I spent most of my senior year in college in the basement of the science building, in a room the size of a closet, watching (and videotaping) fish having sex. I was studying pipefish, a relative of the seahorse in which the males get pregnant. I was interested in learning how this unusual quirk of evolution affected the sex roles of the fish, asking questions such as: which sex is more promiscuous, bigger, and more aggressive? Evolution was at the heart of my biology major, and its existence was palpable in every biology class I took—from Genetics sophomore year to a senior seminar on Ecology. It was clear during my undergraduate education that “nothing in biology makes sense except in the light of evolution.” Continue reading (R)evolutionary Rheumatology
Every few months I have the pleasure of teaming up with one of my fellows (and often a resident, and sometimes a medical student), to evaluate hospitalized patients with known or suspected rheumatic diseases as part of the inpatient consult service. This is quite a change from my typical day as a rheumatologist, where I see patients in an outpatient clinic.
On occasion, patients with known rheumatic diseases land in the hospital—the patient with lupus and worsening kidney disease, the patient with gout and a severe flare, the patient with vasculitis experiencing a relapse. At the same time, many patients are admitted for workup of unexplained symptoms—joint pain, fevers, rash—or develop these while being treated other conditions. For these patients, we are asked to evaluate for the presence of rheumatic diseases.
Having just finished covering the inpatient rheumatology consult service, I am reflecting on my week and have identified 15 factors that help you achieve a successful week. Continue reading Mastering the Inpatient Consult Service
Fevers are tough. They make you feel lousy. They cause worry. They prevent kids from attending school and adults from going to work.
This is video from a small-group teaching session that I led based on the case of a child with recurrent fevers. This case was done as part of my Rabkin Fellowship in Medical Education. I would appreciate your feedback on this teaching session!
This is my first video. Let me know what you think!