ad Libitum6 October 2015Predictive ValueNeil Skolnik, MDNeil Skolnik, MDFrom Jenkintown, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-0226 Audio Reading - “Predictive Value” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Predictive Value," by N. Skolnik. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail (In blessed memory of Jinny Skolnik)I had waited for yearsFor the call:“A spot on the lung,”I was sure they'd say,“She had been coughing,So we ordered the x-ray,”And, then—A hesitation.I rehearsed in my mindHow I'd feelHow many times I'd triedTo convince herTo stop, to give upsmoking. Wasted effort, perhapsBut no effortDone with love is wasted.Then last weekThe call came:Her bone marrow biopsy,Performed after a randomCBC—done for no known reasonShowed low Red cells,White cells, and Platelets:“Acute Myelogenous Leukemia,”The doctor said,Then he continued,“Prognosis: Weeks,Maybe months.”A week later we ... Author, Article, and Disclosure InformationAffiliations: From Jenkintown, Pennsylvania.Current Author Address: Neil Skolnik, MD; e-mail, [email protected]net PreviousarticleNextarticle Advertisement Audio Reading - “Predictive Value” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Predictive Value," by N. Skolnik. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 6 October 2015Volume 163, Issue 7Page: 553KeywordsBiopsyBone marrowCancer chemotherapyCellsChemotherapyCoughingEmotionsLungsMemoryPlatelets ePublished: 6 October 2015 Issue Published: 6 October 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...