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C L O S L E R
Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative
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Creative Arts in Medicine
Connecting with Patients
Passion in the Medical Profession
Lifelong Learning in Clinical Excellence
Topic Search
November 10, 2023 | 2 min read

Final journeys

By Elizabeth Gundersen, MD, University of Colorado

Today, we remember patients who have served our country. We are grateful for the honor and privilege of caring for these veterans through their final journeys.

April 6, 2023 | 1 min read

Finding Parallels

By Mattea Miller, medical student, Johns Hopkins Medicine

When deciding on a specialty in medical school, I looked for similarities between my passion for pottery and an area of expertise. I hope this helps me to connect more deeply with my work and find fulfillment in medicine.

Encourage caregivers to get support.

September 8, 2021 | 2 min read

How to Mitigate Caregiver Burnout

By Simone Lescott, MD, Johns Hopkins Medicine

Caring for a loved one can be emotionally exhausting. Remind caregivers to prioritize self-care and encourage them to seek support from others.

June 1, 2023 | 3 min read

Meditations For Pride Month

By Hailey Haffey, PhD, University of Utah

LGBTQ2S+ Pride Month can provide us with a time not only to celebrate but also to reflect on questions related to shame and alliances in medicine. 

May 10, 2022 | 2 min read

Supporting Underrepresented Trainees

By Vivian Altiery De Jesus, MD, MBE, Johns Hopkins Medicine

When witnessing racism, we must support those affected to foster an environment of safety and respect.

July 7, 2022 | 1 min read

Filial Affection

By Corliss Wong, MS4, The University of Hong Kong

We must listen closely to patients with dementia’s thoughts and feelings, even though their sense of reality may be different than our own.

"Imperial Purple," by Spencer Finch. Photo copyright with the authors.

July 20, 2020 | 6 min read

Art and Connection During COVID-19

By Kamna Balhara, MD, Johns Hopkins Medicine, Sarah Clever, MD, Johns Hopkins Medicine

In a time of physical distancing, stepping out of our comfort zone to find creative and unconventional ways to connect with patients and colleagues can bring us together.

April 4, 2023 | 1 min read

Insurance Denial Fatigue

By Justin McArthur, MBBS, MPH, Johns Hopkins Medicine

After spending hours with patients deciding what tests or treatments are most appropriate, guess how many seconds it takes for an insurance doctor to reject the claim? 

September 7, 2022 | 2 min read

“Hysteria”

By Tina Zhang, MD, Johns Hopkins Medicine

We need to be aware of our own gender biases that could adversely affect women. To combat this, engage in shared decision-making with patients and be a lifelong learner of female health topics.   

January 23, 2024 | 1 min read

Book review of “The algorithm will see you now”

By Joan Naidorf, DO

In this medical thriller set in the not-too-distant future, diagnosis and treatment are performed entirely by AI. The novel serves as a reminder that AI must be used thoughtfully and responsibly.  

August 1, 2019 | 3 min read

Mindset and the Power of Yet: A Conversation With Dr. Gurpreet Dhaliwal

Excellent clinicians are also thoughtful mentors. Mentors are like beacons as we navigate our path forward.

November 13, 2025 | 2 min read

Cognitive shuffle 

For patients with insomnia, coach them to visualize vivid, unrelated images to disrupt rumination and promote sleep onset. You can try it yourself, too! 

March 17, 2025 | 7 min read

Caring and uncaring in medicine and beyond 

By David Kopacz, MD, University of Washington

Every moment in medicine, and in life, we have the choice to base our actions in caring.  

September 4, 2025 | 2 min read

To comfort always 

Providing compassionate companionship to patients can be as healing as any medicine when a cure is no longer possible. 

The stunning Mona "Moe" Driggs at the Boston Harbor Hotel, October 2010. Author's family photo.

November 21, 2019 | 2 min read

The Chosen One

By Ryan Chippendale, MD, Boston University School of Medicine

As a geriatrician, it was still difficult to facilitate compasstionate patient-centered end-of-life care for my grandmother. Honoring patients' goals of care can be challenging when we are intimately invested.

January 5, 2019 | 2 min read

Acceptance

By Neda Gould, PhD, Johns Hopkins Medicine

When we practice acceptance in the present moment, we free up energy to see more possibilities. We may notice some clarity in our minds and even less tension in the body. There is freedom in acceptance.

April 2, 2019 | 5 min read

Connecting to Historical Roots

By Lee Akst, MD, Johns Hopkins University School of Medicine

There are a number of important physicians in history, and an appreciation of our past can further our quest for clinical excellence in the present.

September 8, 2020 | 1 min read

10 Ways to Cultivate Well-being During The Pandemic

It's important to make an effort to improve your sense of well-being to help prevent burnout, especially during the strain of the pandemic.

An example of a trompe l’oeil in a geriatric hospital setting. Copyright by the author.

January 27, 2020 | 3 min read

Ethical Dilemmas in Dementia Care Design

By Diana Anderson, MD, MArch, Clincial Geriatrics Fellow, University of California, San Francisco

Innovative dementia care designs raise moral questions about whether deception of patients is ever ethical. The clinically excellent physician tries to avoid deception at all costs.

December 19, 2022 | 2 min read

Female Leaders in Surgery

By Ming-Hsien Wang, MD, Johns Hopkins Medicine

More women surgeons will increase the diversity of ideas and perspectives needed for excellent patient care. 

March 2, 2022 | 1 min read

Redefining Success

By Jennifer Eitingon, MD, Johns Hopkins Medicine

My patient on palliative radiation died in the hospital, instead of at home as she wanted. I was reminded that we must always create a treatment plan based on the patient’s goals instead of our own. 

June 21, 2022 | 2 min read

“Can’t you put him down?”

By Ivor Berkowitz, MBBCh, MBA, Johns Hopkins Medicine

Medical decision making for critically ill patients is complicated and difficult for everyone involved. It is our responsibility to ensure that patients and families are adequately informed to make choices that align with their values.   

"Dreamscape." Painting by the author.

September 30, 2024 | <1 min read

Approaching the horizon 

By Jessica Berry, PhD, clinical psychologist

My painting, “Dreamscape,” represents the importance of acknowledging and addressing patients' feelings about aging and mortality.  

February 7, 2024 | 2 min read

Vacations: a “how-to” guide 

Vacations have been shown to reduce burnout, but sometimes it can feel hard to take time off. Blocking vacation time at the start of the year and getting coverage in place early may help. 

November 7, 2018 | 3 min read

How to Reduce Caregiver Burden

By Jessica Colburn, MD, Johns Hopkins University School of Medicine

Healthcare providers have the ability to provide support, connection, and resources that can help to reduce caregiver burden and increase caregiver joy.

August 24, 2021 | 2 min read

5 Lessons From my Nonlinear Career in Medicine

By Thelben Mullett, MD, Seattle, Washington

Instead of asking medical students what specialty they intend to pursue, we should help them reflect on their natural strengths and values in planning their career.

August 15, 2022 | 2 min read

Role Modeling Vulnerability

By Daniel Saddawi-Konefka, MD, MBA, Massachusetts General Hospital

When a patient dies, sharing your emotions with trainees normalizes this response and highlights our shared humanity.  

February 9, 2023 | 1 min read

Firearm Safe Storage

By Katherine Hoops, MD, Johns Hopkins Medicine

Child access prevention laws and safe storage of firearms prevent injuries. We must advocate for stronger safety laws to prevent the death of children in our communities. 

Serena Williams playing mixed doubles at Wimbledon, 2019. Public domain, Wikipedia. Photo by Brian Minkoff, London Pixels.

June 24, 2020 | 1 min read

3 Things You Can do to Fight Racism

By Christle Nwora, MD, Johns Hopkins Medicine

We must each take personal responsibility for educating ourselves about racism. Increasing our understanding will allow us to improve health outcomes for all of our patients.

June 18, 2025 | 1 min read

Lewy-body diary 

This poem describes the profound loss of autonomy experienced by patients with dementia. It’s a call to truly see the person grappling with the reality of their diminishing faculties. 

December 8, 2021 | 2 min read

Hitting Home Runs in Healthcare

By Colin West, MD, PhD, Mayo Clinic

Clinicians often struggle with errors and imposter syndrome. Just like in sports, coaching helps clinical performance and promotes well-being.

July 22, 2020 | 4 min read

Virtue Ethics

By Awais Aftab, MD, Case Western Reserve University

Virtue ethics emphasizes the importance of self-knowledge and can help us to understand our patients in the context of the totality of their whole lives.

August 11, 2025 | 5 min read

The push, the pull, and the leap 

Major career transitions can bring up complex emotions; reflection can guide you toward choices that honor your values. Embrace these changes as opportunities to rediscover purpose and help you better care for patients. 

May 26, 2020 | 1 min read

Accelerating Adaptation in Healthcare

By Lia Logio, MD, Drexel University College of Medicine

Efficiency erodes our ability to respond to the uncertainty of life. The messy world of clinical care requires time, patience, and creative experimentation.

May 3, 2023 | 1 min read

Love And Loss

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When a patient is unresponsive, loved ones may have differing ideas about the patient’s condition. We can hold these contradictions with compassion and see them as expressions of love.

December 14, 2023 | 2 min read

Listening for meaning

By Ben Roberts, CRNP, AGACNP-BC, ACHPN, Johns Hopkins Medicine

In my palliative care career, I’ve learned that aligning care with patient goals is one of the most important parts of clinical excellence. To do this, I listen to truly understand what the patient wants. 

February 24, 2018 | 1 min read

Battling The System in Defense of Diagnosis

By Souvik Chatterjee, MD, Johns Hopkins Medicine

Healthcare delivery is at odds with a fundamental aspect of being a physician—strategic curriculum interventions are necessary to preserve the art of diagnosis.

October 5, 2022 | 2 min read

Long Drives, Slow Thinking

By Margot Kelly-Hedrick, MD, University of Washington

I no longer think of my long commute as “wasted” time. Spending it reflecting on the lives of my patients has reignited my passion for medicine.

July 18, 2024 | 2 min read

The French secret 

By Alisha Dziarski, MS, Johns Hopkins Medicine

Clinicians might consider recommending interactive recreational activities to some patients rather than non-specific exercise guidelines. These endeavors provide exercise, community, and social interaction all in one. 

October 27, 2025 | 1 min read

Confounding malaise

Lead with trauma-informed, dignity-first care: clarify the patient’s priorities and take the time to build a trusting relationship.

August 1, 2022 | 1 min read

Keeping Children Safe

By Katherine Hoops, MD, Johns Hopkins Medicine, Monique Burke, MD, President, MD Chapter of the AAP

The new Safer Communities Act helps clinicians connect patients to mental healthcare. Hopefully, this will reduce youth gun violence, including suicide. 

The author and her husband dancing to live music at their wedding. Photo courtesy of the author.

June 25, 2019 | 3 min read

The Shared Experience

By Mariah Robertson, MD, Johns Hopkins Medicine

Part of my history-taking in the future will include a music history to better understand the role music plays in my patient’s day-to-day lives. I am hopeful that this added information about them will strengthen our connection and understanding of one another as humans.

August 22, 2018 | <1 min read

Dr. Goldstein: A CLOSLER Look

By Gretchen Miller, Managing Editor

Check out our 4-minute YouTube interview with pediatric emergency physician Dr. Mitchell Goldstein, who shares how he's guided by the Golden Rule.

December 27, 2018 | 2 min read

“Charm City” Movie Review

The upcoming film "Charm City" emphasizes that the struggles of each patient who comes to clinic extend far beyond a medical diagnosis. We must be conscious of our patients' many challenges and mindful to address them. Making time to ask about your patient's day-to-day concerns, worries, and fears about their homes, neighborhoods, and communities can help you to get a fuller perspective of their medical and social determinants of health. This will allow you to reach relevant goals of care together.

February 25, 2018 | 1 min read

Diagnostic Excellence Starts With an Incessant Watch

By Reza Manesh, MD, Johns Hopkins University School of Medicine

Feedback is the key to improvement of any craft. No one is born an expert. It is earned through deliberate practice and an incessant thirst for progress.

August 29, 2019 | 2 min read

Mindful Doctoring in the EHR Era

By Irene Estores, MD, University of Florida College of Medicine

Mindfulness is essential in clinical excellence. Consider these five tips while working with the EHR.

April 21, 2023 | 2 min read

There’s No AI in Touch

By Drea Burbank, MD, Putumayo, Colombia

Sometimes innovations can make our jobs easier. Rather than competing with AI, embracing it thoughtfully can allow us to spend more time connecting with patients.   

"Sun Rise," by David Kopacz.

August 8, 2019 | 2 min read

The Circle of Re-Humanizing Medicine

By David Kopacz, MD, University of Washington

We need human-based medicine in conjunction with evidence-based medicine. If we only identify as scientists and not as healers, we risk dehumanizing our patients and ourselves.

October 22, 2019 | 2 min read

The Color of my Skin

By Kimberly Turner, MD, Johns Hopkins Community Physicians

With mentorship, advocacy, and open-mindedness by all, it is hoped that there will be greater diversity within the healthcare workforce.

January 19, 2023 | 2 min read

With Only a Nod

By Becky Sansbury, MDiv, Raleigh, North Carolina

Sometimes the best care we can give is to be quiet, observant, and appreciative of our patient’s sharing a life-changing moment.

Our Mission

Stimulating healthcare professionals and trainees to reflect on giving exceptional care to every patient.

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