Patient as Doctor

•February 17, 2012 • Leave a Comment

I usually do Pilates and have lunch with my friend Susan every Thursday. It’s my day off from work, and I do all my household errands and self-care, along with this special weekly date with Susan. But yesterday, I called her and told her I just couldn’t do it. She asked me what was wrong, and I told her I didn’t know, that I just felt like I wanted to crawl under a rock.
She was worried. It’s not like me to cancel, and certainly not like me to hide under rocks. As a general rule I am pretty high-energy, and I’m fairly social.
“If you’re feeling depressed, it would be better for you to get out of the house. It’s not good to isolate,” she told me. She offered to make me lunch, bring it over, or have me over to her house. She is a really great friend, and she meant all this in earnest.
But it wasn’t depression that was the problem. It wasn’t like I wanted to isolate because I was sad or down. I was just exhausted. Not the kind of exhaustion that comes from too much physical activity, or the kind of exhaustion that comes from not enough sleep. In fact, probably I hadn’t had enough physical activity for the few preceding days, and, while, like most of the U.S. population, I’m always on a little bit of a sleep deficit, I wasn’t significantly sleep-deprived. It was more that I was mentally fried. I needed a day to re-charge, and my instinct was that I should do it alone.
I can’t explain exactly why I was so fried. I’m sure it was a combination of factors. A week earlier, I’d taken an unexpected trip to Toronto for my aunt’s funeral. I only went for a day, which was probably foolish. But it was a Tuesday, and I had to cancel patients. And Wednesday is my busiest patient day, so I felt uncomfortable canceling a second day at the last minute. The funeral was, of course, sad, but my aunt had been sick for a while, and that side of my family has a wide net of family support. I convinced myself that this trip was no big deal and I could get back to a normal schedule the next day. Probably my first mistake. The rest of last week was okay, but this week my Monday thru Wednesday patient hours were packed, long and intense. When I work, I really put myself into it. I came home each evening too tired to exercise or do much else. Not pushing myself to get some physical activity was probably the second big mistake.
By Wednesday afternoon, I was beat, barely able to finish my hours. One of my patients, a nurse, looked at me with a furrowed brow during her appointment and said, “Are you sick?”
“I don’t think so,” I answered.
“You don’t look well. Your color is off,” she told me.
It took this to make me stop and pay attention to myself. I’d been running on empty, and I couldn’t keep going.
I think this happens to many people periodically. We plug along, continuing our tasks no matter how tired, hungry, sad, or in some cases, ill, we are. I know better than this, but sometimes I’ll put off eating, drinking, or going to the bathroom in order to keep moving in the office… until putting it off is no longer an option because my body goes into revolt. Maybe it was okay to do this to myself when I was 25, but at 51, it is simply self-abusive. I would never suggest to a patient that it was okay to do these things, yet I’ll do them myself!
It took my nurse-patient’s comment to snap me out of my denial about my own needs. I may have responsibilities to my patients, but unless there is a dire emergency, I clearly need to attend to my physical and emotional needs, or I’m not going to be much good to anyone else.
Fortunately, I had the opportunity for a mental health day today. Not everyone has this. I’m not going to call it a luxury, because it really isn’t. It was essential to get some extra sleep, some good-quality exercise, hydration and nutrition, and a good amount of quiet time today. But unfortunately, our society does not always allow for these needs to be met. We overvalue ‘productivity’ at the expense of well-being, and all the technology that constantly demands our ‘immediate’ attention makes things even worse.
Many other cultures are better than ours at recognizing the need for breaks, both daily breaks during work hours and vacations for more intensive recharge. If our society is not going to look out for the needs of the individual, we each have to try to do it for ourselves.
In the future, I’m hoping not to reach the point of having a patient tell me I’m wrecked before I notice it myself. Lesson learned…I think.


Matters of the Heart

•February 13, 2012 • Leave a Comment


“I’m heartbroken”

“Don’t give me a heart attack!”

“It will only cause heartache”

“Listen to your heart”

“My heart’s not in it”

“She’s cold-hearted”

“Cold hands, warm heart”



I could go on and on.  We hear phrases like these every day of our lives, and I don’t hear anyone questioning the meaning of them.  We all know about matters of the heart.  Valentine’s day is coming up, and hundreds of thousands, maybe millions, of people will give or receive a card with a stylized heart on it, or a box of candy in the shape of a (stylized) heart, or a ‘heart-shaped’ necklace or locket.


But most of us also know that love is not really a function of the heart.  That’s something that came from way, way back, when people believed that emotion, caring, love, romance all came from the center of everything in the body, the heart.


We learn about the heart in many different ways during medical school.  In Anatomy, we dissect the heart of a cadaver and look at the anatomy – the chambers, the valves, the blood vessels running to and from the organ.  In Physiology, we learn about the pumping of blood, the electrical impulses that drive the beat of the heart, the calcium channels and beta receptors that control the strength and speed of the heart’s contractions.  In Physical Diagnosis, we learn the heart sounds,  normal and abnormal, and how to recognize different murmurs and their meanings, and how to see and feel pulsations that might indicate problems with the heart’s function.  In Cardiology rounds, we learn about the different diagnoses- Atrial Fibrillation, Cardiomyopathy, Cardiac Ischemia- and how to treat these conditions.


We learn nothing about love or passion or feelings.


In Neurobiology,  we learn that brain chemicals dictate feelings.  In fact, it’s more complicated than that.  Brain chemicals give us certain physical or neurological sensations, which we then attribute to particular ‘feelings’.    Love is a combination of adrenaline and serotonin and oxytocin released into the body by the brain,  not a function of the heart at all.


But the myth of love as a matter of the heart, and all the clichés and adages that go with that live on, even in those of us who know all the particulars of physiology and neurochemistry.  Doctors and scientists are not immune to sentimentality, and we are most certainly not immune to falling in love or to ‘having our hearts broken’.


When it comes to love, I can get as sticky-sweet as a teenager.  I love my husband more today than when we ‘fell in love’ 25 years ago.  Maybe that’s because my serotonin levels are higher or because our longterm attachment has increased my oxytocin levels.   I doubt it’s adrenaline, since my heart no longer pounds every time I see him… but then again, at our age, that might give me a heart attack.  Whatever it is, I partly feel it as something good at my center, and I’m not going to question that.


Medical training notwithstanding,  I look forward to Valentine’s Day, to giving him the card I chose with the red stylized hearts all over it, and receiving whatever ‘heart-shaped’ objects he chooses to bestow on me.












Technology Tizzy

•February 3, 2012 • 2 Comments

I have been pulled, kicking and screaming, into the age of information technology.  I didn’t want a ‘car phone’ when mobile phones first became available, but soon gave in because of my profession; as a doctor on call, it was very convenient to have a mobile phone, rather than to look for the nearest pay phone when in transit.  Soon, it became pretty important to have that cell phone, as answering services, other doctors, and patients grew to expect a quick response from their physician on call.  Finally, as pay phones became all but extinct, the cell phone was no longer optional.  Now I have and iPhone, and I am utterly lost without it.  I use it for calls, but I also text, get my email instantly, keep my schedule in it, and use a variety of apps (I even call them apps, not applications- that’s how much I’ve bought in) for personal and professional reasons.  I have Epocrates on my phone, which tells me drug doses, side effects, and even prices.  I can log on to the health system’s computers to get patient labs and X-ray results from my phone.  And I can get Uptodate, which gives me the ability to look up just about any symptom or disease state, and get the most sophisticated information available on diagnosis and treatment.  This from the woman who was not going to have a ‘car phone’, much less a computer.  Now I also have two laptops and a desktop.  I was terrified of email 10 years ago- now I don’t know how to function without 24/7 access to it.  I email, blog, Facebook, text- but as of this writing, I refuse to Tweet.  Still, given my history, that is subject to change at any moment.

And now, the transformation is almost complete.  Though, as a small, private, primary care practice, we resisted the Electronic Health Record (EHR) when lots of other doctors had been using it for years, we are now in the process of implementing an EHR in our office.  And I’m scared.  Really scared.  I don’t make these kind of adjustments easily.  But now, it simply can’t be avoided.  We need to come into the modern era.  Our paper charts are antiquated, and we have to make the change.  Paper piles up and gets disorganized.  The charts get too big and start to shred over time.  Pages go missing.  It’s bad for the environment.  Our handwriting becomes more and more illegible as we age.  While we are not being forced by our health system or by private insurers to use EHR, Medicare is putting pressure on by cutting payments to docs who don’t use computerized records and electronic prescribing.  So we have to do it.

Younger people probably have trouble understanding why a computer program is daunting to me.  My kids can’t believe it when I can’t immediately figure out how to use some new piece of equipment or when I struggle with getting some web app to work.  They’ve grown up in a high-tech world.  I hate to admit how old I am, but my introduction to the computer in college was when the computer was the size of a building.  Yes, we went to the computer center, where we sat at one of maybe ten terminals in a little room connected to the gigantic main-frame computer.  We used punch cards, and programmed in Basic, or once we were in Advanced Computer Science, Fortran.  We wrote our own programs for playing poker or working through a mathematical sequence.  Computers weren’t used on a regular basis for things like word processing then, either.  I typed my papers on a typewriter.  I was lucky, because mine was electric, but it didn’t even have a self-correction ribbon, so I used plenty of white-out.  It’s almost shocking how much our day-t0-day lives have been transformed by all our computerized gadgets now, for better and for worse.  Because back then, things moved slower.  If you wanted to reach someone, you had to call them from your home and hope that they were at their home.  Or you had to wait for a letter to go out in the mail, get to its target, get answered and back to you through the mail.  Mail came once a day.  Not like now, when you can get a phone call or text or email any time of the day or night.  This goes on continuously, with callers and senders expecting instant results.  No wonder we’re all so stressed!

But I digress.  Back to the Electronic Health Record. There are some very positive things that an EHR can do for us.  Our charts will be paperless, neat, and organized.  Data will go directly from the hospital lab and radiology and other testing sites to our patient records.  We can share information with a patient’s other providers within our own health system.  Our patients will have access to their own information. Prescriptions will be sent directly from the doctors to the patient’s pharmacy, saving time and energy.  I could go on and on.

But the fact is, there are also downsides.  That’s why I’m scared.  The biggest one for me is what this will do to patient encounters.  Writing in a chart doesn’t keep me from being personal and human with patients, or from making eye contact.  But having a laptop between me and the patient?  Well, that’s an entirely different story.  Lots of my patients complain about encounters they’ve had with other physicians during which the computer seemed to dominate the visit.  I really don’t want that to happen.  It’s going to be a challenge to keep the technology as a tool and not as the focal point.  I’m also worried about my own ability to utilize the system.  I know at the beginning, there will be a steep learning curve, and it will slow me down a lot in the beginning.  A couple years ago, my husband’s whole health system (one of the major Philadelphia health systems/medical schools) went up on an EHR system, his days were a couple hours longer than usual for a while, and he struggled with the many glitches and limitations of the computer program.  Granted, it got better over time, and he now feels it saves him time, but it took a while.  And he is MUCH more technically savvy and facile than I am.  So I think I have a good reason to worry.

Then there are the realities of technology.  The internet can go down.  Data can be lost.  It can even be stolen.  Computer equipment breaks, and I don’t know how to fix it.  Yes, we have tech support, but my IT guy can’t hold my hand all day.  Most frightening of all, I don’t really understand how acomputer, or the internet for that matter, works!  There’s no mystery to paper and ink.  If my pen breaks, or runs out of ink, I just use a different one.  All this complicated machinery is a different story entirely.

Regardless, we WILL be using the EHR.  I will put on a brave face, and forge ahead.  I have mastered use of my computer and my smart phone.  I suppose I should be able to do this too, even if I do it kicking and screaming.                              -RK

I just had a CT…

•January 26, 2012 • 1 Comment

I just had a CT scan of my neck.  To look at my right submandibular gland. If you’re unfamiliar with that, it’s one of the salivary glands.  And CT stands for Computed Tomography.  We used to call them CAT scans (some people still do), but the ‘A’ didn’t stand for anything, and it always reminds me of that dumb veterinary joke that goes something like, ‘A veterinarian tells a dog owner that he is not sure what his wrong with his dog.  Then a cat enters the room.  The client asks why the cat is there, and the veterinarian says that he is doing a cat scan.”  Ha, ha?  Maybe I have the joke totally wrong.  It doesn’t seem right.  But it embodies the spirit of the joke, so it will have to do.

The CT scan came about because I had two episodes of salivary gland swelling caused by stones in  the duct from the salivary gland, occluding the ducts and preventing the normal flow of saliva.  Both times, I was kind of dehydrated (I’d been in hot weather, hadn’t had enough water, exercised… I’m not very good at drinking water unless I feel really thirsty, and by the time someone feels thirsty, they are already at the point of dehydration.)  So there was some reason for these salivary duct stones, but most people don’t get them when they’re dehydrated.  I’m just special.  Anyway, the scan was to look for stones in the actual gland, so that future episodes can be predicted and, hopefully, prevented.  Not a big deal.  My doctor is not looking for a malignant tumor or some other dire situation.  But for some reason, the scan still unnerved me.  

Even as a physician, going into medical settings as a patient is highly charged.  Maybe partly because I have had more serious medical problems in the past and I live with a feeling of a little black cloud over my head.  Or maybe because these settings are just very serious, and many people are there with higher stakes than I have this time.

I have to say that everyone who has cared for me this time, save the first otolaryngologist (ENT doctor) I consulted, was wonderful.  It was unpleasant having the stone, because it caused pain, a big lump under my tongue, swelling under my jaw when I ate, and difficulty eating.  The first doctor, the one who treated me the first time and was fine (but I was already on the way to getting better then), blew me off this time.  He said that he didn’t see much of a problem and I should just hydrate and put warm soaks on my salivary gland.  But I’d told him that the lump in my mouth had been there for days, and wasn’t budging, despite vigorous hydration, sucking on lemon candy (which makes saliva flow) and taking antibiotics, which had been prescribed by phone on the weekend when it started and I was in a lot of pain.  Here’s the problem:  I did not feel at all listened to, nor did I feel that he’d done a thorough exam.  The lump was visible and palpable to me and to my husband.  It hurt.  And he claimed he ‘didn’t really see much.’  I have a strong belief that we must listen to our patients, really listen. Most patients who feel there is something wrong are telling you something important.  It only made it worse that I’d experienced this before, so I knew the territory, and I am a physician, so I know the signs and symptoms of various things from reliable sources.  Still, he was dismissive.

In a previous life, I might have listened to him and kept suffering.  But I knew I was right on this one. So I asked my husband for a referral in his hospital system, and he helped me get a prompt appointment.  This difference between the doctor visits was night and day.  The new consultant immediately saw and felt the lump, and told me that I was right- if it hadn’t moved or changed in 5 days, it wasn’t going to.  So he removed it in his office, virtually painlessly, by making a tiny incision in my submandibular duct.  I had immediate relief, despite a little discomfort at the incision once the lidocaine wore off.  And he suggested that, given the history of two episodes of stones, I should get this scan.  Not an emergency.  Just to dot the i’s and cross the t’s.  He was kind, respectful, even kind of fun to be around.  Everything I would aspire to be with my patients.

I delayed the scan a little.  Not to be non-compliant.  Just because I had to work through my own pros and cons of such a test.  Pros:  I’ll know better how to prevent further episodes.  I’ll know there’s nothing more wrong.  It is a painless test.  Cons:  it’s use of medical resources that I need less than other people.  I will irrationally worry for a day or so, until I get results, that I have a tumor or some other significant problem.  I needed contrast dye, which gives an unpleasant flushing sensation.  It’s radiation (not that I’ve had that much cumulative radiation in my life that it’s a concern, but it’s still radiation.)  Yes, actually more cons than pros, but ultimately I decided that I trust my doctor enough to do what he thinks is right.  

When I arrived at radiology this morning, the receptionist was as lovely as could be.  The check-in process was seamless. I only waited 10 minutes after I checked in, not long enough to get all riled up about the other people there who might be getting tests to look for ovarian cancer or serious heart or lung disease.  The tech who put in my IV for contrast and did the scan was sweet, reassuring, and technically excellent.  I was out of there in less than 40 minutes.  NO BIG DEAL.

Now I’ll wait for results.  I will probably irrationally wonder off and on if there is some horrible thing wrong with me.  I know that, no matter what reassurance I give patients when I send them for tests, many anticipate the worst.  If I can worry about something this non-threatening, I can only imagine how much they worry.  It reminds me once again to contact them as soon as possible once I get a test result.  Worrying is a legitimate form of suffering, and if I have the antidote, I better hand it out as quickly as I can. 


The Chocolate Bar

•January 19, 2012 • Leave a Comment

“Is Pesach over yet?”  my father asked.  It was Sunday, April 15, 2001.  It was the last day of Passover, income tax day, and also Easter Sunday.

“Yes, Dad, it’s after sundown now.  That means you can eat bread with your dinner.”

“That’s good.”

“Yes, it is.  And I brought you a chocolate bar.  I know Max usually brings it, but he couldn’t come tonight, and he asked me if I’d give it to you.  He told me to make sure to get the extra big Hershey bar, that that’s the one you like best.”

“Max is a good boy.”

Max is my son.  He was eleven at the time.  We had a weekly ritual of visiting my Dad, his Poppy, at the assisted living center on Sundays. We always stopped for the chocolate bar on the way, and Max would present it to Poppy when we arrived. Sometimes my husband and our daughter, then 9, would also visit.  But Max was his Poppy’s special friend, and he almost never missed a visit.

This week, though, we’d been away in Washington, D.C. for the weekend.  My husband and I had taken the kids for a museum tour of D.C., and we’d seen the Hirschhorn, the Native American Museum, the International Air and Space Museum.  We returned home late Sunday afternoon and the kids were exhausted.  Max offered to come with me when I got up right after dinner and said I was going to see my father.  It wasn’t that late, and Max didn’t have homework, but for some reason I felt like I wanted to go alone.  Given how tired he was, Max didn’t protest.

“Don’t forget the chocolate bar, Mom.  Hershey’s milk chocolate, the biggest one they have at the drugstore,” he instructed me as I headed out the door.

It was about a 40 minute drive to assisted living.  It would have been easier if he’d been closer, but this one was the best fit because it was a Jewish facility, and my father had always been very connected to his religion.  As he became physically and cognitively impaired from Frontal Lobe Dementia, a form of dementia that causes more loss of judgment and insight than memory in its early stages, and also causes gait disturbance, an environment that included a synagogue, a full-time rabbi, and kosher food was comforting to him.

He had first lived independently in an apartment when he was still able to walk and care for himself, then had stayed in the apartment with an aide to help him during the day, and finally, after a prolonged hospitalization for congestive heart failure and pulmonary problems, was moved to the ‘Care Center’, the  section of the facility that was essentially a nursing home.  The care was good, and he was comfortable, but I feared he would be lonely now that he was unable to attend most of the activities or go out on excursions, so I hired a companion to sit with him and take him on walks during the days.  I visited at least one evening a week as well as Sundays, and often felt I should go more often, but my medical practice, children and household were all competing demands.  He didn’t seem to mind, though.  I think time was kind of blurred for him by then, and he didn’t really realize how much of it passed by between visits.  He did, however, continue to recognize me and my family, and when we came to visit, he carried on fairly lively conversation, though most of it was about the distant past.

Before the assisted living, I thought he’d live with us, with a companion during the day. That was a bad idea.  He stated with us for less than six weeks, and he hated it, saying that between all our comings and goings, the kids and our two dogs, there was too much commotion.  He asked me to find him a ‘continuing care community’.  That was smart thinking from a man who was on his way to dementia.   I could see well before he entered the Care Center that we would never have been able to give him what he needed.

When he first lived in the continuing care facility, he participated in lots of activities.  He went to Shabbat services, current events, physical therapy, Sunday outings to Chinese restaurants, weekday trips to the mall. He went to dinner in the dining room each night, often accompanied by one of the many women there who had a crush on him.  Once he was impaired enough to live in the Care Center, he didn’t seem to miss any of that.  He was content to sit in his lounge chair and listen to opera or classical music for hours, or to watch TV, or be taken on a wheelchair ride by his companion.

I think what he did miss were trips to the grocery store.  He had always loved browsing the food aisles, the deli, choosing vegetables and fruit, even when I was a child.  When he lived in the apartments, he looked forward to the days that the center’s van would take the residents to the Pathmark.  It was something I had trouble understanding, as grocery shopping was just a necessary evil to me at that time.

Driving to the center that night, I remember wondering how long my Dad could hang on like this, half in reality and half in his own world.  I’d already witnessed so many stages:  the beginning when, if you hadn’t known what an erudite, intellectual, and refined person my father was, you wouldn’t have noticed anything at all, the slow decline to confusion and the need for a walker, then loss of independence and motivation, the stage he was in now.  In between were the hospitalizations for other medical issues, and, recently a frightening episode of vertigo and neurologic pain, which thankfully had passed.  This current state of doing and saying little, but appearing comfortable and still enjoying things, was not terrible, but it felt like limbo.  And I knew it couldn’t last.

When I arrived at assisted living, I made the turn the the Care Center, and greeted the nurses as I walked by their station.  They seemed to be on short staff, probably because it was Easter, and my father’s companion also had the day off.  I didn’t expect him to be as well-groomed and neat as he was when she was there to pay attention to him all day, but I was a bit surprised to find him completely disheveled, shirtless, and with his dinner tray untouched and pushed to the side of the lounge chair he occupied.  His white hair, the beautiful thick white hair that everyone admired, was uncombed.  He had a sort of wild look on his face.

“Hi, Dad!”  I said in a falsely cheery voice.  “What’s going on?  Where’s your shirt?  You must be cold.”

“No,” he answered.  “I took it off.  It’s hot in here.”  I saw the shirt tossed to the side of his chair.  It was certainly not hot in the room.

“Here, let’s put it back on.”  He obediently raised his arms as I slipped his long-sleeved polo shirt over his head.  I took the comb from his nightstand and combed his hair.

“Why haven’t you eaten?  Do you need help with your tray?”

“There’s bread on the tray.  It’s Pesach, isn’t it?”

“Not anymore.”

“Is Pesach over?”

“Yes, you can have bread with dinner tonight.”


I wasn’t sure if his unkempt appearance and the confusion about the food was because the nurses had not had the time, or the desire, to help him, or if he had actually thrown his shirt off and messed his own hair up.  But I did notice a difference in him.  Once I put the tray in front of him, he ate clumsily, and with abandon, spilling food on himself.  That was new.  As soon as he finished his dinner, he opened the chocolate bar and began eating.  I chattered at him, but he didn’t respond.  Instead, he seemed to be laughing to himself, as though he had a private joke that he was not going to share.

“What’s funny?”  I asked.

“Funny?  Nothing.  Are the taxes done?’

“Yes, Dad, I made sure they were done and went out a few days early.”


He was polishing off the extra-large Hershey bar, pretty quickly.  Usually he only ate a little, and saved some for the next couple of days.  I thought about saying something, telling him to slow down, that he shouldn’t eat it all at once.  But something stopped me.  Why shouldn’t he eat it all at once if he wanted to?  What difference did it make?  Clearly he was getting worse, and if a chocolate bar gave him pleasure, I was not going to ruin it for him.

I cleaned up his spills, put a clean shirt on him and put the tray out in the hall.  I asked him if he wanted to get into bed, but he said no, he’d just sit, and asked if I could put on some opera music for him.  As he listened to the music, he dozed off, and I decided it was time to go.

“How long is THIS going to last?” I wondered to myself as I got in my car.  What is this?  Was he hypoxic, septic, delirious for some reason other than dementia?  Did it matter?  He wasn’t in any distress.  He seemed to actually be enjoying himself in this even more altered state.  So I did nothing.

My phone rang at 6 am the next morning.  I answered it, still half asleep.  It was one of the nurses from the Care Center.

“I’m sorry to call you so early in the morning,” she said. “I went in and saw your father this morning.  Took his vital signs, everything was fine.  But when I went back with his meds a few minutes later, he had died.  I’m so sorry.”

“He died?” I asked.  “Are you sure?”

“Yes, I’m sure.”  She answered me so respectfully, as though it was a reasonable question.

“Okay, what should I do?”  I knew what to do, but somehow I had forgotten.  Call the funeral home.  Go see him before they come, if I want to.  Start making arrangements for a funeral.  But at that moment it all had escaped me, and the nurse had to give me step-by-step directions.

I woke my husband, told him, and we got ready to go.  I still didn’t quite believe he was dead.  A thousand thoughts passed through my mind on that last trip to the Care Center. You might think that I’d have felt guilty for not acting the night before, when I wondered if there was some acute medical problem.  But I didn’t.  What I thought was, “Maybe the chocolate bar killed him.”  I know that makes no sense, but that’s what I thought.  And then I was glad that I hadn’t stopped him from eating the whole thing.  Because at least he got to have something he enjoyed on the last night of his life.

Welcome to doctorswrite

•January 16, 2012 • 3 Comments

I was posting last year to ‘Dr. Roz Kaplan’s Blog’, which was set up in conjunction with the release of my medical memoir, ‘The Patient in the White Coat’.  This worked for a while, a way to get some readership, but it ultimately became a little chaotic and dissatisfying.  I didn’t post on a regular schedule.  I was writing a lot of other things, and the blog wasn’t priority.  And most importantly, it was a blog without specific focus.  There are way too many bloggers out there just writing ‘stuff’, and I’m not sure that another blog like that was a real contribution to the blogosphere.

So I’m starting this new one, with a focus and a commitment to post 1-2 times weekly.  This site is for doctors, patients, other health care workers, and anyone who is interested in the stories around practicing medicine.  So it’s really a Narrative Medicine blog, and the focus will be bringing the world of medicine to life, in stories and essays, and hopefully informing readers as well as entertaining them.

Let me know how I’m doing as time goes on!