Published: December 09, 2008
Ten years ago, an intelligent, reserved software engineer -- a woman with the complexion of Halle Berry and the physique of a marathoner -- came to my infectious-disease clinic, accompanied by her fiance.
They'd been referred to me a few weeks after a rash and pneumonia prompted a clinic doctor to test the woman for HIV. The test came back positive. Her fiance, tested later, was HIV-negative. Read More
Published: November 25, 2008
Last month at a luncheon marking International Infection Prevention Week at the National Press Club, some speakers reminded me of a shameful and frightening statistic: Almost 60 percent of American health-care workers do not receive the flu vaccine.
Let me put that in context: Influenza, commonly called the flu, strikes 5 to 20 percent of Americans annually. In an average year, more than 200,000 people are hospitalized with flu complications; nearly 36,000 die, either from the flu itself or from complications such as pneumonia or a heart attack. Read More
Why the Presidential Race Should Skirt The Doctor's Office
Published: October 28, 2008
A few weeks ago, as I was making rounds on the oncology floor, one of my patients asked, out of the blue, "Hey, Doc, who you gonna vote for?"
I would have expected this patient to have other questions on his mind. He's a 32-year-old writer whose leukemia had failed to remit after two rounds of chemotherapy. Now a third, more powerful regimen had dropped his white blood cell count to near zero, making him vulnerable to life-threatening infections. Read More
Lack of Compensation Can Tempt Doctors to Tailor Their Care to a Patient's Coverage
Published: October 14, 2008
When I walked into the hospital room of a 19-year-old woman, a foul smell all but overwhelmed me. I called a nurse to assist me and saw her, too, catch her breath.When we examined the young woman we found a chronic infection of her pelvis so painful that she resisted our slightest touch. Read More
Published: September 16, 2008
From the patient's point of view, doctors and hospital officials can seem to be a monolithic medical power structure. But in fact, physicians and administrators often do not see eye to eye.Read More
We Need Carrots and Sticks to Reduce Infection Rates
Published: August 05, 2008
One morning on hospital rounds, I saw a physician colleague enter the intensive care unit where a patient lay intubated and sedated. With his hands unwashed and ungloved, the physician palpated the patient's abdomen, scratched his own head and then placed his stethoscope on the patient's chest to listen to his heart. Then he walked to the nurses station, rubbed his nose and entered a note in the patient's chart. Read More
Published: August 05, 2008
“I have been waiting to see you, and I want answers now,” my patient said angrily as I entered her hospital room.
Like a silent guard, her husband stood three feet from her, costumed in olive-green gloves and a bright yellow paper gown. Read More
Published: July 15, 2008
Last summer, my oldest daughter, Sapna, passed a multiple-choice driver's exam, secured a learner's permit and asked to sit in the driver's seat. This was a source of concern for me. As an epidemiologist, it is my job to look at incidence and prevalence of disease in large populations and suggest ways to keep people healthy and safe. I know that motor vehicle crashes are the leading cause of teenage death, accounting for more than a third of the fatalities in this age group. Read More
Published: June 10, 2008
My patient is an elderly man with end-stage congestive heart failure, kidney failure and now an infected dialysis line, and he is unlikely to live more than six months. The Bible lies on his bedside table next to his hospital breakfast tray and the morning newspaper. I wonder if I should pray with him. Read More
Patient's Routine Visit Becomes An Ethical Challenge for a Doctor
Published: March 04, 2008
My patient had come for a routine doctor visit. He was a well-built, soft-spoken middle-aged man who was always polite, respectful and adhered meticulously to his HIV medication. He complained only if he was in a great deal of pain or discomfort.
As usual, I asked him about his family: three adopted children. Over the years that I had known him, the children had grown to adults and had left home. One had secured a job, the second was in college, and the third had just joined the Marines. We talked about his work; he sorted packages at a warehouse. We chatted about the weather and then turned to his health.
