Some time ago, a young man came to see me in the office accompanied by his mother. I cannot recall a single detail of what led him to see me. But I remember very clearly a medical intervention that he had as an infant that bore no relevance to the forgotten reason for his visit. One of the tasks that physicians perform on patients we see is to review the past medical history (PMH). We do this to assemble a medical portrait of the individual who is before us. Oftentimes, the historical medical events are not directly relevant to the issues at hand. But often they are. For example, if a patient has been experiencing chest discomfort, and the PMH includes a heart bypass operation, the physician will be on heightened alert to consider a cardiac explanation. When I am reviewing the PMH, I do so in a routine manner, not really acknowledging how many of these items were major life experiences for the patient and his family. It’s likely t...
Editor’s Note: For 16 years, I've published weekly essays here on Blogspot, which will continue. I’ve now begun publishing my work on a new blogging platform, Substack, and I hope you’ll join me there. Please enter your email address at this link to receive my posts directly to your inbox. I have written about labor unions on the blog from time to time. I have lambasted the teachers unions , for example, for their self-serving positions during the Covid-19 pandemics. On the other hand, I have supported hospital nurses organizing as the power imbalance between them and their employers has stifled needed reform. And I have mused about employed physicians who are threatened with burnout and endless burdens seeking union protections. Earlier on the day that I penned this post, I read of a labor agreement between a dockworkers union and its employer. Fortunately, a strike was avoided. The agreement has yet to be formally ratified. ...