Newmans Notions
Quincke's legacy
It's all you ever wanted to know about hereditary angioedema but were afraid to ask.
Techie or Luddite?
Don't tell the robot overlords, but sometimes a book can be useful.
Baron
A miniature horse can have a large impact.
Parasites of the future
Thanks to environmental change and scientific experimentation, we could be in for some intriguing developments in parasites.
The rise and fall of the urine eosinophil
A resident teaches an attending something about high-value kidney assessment.
Zero-truth medical updates
Catch up on the latest imaginary medical news, from manic mannequins to microleeches.
The ACO SNF waiver
Learn how an accountable care organization (ACO) can help get your patient into a skilled nursing facility (SNF).
The palliative car consult
A conversation with an expert helps a family make a big decision.
Unlicensed
Small oversights can line up to cause a major problem.
Carminative
A little-known word and long-lasting snack from a long-ago physician.
Could you repeat that?
It was a very quiet day on the geriatrics service, at least for one physician.
Friction
The forces of physics can explain clinical and other functions of the hospital.
Audience archetypes
Two frequent conference speakers offer their taxonomy of attendees.
Hospital medicine, Brazilian style
Hospitalists describe how the growth of their field has made an impact on one country's health care system.
Huddle up
Hospital huddles are just the latest iteration in a long tradition.
Concrete thinking
An initial diagnosis of bilateral cellulitis leads to some digging and hard thinking.
Irony
An intern and an attending try to iron out a misunderstanding.
Hospitalist encounters of the third kind
A first-year medical student reflects on a week of hospital medicine.
How am I doing?
Our humor columnist imagines his online reviews.
Deep in the ticks of Texas
A young physician's job in the animal industry led to a new understanding of disease spread.
Thoracic Park
Get ready for the medical remakes of your favorite blockbuster movies.
SSSSS
Five Japanese terms and their alliterative English equivalents helped bring order to a hospital command center.
Trust your gut
Throughout history, medical researchers have taken some extreme steps to prove their theories.
Where's my patient?
Real-time location services are gaining traction as a tool for finding equipment and patients in the hospital.
A joint approach
A case study helps explain how to differentiate gout from pseudogout.
Me, my fridge, and I
We take refrigeration for granted, but a geriatric fridge plays an important (and humorous) role in one physician's work from home.
Home is where the hospital is
Learn how the hospital and the home are the same but different.
Archaic
Take this quiz and see how well you understand terms that predate the precursor to ICD.
The ward of Damocles
Our narrator encounters Dr. Cicero and Dr. Dan O’Klees.
The pedi essay, or how I learned to PDSA
Plan, Do, Study, Act. Kind of catchy.
The Intergalactic Hospital for Malfunctioning Mechanicals
Since the hospital's inception, no mechanical beings have passed the rigorous entrance examination to practice there.
The epic of Narcissus
A medical miracle becomes a medical student in an updated fable for hospitalists.
De-Mentored
Learn how not to mentor.
Cytokine storm
Cytokine storm is poetic for a medical term.
Feeling shifty
There are so many shifts: left, antigenic, night, phase, and more.
Lucky doc
When you think you're lucky, is it just the post hoc ergo propter hoc fallacy?
ZZZooming
Administrative life is about committing to committees and moving from boardroom to bedroom lately.
The face mask of the red death
A tale of plague and class suits this Halloween.
Little Red Stethoscope and other tales
Read some hospitalist fables for the modern era.
Spidey sense
A well-developed spidey sense is a valuable tool for hospitalists.
An uphill battle
Envisioning the future of the pandemic was difficult at the end of March.
The seven deadly hospitalist sins
Avoid these sins and aspire to the virtues instead.
Monitored
A hospitalist encounters a new efficiency system.
Administrative archetypes
Learn how some C-suite regulars will handle the latest committee concept.
The violent Vorg
Working in a hospital on a space station, you meet all types of patients.
Scorecard
Sometimes it's hard to really know how you are doing, as a clinician or an organization.
The Hospital Game Show Network
Get ready to compete.
The Phantom of the Operation, and other tales from the crypt-ococcus
Catch up on the horrors of hospital medicine.
Uncharted
The despair of administrative backlog has changed but not disappeared.
A berth on the Tsukuba
Understanding beriberi took research around the world over centuries.
Fighting the Speckled Monster
Vaccination has been an issue for a very long time.
Selection bias
An old doc gives a new model of practice a try.
A hospitalist primer
Learn hospital medicine from A to Z.
The suite spot
Some hospital administration acronyms are explained.
Deleted
A resident discovers a very special hospital computer.
The hostile hospitalist
Dr. Oscar Adversum is not happy about anything, but especially not the night shift.
Little plastic Santa
Dr. Newman tells a heartwarming (and true) holiday story.
Giving thanks
Colleagues, mentors, electronic records, and readers all make Dr. Newman grateful this month.
The ID of Dorian Gray: A tale of medical horror
The picture showed a bright-eyed, earnest young healer.
The transgender inpatient
Transgender and gender-nonbinary people face significant barriers to gender-affirming and high-quality health care.
On Her Majesty's hospital service
Read about the health care adventures of Spond, Dr. Jane Spond, pager number 00007.
Catastrophization
It seemed like the end of the world was coming and everything was out of control. Was it a collective Chicken Little moment? Or was the sky really falling?
Readmission impossible
A dedicated team strives to keep a complex patient out of the hospital.
A digestible problem
A young physician remembers army surgeon Dr. William Beaumont, his patient Alexis St. Martin, and the study of gastric secretions.
Rounding with the Bard
Shakespeare's words apply to hospital medicine, a fictional physician finds.
The antisesquipedalianist
An intern encounters a patient with something to say.
Monkey medicine
You may feel like you've entered a zoo and your ward has become the primate house, so here are the terms you will need to be a successful hominid hospitalist.
Morbid fascination
Obesity is only one of many conditions that could be called morbid.
The Royal Infirmary of Edinburgh
A look at admission and discharge in 1780.
Is there a doctor on board?
I heard the words you never want to hear on a plane, especially over the middle of an ocean: “Is there a doctor on board?”
Oh, what a night: The hospital playlist #2
Some songs to get through a tough night shift.
Canine colloquialisms
These will help anyone who works in the hospital get to the head of the pack.
Byzantine
Whether it's ancient Persian credentialing, colonial American utilization review, or medieval admission criteria, the things that drive us mad today did the same to our distant medical forbearers.
Ignaz and Cassandra
Two voices called out warnings, but they fell on deaf ears.
Strategy by the sea
The columnists question if this strategy will hold water.
Dumb luck
Rounds went very smoothly, until we got to Mr. Fibonacci.
The internet of things to come
Technology isn't always as helpful as it seems.
Notes from the field: Hospital medicine in Japan
In Japan, hospital medicine may help to resolve several pressing issues, the biggest being the aging population.
Initial assessment
When you've spent as much time in a hospital as I have over the years, you tend to develop a sixth sense as to when something isn't quite right.
Hospital Servi-Sisyphus
It was that kind of morning: hypertensive patients who couldn't pay for their meds and little old ladies, sweet and otherwise, who kept on falling.
Discharge meds
A patient's request presents an ethical dilemma.
A newfangled column
The first stethoscope was created with a rolled-up sheaf of papers in 1816.
Physician biomarkers
Astounding differences have been found in the gene expression of the various archetypes of physicians haunting hospital halls.
Elevator pitch
A good pitch must be concise and clear, engaging and persuasive, well-rehearsed and actionable, and less than 30 seconds long.
Colica Pictonum
Ancient Rome and Flint, Mich., share a connection.
Little's Law and you
To understand what's really happening in your hospital, you need to consider Little's Law.
Notes from the field: Hospital medicine in India
Last December, speakers from several countries joined their colleagues in Kochi, India, to discuss clinical administrative, and education issues during a multi-day conference.
Armadillo exposure, subsequent encounter
If there is no code for it in ICD-10, there is no way I could have an armadillo-related disease.
Apophenia
There is a black cloud hanging over your head; the universe is out to get you.
Sedimentation
One of the first descriptions of the erythrocyte sedimentation rate is detailed in a book by British surgeon and anatomist John Hunter.
The little brown bottle
The first documented recommendation of nitroglycerin for angina pectoris was described by Dr. William Murrell in 1877.
Magnificent maggots
Sometimes the best treatment plan can include an effective and simple intervention of antiquity.
Morpheus
For thousands of years, ancient civilizations in Asia Minor have been cultivating the opium poppy.
Choosing unwisely
A fictionalized ED visit for a simple cut spins wildly out of control.
Committee life
Members of a hospital committee see each other in very different ways.
Almost a 5-star column
The “Great Satisfaction Madness” of 2027 is over.
House of Cards-iology
Hospital administration can sometimes be ruthless.
Pott-y language
Tuberculosis with spinal involvement is often referred to as Pott's disease.
Quattro formaggi
Working in the hospital can be a cheesy experience.
The lost cohort
A fictional class for an MHA leads to some literal wayfinding.
Newman's handy-dandy recommendation letter
A tongue-in-cheek template for handling recommendation requests.
The case of the undulant ungulate
A graduate student discovers the dangers of gourmet roadkill.
Simulation and reality
The author recounts his mother's career as a simulated patient.
Dusty grapes
When planning a conference, you can't please everyone.
The chairman of the bored
An adventure in hospital committee participation.
Aphorism-based medicine
Analyzing medical truisms can help us understand how medicine has progressed over time.
High efficiency
A fictional tale about the need to balance speed with thoughtfulness.
Vital signs are vital: Pain
The newest vital sign has old roots.
Vital signs are vital: The history of respiration
Stop... and take a breath
Vital signs are vital: The history of pulse oximetry
It will likely surprise younger physicians to know that the modern pulse oximeter was not invented until the early 1970s and did not become commercially available until the 1980s.
Vital signs are vital: Sphygmology
There is much more to checking a pulse than noting its presence or absence.
Vital signs are vital: Focus on fever
Human body temperature must rank as one of the earliest "vital signs" recognized by our ancestors.
Vital signs are vital: Focus on blood pressure
Focus on blood pressure.
Vital signs are vital
Introducing a new series that highlights the importance of vital signs.
The new observation status
Here's the lowdown on the good, the bad and the ugly of the new CMS regulations.
Eponymous chest pain
A hectic day is made worse by a know-it-all fellow.
The unusual occurrences in room 687
An earnest young doctor finds himself practicing medicine in a whole other dimension.
Quincke's legacy
This nineteenth-century physician described angioedema, invented diagnostic lumbar puncture and described a sign of aortic insufficiency, but was still rejected for a Nobel Prize.
Dungeons and doctors
A new way to teach students is modeled after a popular game.
How to stay safe
Safety--in the hospital and in life--is about more than following prescribed systems.
A palette of patients
When in the throes of illness, a patient can project one of a wide range of hues.
Yiddish for hospitalists
After our Latin primer for hospitalists, it only seems right to explore another language that's likely to be of great help.
Pimp my service
I should have been more nervous. Everyone else on the service was.
A looney tenens
This month's column presents a fictional look at a very cartoonish hospital.
The one that got away
I was ready to reel in the diagnosis I was fishing for, only to feel it swim away on an emetic river of blood.
The center of your universe
You start your morning rounds. You will spend the next 12 hours here. This is your world. And you are the center of it.
Get 'er done
A fictional doctor embarks on a quest to place a dialysis catheter.
Food for thought
Take a humorous look at a fictional doctor's quest to get some food during a busy day.
Latin for hospitalists
Here are the top 10 useful Latin phrases for hospitalists for 2012.
Quality time
What would happen if quality measures were applied to your personal life?
The Hospital-List
These 10 hospitals have a huge amount of historical significance.
Generic discharge summary
What's lost in accuracy will be more than compensated with personal time saved.
Rounds in motion
Our goal was to round with precision, though it was more likely we would meander due to the effects of Brownian motion, bouncing randomly around the hospital, starting at one point and ending up somewhere else.
In like Flint
The Austin Flint murmur was named for a physician who disliked eponyms.
The apocalyptic hospitalist
A PubMed search for the phrase “end of the world” had no matches, so we must make certain assumptions in this report.
Groundhog shift
I'd seen that movie. Could it really be happening to me?
Food for thought
A Thanksgiving meal develops disturbing medical connotations.
A jolly old locums
A locums assignment in a northern region leads to an unusual patient.
Life is sweet: An extremely brief history of diabetes
One thousand years before Hippocrates, healers knew that the passing of too much urine was a bad sign.
The wisdom of teens
Our editorial advisor learns a thing or two about diagnosis from an unusual source: his teenage son.
Top 10 reasons not to discharge your patient
Our editorial advisor examines length of stay.
August 1865
An important transition occurred in medicine nearly 250 years ago.
First call: 1985
Our editorial advisor remembers his first night on call.
Dressed to kill
A doctor's elegant attire causes trouble in more ways than one.
Hospital failure
Like a conscientious physician, hospitalists must play doctor to their own facilities.
Stair wars
I came to an agreement with the medical students on service with me: We would spend our week "elevator-free."
A day in the life: The hospital playlist
A typical hospitalist's day if set to music would go a little something like this.
Safety first
I know I need to get up and get started, get my children ready for school... and I have an early morning meeting to which I just can't be late.
The fantasy hospitalist league
What if there were a fantasy league for hospitalists?
A lesson in serendipity
Sometimes after a hard morning of rounding, I hide in my office and distract myself by reading a tome from the past.
Day of the undead: The zombie intern
I didn't think my fellow first-years were really worried about my consuming them, but you never know about the strange prejudices of the living.
Arsenic and Olds Lake
Could this patient have arsenic poisoning?
Hospital medicine in Chile
The international hospitalist movement continues to grow, especially in South America.
That smell
Certain diseases have characteristic odors.
Hospital medicine in Portugal
Our editorial advisor reports from the 16th National Portuguese Congress of Internal Medicine.
Iatrogenica
A chance encounter with an old friend leads our editorial advisor to reminisce about patients past.
Heroic measures
A locum tenens has a strange experience at a new hospital.
Ruppy: Teaching old dogs new tricks
By focusing on teamwork, communication, and strong relationships, successful collaboration between clinicians and other providers can be achieved.
The fascinating foxglove
We were rounding on the hospital service when one of our patients, already hypotensive, went into atrial fibrillation. The most appropriate drug wound up being one with a long and illustrious history.
Write it up
The source of my tension on this particular day was Karin, the incredibly intense fourth-year medical student rounding with me.
Going up, please
Every morning, our team faced the same difficult decision: going up the stairs or getting on the elevator.
The write stuff
Have you ever been given a prescription from your physician that was completely illegible?
Fight the noise
We all know the difficulty in functioning within a noisy hospital. But in hospitals we don't always have the option of suggesting that we move our discussion to a quiet coffee shop instead. Noise pollution in hospitals is an issue that confronts us all as hospital workers.
Locum terror
Here I was pulling into the staff parking lot of a funky old private sanitarium in the middle of stinking nowhere. I rang the bell and the creaky door swung open. A very pale and dusty nurse pointed to the staff lounge, but said nothing, though I seemed to detect the ghost of a smile.
A tick's tale
People have always been fascinated by medical comedies, medical dramas and medical reality shows. One of the most interesting of the current crop has to be "House, M.D." -- not because it is the most believable, but because it is by far the most inaccurate.
Hooked on mnemonics
Memory is elusive (and of course, it "lights the corners of my mind" -- or at least Barbra Streisand's mind). That's why there are so many tricks to remembering things, like acronyms, acrostics, rhyming keys, the image-name technique and the keyword method.
A leap forward
Life was fairly dull on Ganymede-13. I sat in my small bungalow on the edge of a vast forest of genetically engineered bamboo, looking at several foot-long segments of the plant.
Lunch with Lynch
Lunch with a former residency director leads to reflections on a career in medicine.
A very brief history of credentialing
While many may think of it as a modern concept, credentialing has been a part of physicians' careers since long before the Middle Ages.
Colombia, the new kid on the hospital medicine block
Hospitalists continue to gain exposure and acceptance in the U.S. as well as in other parts of the world, including Australia, Europe and Brazil. We are very excited that now the vibrant Andean country of Colombia is jumping on board.
Work hour limits: No gain without pain
Nobody would want their child riding on an icy road at 70 miles per hour in a school bus driven by someone whose head keeps nodding. Similarly, who would want to be cared for by a physician who is so fatigued he can’t remember the difference between the cranium and the cremaster?
Safety versus dignity: A balancing act
In the hospital, privacy is a scarce commodity often sacrificed in return for patient safety or our own convenience.
Just for the record
A computer crash prompts reflection on EHRs.
The final page
Medical editor Jamie S. Newman, FACP, remembers his first pager, and his next, and then wearing three at once....
The hospitalized hospitalist
Jamie S. Newman, FACP, recalls (somewhat fuzzily) his hip transplant.
The House of God revisited
Jamie S. Newman, FACP, offers a hospitalist's perspective on a classic book.