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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
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February 23, 2021 | 3 min read

Tips For Giving Medical Updates to Families

By Joshua Budhu, MD, Mass General

A physician’s disappointment in hearing surprises about his loved one’s condition sparked new insights on the value of regularly updating families about the patient.

August 28, 2023 | 2 min read

Travelers on an Unfamiliar Road

By Daniel Pomerantz, MD, Montefiore New Rochelle Hospital, New York

A rabbi once taught me the distinction between curing and caring. As I accompany patients on the rough road of illness, I consider ways to make their journey a little smoother. 

March 22, 2022 | 1 min read

Navigating my First Patient Death

By Elissa Abou Khalil, MD, University of Pittsburgh Medical Center

Acknowledging feelings and asking for support may help when dealing with loss.  

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.

March 2, 2023 | 2 min read

Meaningful Chords

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

When my patient’s wife brought his guitar to the hospital, I realized it’s impossible to overestimate the impact of reuniting patients with what matters most to them. Do what you can to make this happen. 

February 27, 2023 | 2 min read

Children Need Hospice Too

By Emily Johnson, MSN, RN, Johns Hopkins Medicine

Regularly reassessing goals of care is necessary during critical illness. This can help families maintain hope and realistic expectations. 

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. 

December 22, 2022 | 2 min read

Bittersweet holidays

By Taryn Schuelke, MS, CT, CCLS, Texas Childrens Hospital

Many experience grief during the holidays. Make sure to acknowledge your patients’ feelings and consider encouraging them to heal through ritual. 

November 7, 2022 | 2 min read

Suggestions For Coping With Grief

By Justin Jeffers, MD, MEHP, Johns Hopkins Medicine

When you or others are grieving, give permission to be vulnerable and accept help. It may sometimes be helpful to work with a therapist. 

September 28, 2022 | 1 min read

The Fist Bump

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

My patient and her family showed me how to celebrate and enjoy each moment, even in the face of a terminal diagnosis. 

September 27, 2022 | 2 min read

When?

By Shreya Srivastava, medical student, Albany Medical College

When my friend was struggling with her mother’s new diagnosis, she listened to the popular French song about cancer entitled, “Quand c’est?” It gave her a sense of support, empathy, and solidarity with others.

September 6, 2022 | 3 min read

Photographs at The Bedside

By Charlotte Grinberg, MD, Tufts Medicine Care at Home

Asking to see videos and memorabilia from a patient’s past may help us connect with each person in a more personal and complete way. 

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.  

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.   

April 27, 2022 | 2 min read

Listening to Your Patient’s Grief

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

By listening to a patient’s story of loss, we bear witness and affirm their experience. 

April 14, 2022 | 2 min read

“Explainaholics”

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

Sometimes patients and caregivers feel overwhelmed when clinicians provide too much information. When you sense this to be the case, offering clear recommendations can be helpful.

April 6, 2022 | 3 min read

The Last Inning

By Mark Duncan, MD, Johns Hopkins Medicine

Sometimes, patients have the opportunity to write a beautiful concluding chapter to their lives. We can encourage them in this endeavor.  

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. 

February 17, 2022 | <1 min read

Throw The Heart Machine Out The Window

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

In serving patients, it is sometimes best just to listen, show respect, and withhold judgement.     

February 10, 2022 | 1 min read

How to Express Empathy With Humility

By Rebekah Fenton, MD, Northwestern University

To show we care, we can simply say something like, “I can’t imagine how hard this must be.”

January 10, 2022 | 2 min read

Being Present During The Dying Process

By Shireen Heidari, MD, Stanford University

It’s the job of all clinicians to guide patients and their loved ones through the experience of death. Offering support and being present can help them navigate the end of life. 

December 15, 2021 | 1 min read

The Power of Humor

By Jennifer Eitingon, MD, Johns Hopkins Medicine

My dying patient taught me that laughter can sometimes normalize difficult situations. Finding humor in the problem lightened the mood and allowed us to devise a care plan that preserved her dignity.  

September 16, 2020 | 1 min read

Music For Stress Reduction

By Chris Dingman, vibraphonist and composer

Spend time each day doing something you enjoy, like listening to music. Just a few minutes can help you remain balanced, avoid burnout, and give better care to patients.

December 13, 2021 | 1 min read

Grace

By Farah Ali, DO, Johns Hopkins Medicine

Faith plays a significant role in many patients’ lives. Learning more about their beliefs can help us to understand them better and allows us to serve our patients in line with their values. 

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.

November 18, 2021 | 3 min read

Adequate Bandwith

By Jennifer Eitingon, MD, Johns Hopkins Medicine

Recently, a patient dying of cancer requested CPR despite many clinicians advising against it. When it feels challenging to understand a patient’s decision, I remind myself to consider the situation from a different perspective.

March 27, 2025 | 1 min read

“Breaking bad news”: a poem

By Miriam Colleran, MD, St. Brigids Hospice & Naas General Hospital, Ireland

I wrote this poem to explore sharing and receiving challenging news from the perspective of both clinician and patient. Reflecting on situations from multiple points of view enhances my ability to empathize.

November 2, 2021 | 2 min read

What All Clinicians Must Know About End-of-Life Care

By Pringl Miller, MD, San Francisco, California

Initiating and withdrawing life-sustaining medical treatment is the patient’s or their surrogate's decision, not ours. We must always honor their wishes.

October 9, 2024 | 2 min read

Softening the “SPIKES” 

When delivering challenging news, it is crucial to tailor the communication to the patient's preferences. Break down the message into small, spaced-out segments to allow for gradual processing. 

October 19, 2021 | 2 min read

Asking About Your Patient’s Pet

By Elizabeth Steuber, MD, Johns Hopkins Medicine, Todd Brenner, MD, Johns Hopkins Medicine

Ask patients about their pets. This can build a bridge to talking about topics like functional status, home life, and family dynamics.

"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.  

October 11, 2021 | 2 min read

Helping Patients Share Disappointing Diagnoses With Loved Ones

By Ambereen Mehta, MD, Johns Hopkins Medicine, Michelle McWhirter, LCSW-C, Johns Hopkins Medicine

Patients often want to share significant health news with loved ones. You can help them choose when and how to disclose this information.

July 17, 2024 | 1 min read

Building bridges

Some patients have strong preferences that may not align with best practices of care. Empathy, active listening, and kindness can build trust and guide patients toward making informed medical decisions.

September 30, 2021 | 1 min read

The Cancer is Back

By Anonymous Physician, Johns Hopkins Medicine

I recently lost a young patient to cancer. I was reminded that even when we cannot cure our patient’s illness, we can always show empathy and compassion.

May 1, 2024 | 2 min read

The patient’s voice: a doctor’s song

By Sujay Pathak, MD, Johns Hopkins Medicine

A clinician who heals truly listens without judgment and sees things from the patient's perspective.

August 2, 2021 | 1 min read

How to Support Patients Facing an Upsetting Diagnosis

By Steve Kravet, MD, MBA, Johns Hopkins Community Physicians

In medicine, we often inform patients of new diagnoses that are life-altering—sometimes overwhelmingly so. At these times, we must show empathy and check-in frequently with them.

April 10, 2024 | 1 min read

Toxic positivity

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

A stage 4 cancer patient taught me how constant encouragement can be emotionally draining for someone facing their mortality. Presence, love, and understanding may be better received. 

June 5, 2024 | 2 min read

Near death

By Aurora Grutman, medical student, Johns Hopkins Medicine

Overcoming anxiety about the end of life allows one to explore concerns with empathy and openness. A willingness to learn about patients’ spiritual beliefs can help clinicians provide compassionate and holistic care.

March 25, 2019 | 2 min read

Movie Review of “End Game”

By Barry Bryant, MD, Johns Hopkins Medicine

The documentary "End Game" includes honest and reflective conversations with patients about what dying might be like, and investigation into what patients want the end of their life to look like.

April 11, 2018 | 3 min read

Five Tips to Support Your Grieving Patient

By Jane Schindler, LCSW-C ACHP-SW, Johns Hopkins University School of Medicine

A licensed clinical social worker offers her top tips for supporting grieving patients.

September 26, 2024 | 3 min read

Under the influencers 

By Adam Schiavi, MD, PhD, Johns Hopkins Medicine

The social media "Black out challenge" promotes asphyxia that can result in irreversible brain damage or death. Healthcare professionals should warn patients and caregivers to be cautious about social media trends and provocations. 

A child playing with a parent's gun that wasn't safely stored.

October 15, 2020 | 3 min read

How to Talk About Firearm Safety During the Pandemic

By Katherine Hoops, MD, Johns Hopkins Medicine

With a surge in gun sales during the pandemic, exposure to firearms has increased for all. It’s imperative that clinicians give comprehensive firearm safety counseling to patients during these challenging times.

February 6, 2025 | 2 min read

Code blue 

By Ursula Gately, medical student, Johns Hopkins Medicine

Extreme heat often dominates the climate change conversation, however the dangers of extreme cold may be more perilous. Support patients, particularly those who are unhoused or with housing insecurity, by making sure they know about local warming shelters and advising them to limit exposure to the elements. 

July 8, 2020 | 2 min read

Appreciating ALL Healthcare Workers

By Gaye Cunnane, MD, PhD, Trinity College Dublin

All healthcare workers contribute meaningfully to the care of patients. Taking the time to offer a kind word to those who may be underappreciated can make an enormous difference.

March 15, 2018 | 3 min read

Imperturbability, Aequanimitas, and “In Shock”

By Tom Hutchinson, MB, McGill University

Moving towards a deeper understanding of Osler's dicta of imperturbability and aequanimitas.

"Odysseus in front of Scylla and Charybdis." Henry Fuseli. 1794-1796. Public domain.

November 7, 2019 | 4 min read

Responsible Opioid Prescribing

By Travis Rieder, PhD, Johns Hopkins Berman Institute of Bioethics

Responsible opioid prescribing requires navigating between the Scylla of over-prescribing and the Charybdis of under-prescribing. Clinicians can work toward this goal by initiating prescriptions when (and only when) appropriate, managing them over the long-term, and knowing how to compassionately deprescribe when the time comes.

May 16, 2018 | 2 min read

The Stigma of Opioid Use Disorder

By Margaret Chisolm, MD, Johns Hopkins Medicine

Building a strong therapeutic alliance between patient and clinician—via open communication, mutual respect, and trust—is a lifeline for the individual patient with an Opioid Use Disorder.

Anchoring bias occurs when we rely too heavily on information received up front and too little on information received later when making a judgement about the most likely diagnosis. 

November 26, 2024 | 4 min read

Lessening the chances of making diagnostic errors 

By Elizabeth Fracica, MD, MPH, Johns Hopkins Medicine

To minimize common mistakes in diagnoses, clinicians must be mindful of cognitive and anchoring biases. Regularly seeking alternative explanations is one way to accomplish this. 

"Sunflowers," Vincent van Gogh, 1889. Philadelphia Museum of Art.

May 2, 2019 | 4 min read

Grieving Unexpected Patient Outcomes

By Stacia Dearmin, MD, Akron Children\'s Hospital

Acknowledging and processing grief can bring healing to the clinician.

Miami, FL, USA - March 23, 2024: Passing out Narcan nasal spray at the Ultra Music Festival Miami.

April 23, 2024 | 1 min read

Outside the clinic walls: making Narcan accessible to everyone

By Panagis Galiatsatos, MD, Johns Hopkins Medicine

Addiction is a chronic disease that requires a combined approach of medical treatment and community engagement. Clinicians must work to educate their community about addiction and provide them with resources like Narcan.

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