Tag: difficult patients

Michael James (2 Posts)

Contributing Writer

CUNY School of Medicine


Michael is a medical student at the Sophie Davis/CUNY School of Medicine in New York City, a seven-year combined BS/MD program in New York City, Class of 2026. In 2022, he graduated from the City College of New York with a Bachelor's of Science in biomedical sciences. He enjoys playing billiards and the classical guitar in his free time. After graduating medical school, Michael is interested in a career in vascular or cerebrovascular surgery. His research interests include regenerative medicine, medical education and medical technology.




A Patient in Denial: Is the System at Fault?

I’ve come to realize having an automatic word filter is one of my greatest blessings. It becomes quite useful when, in the middle of rounds, a patient’s single, monosyllabic response inspires such a flurry of mismatched curse words that only a properly formed filter can save my dignity. What exactly did this patient say that stunned me so violently? My attending had asked him a straightforward, albeit grim, question. “Do you know you have cancer?” …

And She’s Back: An Honest Reflection about Frequent Fliers in our Emergency Departments

The only thing different was the room number and the day of the week. “Hey, our favorite flyer is back,” said my attending as I went to see the patient in room 10 for the first time in my life. The patient was already doomed as I became jaded, cynical and wondered what the health care system or we as physicians could do with patients like this. Let’s be clear, I still had never met …

In Their Shoes

I met a resident who advocated that all medical students should become patients and have the same procedures that they order for their patients performed on them à la the movie “The Doctor.” While I agree that being a patient offers perspective, I don’t agree that I need to have tertiary syphilis to understand how to interact with a patient facing the illness. We act as health care providers and now view the world in …

Don’t Judge a Book by Its Cover: A Complex Twist in a Patient with Diabetic Ketoacidosis

Here was a 45-year-old Type 1 diabetic who presented to the emergency department in a near coma with diabetic ketoacidosis. The diagnosis seemed clear as day, with some of the classic presenting signs: polyuria, polydipsia, hyperglycemia, high anion gap, low serum bicarbonate and presence of ketones in the urine. She was admitted and treated appropriately. Once she was stabilized, the human interaction and history-taking began, which proved to be far more convoluted. She thoroughly explained …

A Taste of Your Own Medicine

I remember when I was young, my parents told me they wished to be a kid again. Now I understand why. Do you miss the days when your only task was reading one of Aesop’s Fables? I do. Do you remember “The Cobbler Turned Doctor?” If not, I’ll refresh your memory. It’s about an unsuccessful cobbler who decided to move to another town where no one knew him so he could work as a doctor …

Friend or Foe?

A patient with a past medical history of hypertension and IV drug use (IVDU) presents to the ED. He reports a one month history of neck pain. He denies any trauma. He also reports having upper extremity weakness for two weeks. He denies any previous episodes like this. He denies any fevers or chills. He reports an IV drug history for a number of years and reports that his last heroin injection was two days …

Donald Brown Donald Brown (1 Posts)

Contributing Writer Emeritus

Wayne State University School of Medicine


Donald Brown has a bachelor's in biology and pre-medicine from Xavier University of Louisiana and is currently a Class of 2013 medical student at Wayne State University School of Medicine. He is on the executive board for the Aesculapian Honor Society which recognizes students who are greatly involved in community service and is an active member in the Gold Humanism Honor Society. He plans to pursue a career in psychiatry, and in his free time he enjoys watching and playing trivia and board games, hanging out with friends, and playing basketball and football.