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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?

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.

Blueprints to the Clinical Research Underworld

“If you don't know what you want, you end up with a lot you don't.” ― Chuck Palahniuk, "Fight Club" 1999

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.

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: 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. 

Best of 2018: The Delayed Diagnosis of Spondyloarthritis

You see them from the corner of your eye, standing with a kyphosis in the waiting room. They are filling out their paperwork, standing up because sitting is just not pleasant. You are the rheumatologist with an  interest in ankylosing spondylitis (AS) and spondyloarthritis, so more likely than not, the patient with the bent spine is going to be your next new patient. In the back of your mind you are hoping that they are not so far along so that the therapy you may prescribe can make a difference in their life.

Advice for Young Rheumatologists

You may not want my advice, but I’m going to give it to you anyway. 

Pain: Objectifying a Subjective Symptom

My typically pleasant 76 year old male was livid when I walked into the exam room. He was pacing back and forth with furrowed eyebrows. I gingerly inquired what was bothering him the most.

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