My messages are simple: Mastery of the obvious; Reflective learning; Balancing optimism with realism; Plan for health; and this biggie: Stack together lots of small changes. Strive for small wins. They add up to big things. They are all here, plus some science. Dr. Mike Evans is a doctor, professor and creator extraordinaire. This is […]
A friend recently asked me why I am so hard on doctors. “You write a lot of negative stuff about us,” he said. That worries me. I am not a nihilist. I believe in what we do. I put doctoring decidedly in the noble category, right alongside teachers. In fact, my attachment to doctoring is […]
I made a discovery this week about the novel anticoagulant medications, dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Lixiana). I was looking into the often-asked question of how these new drugs compare to the old standard, warfarin. The discovery felt like a Eureka moment. I ran it by my stats guy–my son–and a couple […]
Some things are hard to see until one leaves his or her normal surroundings. For American doctors, especially procedure-based doctors, it’s easy to get used to the wastefulness and largesse of delivering care. Then you travel. You go to another healthcare system and are left to gasp. An AF ablation ‘costs’ 100,000 in the US, […]
Last night, Staci and I watched the award-wining documentary, The Waiting Room. Here is an intro from the website: The Waiting Room is a character-driven documentary film that uses extraordinary access to go behind the doors of an American public hospital struggling to care for a community of largely uninsured patients. The film – using […]
“We should be as demanding of ourselves as we are of those who challenge us.” Dr. Jerome Groopman, writing in the New Rupublic Writing about the medical decision-making surrounding vaccines proved to be sketchy. Yesterday’s post brought stinging criticism from both sides of the debate. A pediatrician felt the structure of the post was patronizing. […]
I’ve been thinking a lot about vaccines. As a learner, an observer of humans and our nature, a worshiper of the scientific method, a doctor, a new grandfather, and a member of society, few debates could be more compelling. The kerfuffle over vaccines has it all. It’s the Lance Armstrong story on steroids. (Grin.) The […]
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Thinking of Mom
Two years have passed since my mom died on Thanksgiving morning. The Mandrola children lived a blessed childhood, immersed in love and nurturing. A cocoon of normalcy, if you will. This morning, as I sit at the computer in the predawn stillness, I reread the post I wrote in the days after Mom died. I […]
I’m going to be proud for a moment. Yesterday, the journal JAMA-Internal Medicine published an invited commentary that I co-wrote with Dr. Dan Matlock (@Dan_Matlock) from the University of Colorado. The title of the piece is The Antidote for Unprepared Patients — A Caring Clinician. It’s available for free. Invited editorials in medical journals are often […]
Just a few weeks before the 2013 American Heart Association Sessions, Shelley Wood, the managing news editor of theheart.org emailed to ask if I was up for going to the meeting. With trips to San Francisco, Denver, Athens and Amsterdam already in the books this year, I had counted 2013 as a win. I was […]
Part one of Progress in Cardiology was a sober look at the current lull in innovation. In part 2, as promised, I tell you what is right and optimistic about my field. There is a lot. The post touches on the return of the basics. Basics in doctoring and basics in therapeutics are huge new […]