Hepatitis E
This JAMA Patient Page describes the symptoms, prevention, diagnosis, and treatment of hepatitis E. (Source: JAMA)
Source: JAMA - May 12, 2020 Category: General Medicine Source Type: research

Truth Machine
A colleague once called CT scanners truth machines, as if passing people through them could coax secrets out of the body and into the air of darkened reading rooms. (Source: JAMA)
Source: JAMA - May 12, 2020 Category: General Medicine Source Type: research

Cultivating Hope Through Advocacy, Love, and Resilience
In this narrative medicine essay, a pediatric psychiatrist relates how her younger sister with Down syndrome and congenital heart disease has lived well beyond expectation inspired her to help children cultivate hope through love and resilience. (Source: JAMA)
Source: JAMA - May 12, 2020 Category: General Medicine Source Type: research

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(Source: JAMA)
Source: JAMA - May 12, 2020 Category: General Medicine Source Type: research

Discovering Why Some Infants Have Delayed Hearing Loss Detection
Several socioeconomic factors were linked in a recent study with delayed hearing loss diagnoses in Minnesota infants. Launching initiatives to pinpoint these populations and identify infants with hearing loss more quickly could help reduce their risk of delayed speech and language development, the study ’s authors noted. (Source: JAMA)
Source: JAMA - May 12, 2020 Category: General Medicine Source Type: research

Despite Gains, Progress Toward TB Elimination Has Slowed
Although the US incidence of tuberculosis (TB) reached an all-time low in 2019, CDC researchers expressed concern in a recent report that the rate of decline has slowed in recent years. (Source: JAMA)
Source: JAMA - May 12, 2020 Category: General Medicine Source Type: research

Writing Medicine
My first glimpse into the craft of physician-writers did not come through Anton Chekhov, Walker Percy, or William Carlos Williams, whose works I only came to after medical school. As a schoolboy, I loved W. Somerset Maugham, although he never practiced medicine, and his craft had little to do with his medical degree. My introduction to physicians as writers came through my textbooks. Boyd ’s Pathology made me aware of literary voice, the ability of authors to place themselves in the text, let their personality come through, and subtly become a character in the reading experience. On the topic of defining the moment o...
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Forty Years of A Piece of My Mind
Forty years ago, in 1980, Jimmy Carter was president. Pac-Man debuted. In medicine, smallpox was declared to be eradicated. Additionally, on May 9, 1980, A Piece of My Mind was inaugurated in JAMA. The first essay, “Tuna on Rye, 1984,” was written by then–senior editor Samuel Vaisrub under the pen name Sam Vee. He introduced the column with an editorial entitled “For the Peace of Your Mind.” (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Audio Highlights
Listen to the JAMA Editor ’s Audio Summary for an overview and discussion of the important articles appearing in this week’s issue of JAMA. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

For the Peace of Your Mind
We hasten to assure our readers that a piece of my mind...is not intended as a sounding board for peevish gripes, nit-picking beefs, or sundry assortments of righteous indignation, which are usually prefaced by an angry “let me give you a piece of my mind.” Nor is this section of The Journal meant to be a podium for pompous preachments and ex cathedra pronouncements. Nor again is it designed to be a forum for half-baked speculations and warmed-over hypotheses. Least of all is a piece of my mind envisaged as a j amboree of jokes and a shivaree of limericks. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Tuna on Rye, 1984
“Your medical clearance, sir?” (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

The Environment: People Pollution
Meeting basic food and shelter needs of a growing population and catering to the insatiable consumer demands of people profoundly influences the quality of our environment. President Nixon observed that many of our present social problems may be related to the fact that we have had only 50 years in which to accommodate the second 100 million Americans. To provide for the increasing needs and demands of people, we are polluting our air, soil, and water. Unchecked population growth, people pollution, is not merely a problem, it is a paradox. It is an issue that is intimately private and yet inescapably public. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

My Friend Claims Her Second Round of Cancer
As my Italian father would say, since the house is burning      let us warm ourselves, and so (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

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with a weak smile the rabbi (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

The Changing of the Seasons
In this narrative medicine essay, a level-one trauma nurse compares Arizona ’s 2 seasons with the waning and the waxing of patient admissions and with the cycle of grief for loss of her mother and son, realizing how much their deaths have affected her nursing. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Doppelg änger—Parallel Struggles to Lose Weight
In this narrative medicine essay, a primary care physician describes his patient ’s struggle with obesity, sees himself in his patient, and wonders if his own struggles with weight loss impede his patient’s efforts to lose weight. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Miles Together —A Patient-Physician Journey
In this narrative medicine essay, a family physician shares the beginning and ending of a near 12-year journey with a patient, helping him reach sobriety that led to a full though short life and feeling humbled to have been so entrusted to travel with him. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Of What Am I Afraid? Plumbing the Depths
In this narrative medicine essay, a psychologist peels back the layers of her reticence and comes to terms with working with transgender patients as a member of LGBT community. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

The Cost of Technology —Patient-Centered Care
In this narrative medicine essay, a primary care physician describes a drawing by a 7-year-old patient who is sitting on an examination table with her mother cradling her baby sister with the physician ’s back to them entering data in the computer as an example of a system that is sacrificing human contact for electronics. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

To Isaiah, a Casualty of a Fractured System
In this narrative medicine essay, Donald M. Berwick shares the story of his patient Isaiah with the 2012 Harvard Medical School graduating class as an example of a patient who deserved the treatment that cured him of leukemia but whose life was lost to poverty and exhorts them to regard health care as human right that must be preserved in the clinic and in public. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Learning to Talk: Speaking the Language of Patients
In this narrative medicine essay, a resident physician recalls the joy she felt while learning the formal language of medicine as a student and anticipates the lifelong joy of learning to interpret that language in ways most helpful for her patients. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

John Lennon ’s Elbow: The Long, Winding Road of the EMR Progress Note
In this narrative medicine essay, an attending physician shares his observations of how the changing nature of electronic medical record (EMR) hospital progress notes —often entered out of sequence and becoming ever longer and more unreadable—can hamper interacting with patients and providing patient care. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Patient ’s Sister, Seeking Job: Toward More Patient-Centered Care
In this narrative medicine essay, the sister of a young man with Gardner syndrome reflects on the care her brother received over his nearly three decades of life and offers her observations on several things physicians and other members of health care teams can do to achieve true patient-centered care. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

The Road Back to the Bedside
In this narrative medicine essay, a group of physicians from an academic program in bedside medicine offer their observations on deficiencies in the assessment of US medical residents ’ clinical skills and suggest principles for enhancing the teaching and high-stakes assessment of these skills to improve diagnostic accuracy and achieve truly patient-centered care. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Crossing Boundaries —Violation or Obligation?
In this narrative medicine essay, a physician reflects on the rise of professional boundaries; on the ways in which such boundaries can in some instances foster uncaring patient-physician relationships; and on ways physicians might balance providing objective medical care and addressing social and economic injustices in the lives of their patients. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

EBM ’s Six Dangerous Words
In this narrative medicine essay, a physician shares his thoughts about how the phrase “there is no evidence to suggest,” commonly used in the medical literature, can lead to false inferences and suppression of clinical intuition, and suggests four alternative phrases for clarifying inferences and improving shared decision-making. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

What Would You Do, Doctor?
In this narrative medicine essay, an emergency medicine physician recalls an encounter early in her career when she was asked by parents to make a recommendation regarding ending life support for a young child, reflects on the way practice has changed from physician-centric to patient-involved decision-making, and discusses how her husband ’s pancreatic cancer diagnosis brought up a different perspective. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Pimping Socrates
In this narrative medicine essay, a medical student reflects on individualized teaching practices in medicine, such as “the Socratic method,” in the context of her intervening course work related to a PhD in ancient history. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

The $50  000 Physical
In this narrative medicine essay, a physician reflects on his father ’s experience, at the age of 85 years, of getting a physical examination from a new primary care physician that ended up setting off a cascade of examinations and treatments. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

The Nod
In this narrative medicine essay, an African American physician reflects on her experience one day with a white member of her ward team made up of two interns, three medical students, and a senior resident that sparked cultural and racial discussions throughout their month together that usually do not occur in such a diverse group. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Whose Autonomy?
In this narrative medicine essay, a physician reflects on an experience during his medical residency involving the family dynamics of a couple in an effort to treat the pain of the husband. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

What Gets Measured Gets (Micro)managed
In this narrative medicine essay, an attending physician reflects on the evolution of the role of the attending physician from a supervisor in the background to a micromanaging supervisor to ensure that the proper steps are followed to meet the quality metrics in place in the current health system. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

A Silent Curriculum
In this narrative medicine essay, a medical student reflects on the ways in which she has seen racism and implicit bias affect clinical practice and emphasizes the importance of examining and challenging these biases to address health inequalities. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

I ’m Sorry
In this narrative medicine essay, a physician recounts an error in which his patient received double the dose of a medication he prescribed, and what he learned from asking the patient for forgiveness. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Story as Evidence, Evidence as Story
In this narrative medicine essay, a physician describes the power of anecdotes and stories as tools for public communication, education, and advocacy. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

The Greatest Generation
In this narrative medicine essay, the author discusses the inaccuracies of generational stereotypes and unfounded criticisms about trainees, and the problems that faculty members who voice these criticisms can cause among physicians. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

The Unreasonable Patient
In this narrative medicine essay, the author describes his experience with a patient referred to as “unreasonable,” and what the experience taught him about the need for physicians to perhaps improve their communication skills with patients rather than jump to labelling them. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

My Name Is Not “Interpreter”
In this essay, the author relays his personal experience with ethnicity-based discrimination and discusses the “microaggressions” that medical trainees from underrepresented groups based on race/ethnicity, gender, or sexual orientation experience. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

The Quick Physical Exam
In this narrative medicine essay, a teaching physician uses the fictitious characters Holmes and Watson to dispell the belief held by many physicians —that a thorough physical examination is an unnecessary art of the past. His emphasis: taking time to gather data and observe can avoid unneeded tests and guide accurate diagnosis. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Questioning a Taboo
This narrative medicine essay summarizes ways in which physicians can use polite and scripted interruption to help patients effectively communicate their medical concerns, encourage further details, improve accuracy of the diagnosis, and set the agenda for the medical visit. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

A Death in the Family
In this narrative medicine essay, an anesthesia resident describes his feelings of loss and unease when a coresident is admitted as a patient and dies of an overdose of fentanyl; this article emphasizes the importance of prioritizing physician wellness programs to help avoid burnout and substance use disorder. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Moral Choices for Today ’s Physician
In this essay, Don Berwick considers moral choices physicians face personally, organizationally, and globally and exhorts them to understand that the health of humanity depends on their speaking out against the social injustice of overpricing drugs and services, mass incarceration, and the lack of environmental responsibility. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Physician-Parents Whose Children Have Rare Diseases
In this essay, a critical care pediatric hospitalist finds herself on the other side of the office table advocating for the specific medical care needed to address her son ’s rare skeletal dysplasia and her search for a pediatric specialist with whom to travel on this quest. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

A Medical Student Shares Her Struggle With Depression
In this essay, a young medical student describes her struggle with depression and how the experience of vulnerability has bred a deep compassion for her patients and peers. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Mentoring in the #MeToo Era
In this narrative essay, the author wonders what effect the #metoo phenomenon will have on mentoring between male mentors and junior female trainees and faculty and recalls male mentors who were supportive of her and other women colleagues ’ professional development in a plea for diversity and inclusion among leaders in medicine that supports the entire academic medical community. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

How to Mentor Millennials
In this narrative medical essay, the authors present 3 scenarios exemplifying the collision between mentoring expectations among millennials and older generation faculty and proposes strategies to bridge generational divides and engage the next generation of physicians. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Advice for Starting Medical School
In this narrative medical essay, an internist offers three basic lessons not taught in medical school that he learned about practicing medicine based on his experiences from a patient with whom he has built a trusting relationship over the years. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Grief After Suicide
In this narrative medicine essay, the author mourns the suicide of young adult of a friend and relives his brother ’s suicide 30 years earlier in a stream of consciousness montage of grief and advice to succor for those left behind. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Friendships Across Cultural Barriers —We Are All the Same
In this narrative medicine essay, a family practitioner tells the story of how her relationship with an old-order Mennonite woman whose newborn son she examined and took to the hospital for cardiac surgery one Christmas day turns to friendship and a relationship with her broader community when the woman stays with her during her newborn daughter ’s cardiac surgery. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research

Full Circle: How Medicine Enabled Avoidance and Acceptance
In this narrative medicine essay, a psychiatrist used her residency to avoid grieving the loss of her brother to suicide but through participation in a grief support group during training she began to thaw enough to remember her brother, watch videos of ephemeral moments like celebrating his fourth birthday, an act that allowed her to see him and her family again. (Source: JAMA)
Source: JAMA - May 5, 2020 Category: General Medicine Source Type: research