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The House of God After 40 Years: A Rheumatologist's Reflection

The House of God is probably more known of than read, with over 3 million copies sold since its release when I was a Chief Medical Resident in the era of its writing. The book itself, according to the author Samuel Schem (aka Steven Bergman, MD, DPhil), a psychiatrist and currently Professor of Humanities at NYU, is a true account of his internship, albeit laden with some liberties of fiction - and it's been quoted for generations. The House of God is cruelly funny and portrays many uncomfortable and dehumanizing aspects of medicine, including substance abuse, bawdy sex (and lots of it), sleeplessness, depression, and suicide to name a few. Taken at face value, it would seem countercultural to our current aspirations of putting patients first, #MeToo and burnout concerns. Is this book merely a humorous anachronistic rant, or a serious work of reflection meritorious of being read and pondered upon?

When Your Patient Asks Why?

This is probably the most difficult question that a physician is confronted with. A patient is stricken with a new disease or problem and before it even sinks in or is fully comprehended, the patient wants to know “why” or “how” long before they want to know what are we can do about it.

Rheumatologist's Vacation Checklist

Nearly half of all available vacation days go unused and over 40% of Americans failed to use any vacation days in 2015. Common sense says that taking more time off (not less) is likely to lead to increased work productivity. Your next vacation is essential to building a better you. Here are some tips to insure you get the most from your time off.

When To Give Up

He would have died. About 4 weeks ago, my 74 year old father-in-law, “Pops” was admitted to a small community hospital for delirium and worsening congestive heart failure. He was seen by a caring hospitalist and a local cardiologist who was deemed good by all the locals, but they could not get him better.

How to Best Use RheumNow

This “How to Use RheumNow” blog is intended to help those of you who would like to get better use and quick hints on consuming RheumNow content. This is also a good opportunity to get some feedback from you on what we could do better or how we could serve your interests and online education. What keeps you up at night? We would really like to know.

Why Rheumatologists are the Happiest

It’s hard work wearing a crown. The dermatologists have been dethroned as Medscape’s happiest specialty after years at the top. While studies only detail that we are the most satisfied outside of work, I argue we are the happiest working, too. With an N of 1, here are my 10 observations.

10 Things To Do in 2019

Resolutions are about the new and better you. Yet most people discard resolutions, largely because they are satisfied with the status quo or are afraid of change. Here's are some suggestions for being the best version of yourself in 2019.

Best of 2018: Rheumatology Dead Word Cemetery 2019

I recently heard of a secondary school assignment wherein students were challenged to “bury” a word that was no longer useful or appropriate. Their exercise has now evolved into an unofficial RheumNow task force to retire diagnostic terms that have grown into misuse in rheumatology and medicine. How did we decide which words should perish? And by what criteria? Who has the final say?

Best of 2018: 5 Mistakes When Diagnosing Adult-Onset Still’s Disease

Adult-onset Still's presents an interesting and diagnostic challenge when encountered. Here are 5 tips to improve your diagnostic acumen for this febrile disorder.

Best of 2018: The Millennial Doctor- Mighty or Mediocre?

A 3rd year medical student started his rotation with me this past week and the rotation was a challenge for us both.

Best of 2018: Dealing with Drug Reps - Dead or Alive

Several years ago, long before promotional lectures, I traveled for a series of lectures. I flew north for 4 days and 4 lectures, 2 at major university programs and 2 dinner lectures to local rheumatologists.

The first lecture went well but the weather turned bad, with a snow storm in the overnight forecast.  Hence my host, a local drug rep, suggested we drive at night to beat the snow and get to the next city for the 10 am University lecture the following morning.

The one-hour drive felt like a week in Cleveland. 

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