reflections on reflection

As I have written recently, I am working with the pediatric residents on enhancing professionalism in our practice of pediatrics. Part of this entails the process of reflecting upon situations or cases that exemplify issues which either pose a challenge to one of the pillars of professionalism, or have presented personal challenges in response to difficult situations.

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do you need a vacation?

Of course you do. Everyone does, at least occasionally.

I know that I certainly need one, and am delighted that I am about to start my one week “family” vacation.

A time to enjoy the grandkids, who live too far away for me to visit as much as I would like.

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what's the big deal about budget season?

Those of you who know me in person may have detected a bit of increased tension over the last few weeks. I find I am not as fun to be around as usual. I am probably scowling more than I am smiling. I have frequent headaches.

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a first step toward humanism

I have become rather obsessed lately with how to facilitate the development of professionalism in physicians.

Humanism is important in medical practice, and is included as a component in most definitions of medical professionalism. A healthcare practitioner who acts humanely thinks about the person under his or her care in a holistic manner, and behaves accordingly. Such a practitioner considers multiple perspectives and includes the patient and family in the decision-making process, identifies where the patient's perspectives might conflict with his own, or with societal norms and values, and finally acts in a way that puts the patient's perspectives and values first.

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the worst case

This is the first "story" in my intermittent ongoing series on child abuse, sometimes called "child maltreatment"  or "non-accidental trauma." I have found this one very difficult to write.

I have been working on it for over two weeks, although it has been begging to be written for over two decades.

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learning to walk

My babies were delivered the third week of June. They spent two weeks getting fed a variety of information, most of which they have probably already forgotten. Then, on Monday, July 2, they began their three-year journey toward becoming the world’s best pediatricians.

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my babies are coming

Well, you and I both know they aren't really babies, but they will feel like my children for the next three years--and probably for the rest of my life. Our first pediatric residents arrive on Monday, June 18.


They will spend two weeks getting oriented and acclimated to their new "home" and will start working as physicians on July 1 or 2. Today I received their blackberry numbers and their photos. They all have institutional email addresses. Most of them probably don't know this information yet. I am so excited I can barely contain myself.

I see this time as a "coming of age" of our pediatric program.

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I looked at my grandson and started to cry

I visited my grandchildren last weekend—and my daughter and son-in-law, too, of course. It’s hard living so far away, but I try to get there about once a month if the weather and the airlines cooperate. My newest grandson is a little over 3 months old, and he is kind of hefty—weighing in at 17 pounds, about the size of a typical 7 –9 month old. He is healthy and is obviously thriving on his diet of breast milk only. While I was sitting on the couch, holding him, talking with him, cuddling him and making him laugh, I started to cry. I was overcome with sadness. I was thinking about how much love this little guy receives now, and will for the foreseeable future, and at the same time, about how many children may never know love, kindness, or a full belly.

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my interview with Mike Wallace-part 2

Yes, it really did happen.

It was late spring of 1990, and Mike Wallace was headed to Baltimore and the University of Maryland Medical Center to interview me. Not JUST me, but me and several of my medical and surgical colleagues.

I wasn’t really all that scared, although in retrospect I should have been. He didn't seem all that bad.

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on excellence-an open letter to our incoming pediatric residents, and to graduating medical students everywhere

This is graduation season. I have given a number of graduation talks to residents beginning a new facet of their careers. I thought I would share parts of the last graduation speech I was invited to give to the finishing pediatric residents at the University of Maryland Medical System and School of Medicine, before I left there to start the newest facet of my career at Carilion Clinic Children’s Hospital. Excellence has been on my mind lately, as I contemplate the start of our new Pediatric residency. And so instead of waiting until they are going out into the world at large following their training with us, I would like to share my feelings about excellence as they get ready to start.

 Dear in-coming resident:

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