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May 2021 - July 1883

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May 5, 2020, Vol 323, No. 17, Pages 1633-1733 | A Piece of My Mind

In This Issue of JAMA

Audio Highlights

Abstract Full Text
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JAMA. 2020;323(17):e200019. doi:10.1001/jama.2020.0019
A Piece of My Mind

The Changing of the Seasons

Abstract Full Text
JAMA. 2020;323(17):1653-1654. doi:10.1001/jama.2020.2746

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.

Doppelgänger

Abstract Full Text
JAMA. 2020;323(17):1655-1656. doi:10.1001/jama.2020.2748

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.

Miles Together

Abstract Full Text
JAMA. 2020;323(17):1657-1658. doi:10.1001/jama.2020.2749

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.

Of What Am I Afraid?

Abstract Full Text
JAMA. 2020;323(17):1659-1660. doi:10.1001/jama.2020.2751

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.

The Cost of Technology

Abstract Full Text
JAMA. 2020;323(17):1661-1662. doi:10.1001/jama.2020.2752

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.

To Isaiah

Abstract Full Text
JAMA. 2020;323(17):1663-1665. doi:10.1001/jama.2020.2754

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.

Learning to Talk

Abstract Full Text
JAMA. 2020;323(17):1666-1667. doi:10.1001/jama.2020.2757

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.

John Lennon’s Elbow

Abstract Full Text
JAMA. 2020;323(17):1668-1669. doi:10.1001/jama.2020.2759

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.

Patient’s Sister, Seeking Job

Abstract Full Text
JAMA. 2020;323(17):1670-1671. doi:10.1001/jama.2020.2761

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.

The Road Back to the Bedside

Abstract Full Text
JAMA. 2020;323(17):1672-1673. doi:10.1001/jama.2020.2764

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.

Crossing Boundaries—Violation or Obligation?

Abstract Full Text
JAMA. 2020;323(17):1674-1675. doi:10.1001/jama.2020.2853

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.

EBM’s Six Dangerous Words

Abstract Full Text
JAMA. 2020;323(17):1676-1677. doi:10.1001/jama.2020.2855

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.

What Would You Do, Doctor?

Abstract Full Text
JAMA. 2020;323(17):1678-1679. doi:10.1001/jama.2020.2858

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.

Pimping Socrates

Abstract Full Text
JAMA. 2020;323(17):1680-1681. doi:10.1001/jama.2020.2861

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.

The $50 000 Physical

Abstract Full Text
JAMA. 2020;323(17):1682-1683. doi:10.1001/jama.2020.2866

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.

The Nod

Abstract Full Text
JAMA. 2020;323(17):1684-1685. doi:10.1001/jama.2020.2868

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.

Whose Autonomy?

Abstract Full Text
JAMA. 2020;323(17):1686-1687. doi:10.1001/jama.2020.2873

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.

What Gets Measured Gets (Micro)managed

Abstract Full Text
JAMA. 2020;323(17):1688-1689. doi:10.1001/jama.2020.2878

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.

A Silent Curriculum

Abstract Full Text
JAMA. 2020;323(17):1690-1691. doi:10.1001/jama.2020.2879

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.

I’m Sorry

Abstract Full Text
JAMA. 2020;323(17):1692-1693. doi:10.1001/jama.2020.2882

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.

Story as Evidence, Evidence as Story

Abstract Full Text
JAMA. 2020;323(17):1694-1695. doi:10.1001/jama.2020.2968

In this narrative medicine essay, a physician describes the power of anecdotes and stories as tools for public communication, education, and advocacy.

The Greatest Generation

Abstract Full Text
JAMA. 2020;323(17):1696-1697. doi:10.1001/jama.2020.2972

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.

The Unreasonable Patient

Abstract Full Text
JAMA. 2020;323(17):1698-1699. doi:10.1001/jama.2020.2974

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.

My Name Is Not “Interpreter”

Abstract Full Text
JAMA. 2020;323(17):1700-1701. doi:10.1001/jama.2020.2976

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.

The Quick Physical Exam

Abstract Full Text
JAMA. 2020;323(17):1702-1703. doi:10.1001/jama.2020.2978

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.

Questioning a Taboo: Physicians’ Interruptions During Interactions With Patients

Abstract Full Text
JAMA. 2020;323(17):1704-1705. doi:10.1001/jama.2020.2980

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.

A Death in the Family

Abstract Full Text
JAMA. 2020;323(17):1706-1707. doi:10.1001/jama.2020.2982

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.

Moral Choices for Today’s Physician

Abstract Full Text
JAMA. 2020;323(17):1708-1709. doi:10.1001/jama.2020.2984

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.

I Am That Parent

Abstract Full Text
JAMA. 2020;323(17):1710-1711. doi:10.1001/jama.2020.2986

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.

I Solemnly Share

Abstract Full Text
JAMA. 2020;323(17):1712-1713. doi:10.1001/jama.2020.2988

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.

Mentoring in the Era of #MeToo

Abstract Full Text
JAMA. 2020;323(17):1714-1715. doi:10.1001/jama.2020.2990

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.

Mentoring Millennials

Abstract Full Text
JAMA. 2020;323(17):1716-1717. doi:10.1001/jama.2020.3085

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.

Advice for a Student Starting Medical School

Abstract Full Text
JAMA. 2020;323(17):1718-1719. doi:10.1001/jama.2020.3087

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.

Grief After Suicide

Abstract Full Text
JAMA. 2020;323(17):1720-1721. doi:10.1001/jama.2020.3089

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.

We Are All the Same

Abstract Full Text
JAMA. 2020;323(17):1722-1723. doi:10.1001/jama.2020.3091

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.

Full Circle

Abstract Full Text
JAMA. 2020;323(17):1724-1725. doi:10.1001/jama.2020.3093

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.

Systole and Diastole, Strength and Openness

Abstract Full Text
JAMA. 2020;323(17):1726-1727. doi:10.1001/jama.2020.3095

In this narrative medicine essay, a physician finds in the motion of diastole, the process of letting go and filling up, an apt metaphor for how to handle the burnout, anxiety, and depression of medical training.

Reflections on Leadership: Seizing and Embracing Opportunities—Holding up Half the Sky

Abstract Full Text
JAMA. 2020;323(17):1728-1729. doi:10.1001/jama.2020.3097

In this narrative medicine essay, a medical school dean talks about the reticence most women feel when considering leadership roles and urges women to work out of their comfort zones, seize diverse opportunities, and step into leadership roles.

The Sound of Silence—When There Are No Words

Abstract Full Text
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JAMA. 2020;323(17):1730-1731. doi:10.1001/jama.2020.3101

In this narrative medicine essay, a surgeon and palliative care physician describes the isolating silence that she felt her after the slaying of her father in Egypt when she was 18 years old and how that lingering silence has come to guide her when sitting with patients, when there are no words.

You Did Not Teach Me What You Thought You Did

Abstract Full Text
JAMA. 2020;323(17):1732-1733. doi:10.1001/jama.2020.3105

In this narrative medicine essay, a clinical educator uses her experiences enduring the aftermath of treatment for acute myeloid leukemia to reflect on the difference between physician-teachers and patients’ experience of illness and to locate meaning in what she can offer her colleagues and trainees despite persistent disability.

Editorial

Writing Medicine

Abstract Full Text
JAMA. 2020;323(17):1649-1650. doi:10.1001/jama.2020.1488

Forty Years of A Piece of My Mind

Abstract Full Text
JAMA. 2020;323(17):1651-1652. doi:10.1001/jama.2020.3760
Poetry and Medicine

My Friend Claims Her Second Round of Cancer

Abstract Full Text
JAMA. 2020;323(17):1638. doi:10.1001/jama.2020.0976

pasture

Abstract Full Text
JAMA. 2020;323(17):1640. doi:10.1001/jama.2020.2486
JAMA Revisited

For the Peace of Your Mind

Abstract Full Text
JAMA. 2020;323(17):1642. doi:10.1001/jama.2019.13422

A Piece of My Mind: Tuna on Rye, 1984

Abstract Full Text
JAMA. 2020;323(17):1642. doi:10.1001/jama.2020.3299

The Environment: People Pollution

Abstract Full Text
JAMA. 2020;323(17):1643. doi:10.1001/jama.2020.3300
JAMA Masthead

JAMA

Abstract Full Text
free access
JAMA. 2020;323(17):1633-1634. doi:10.1001/jama.2019.13415
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