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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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April 20, 2020 | 3 min read

Gender-Affirming Care During the Pandemic

By Carl G. Streed Jr., MD, MPH, Boston Medical Center, Liam Hein, PhD, RN, University of South Carolina, College of Nursing, Paula Neira, JD, MSN, RN, CEN, FAAN, Johns Hopkins Medicine

Postponing procedures safeguards public health but can be distressing, particularly for transgender patients. Be proactive and transparent about access limitations during the pandemic.

March 26, 2019 | 3 min read

Tunnel Carver

By Christopher Wolfgang, MD, PhD, Johns Hopkins University School of Medicine

"Carve a tunnel of hope through the dark tunnel of disappointment." ~ Reverend Martin Luther King Jr.

"I think of my daughter standing on her tippy toes, her soapy hands in mine sticky with the day’s adventures. "

January 25, 2024 | 1 min read

At the scrub sink 

By Brandi Scully, MD, MS, Johns Hopkins All Childrens Hospital

During the pandemic, living away from my family was rough. I found spending brief periods engaged in an artistic pursuit, like writing poetry, to be healing. 

March 24, 2025 | 2 min read

Bones and “bons mots” (Fr)  

Narrative medicine provides a framework for integrating empathy, reflection, and trust into all fields of medical practice, fostering deeper connections between practitioners and patients. 

March 24, 2021 | 3 min read

Life, Death, and Taxes

By William Hornberger, CPA, JD, Dallas, Texas

As a patient who’s a lawyer, I’ve learned that lawyers and doctors have more in common than you might think. Finding a professional who is humble, kind, and trustworthy can make all the difference in your experience with law and medicine.

November 28, 2018 | <1 min read

Dr. Jim Black, A CLOSLER Look

By Gretchen Miller, Managing Editor

A favorite part of my job is telling patients when they, in fact, do NOT need surgery!

October 9, 2019 | 3 min read

Return to Play

By John Wilckens, MD, Johns Hopkins Medicine

While research findings are critical for clinical decisions, they only support the human art of empathizing with and understanding your patients.

October 3, 2023 | 2 min read

Never Forget Where You Came From

By Hanghang Wang, MD, PhD, Johns Hopkins Medicine

Reflecting on my journey to becoming a cardiothoracic surgeon reminds me of how far I've come. This also helps me to imagine the rewards of giving clinically excellent care to future patients. 

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. 

August 29, 2022 | 2 min read

Takeaways From “The Making of a Surgeon”

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

Reading this book while I was in training inspired me to pursue a surgical career. Rereading it years later, I’m reminded of the importance of treating all patients with dignity.  

October 18, 2023 | 2 min read

Have you done this before?

By Scott Lifchez, MD, Johns Hopkins Medicine

Listen for a patient’s anxiety when they ask questions about treatment. Addressing all concerns builds a trusting relationship and helps them better tolerate procedures that may initially be painful. 

July 2, 2019 | 5 min read

Shock, Grief, and Arrival

By Paulo Selber, MD, Columbia University

In the process of decisions regarding children’s welfare, listening to the parent’s feelings will always be the right thing to do.

November 20, 2023 | 1 min read

A surgical sojourn in China

By Hanghang Wang, MD, PhD, Johns Hopkins Medicine

Engaging with healthcare professionals in other countries represents an invaluable learning opportunity. My clinician colleagues in Nanjing helped me to appreciate the value of teamwork across cultures. 

January 14, 2025 | 3 min read

The vinyl sessions 

Uncover and leverage patient passions—from Abba to Zappa—to enhance treatment. Personalizing care fosters deeper patient engagement and improved outcomes. 

September 5, 2019 | 2 min read

Book Review of “In Pain”

By Traci Speed, MD, PhD, Johns Hopkins University School of Medicine

Clinicians need to understand that patients' pain is real to build rapport and reassurance, which will help patients be open to the full range of treatment options.

November 14, 2024 | 3 min read

A surgeon’s wakeup call: Learning about helmet safety the hard way 

By James Harris Jr., MD, Johns Hopkins Medicine

Healthcare professionals can do more than treat injuries; they can help prevent them. Educate patients and their loved ones about safety gear, share real-life stories, and empower people to make wise choices. 

November 4, 2024 | 2 min read

B-6 B-ware! 

By Ashli Greenwald, MS, RDN, LDN, Johns Hopkins Medicine

Vitamin B6 toxicity is often overlooked, especially when patients present with cardiac or neurological symptoms. When diagnoses remain elusive, ask about supplement usage and energy drink consumption. 

May 2, 2024 | 2 min read

Resilience in the face of setbacks

By James Black, MD, Johns Hopkins Medicine

Treating aortic dissections has taught me the importance of staying positive, both in communicating with families and in my own approach. 

January 10, 2024 | 2 min read

Risk and reward 

By Hien Tan Nguyen, MD, MBA, MPH, Johns Hopkins Medicine

During surgical residency training, I learned how to operate. In practice, I learned how to decide WHETHER to operate based on individualized versus protocol-driven parameters. 

November 27, 2023 | 2 min read

When the truth (literally) hurts

By Eric Last, DO, Northwell Health, Wantagh, New York

When our patients are facing surgery or other procedures, thoughtful questions can help allay their worries.  

September 6, 2023 | 3 min read

Getting Older in Medicine

By Joanne Shay, MD, Johns Hopkins Medicine

Both of my knees need to be replaced—I already can’t wait to get back to playing pickleball. I now have renewed empathy in the OR and remind patients: “Recovery will take time. Try to be patient.” 

June 12, 2019 | <1 min read

Dr. Jamie Wright, A CLOSLER Look

Making the time to ensure that patients understand what you are teaching them about their bodies will help them make better decisions about their care.

October 8, 2018 | <1 min read

Alleviating Patients’ Emotional Burden

By Paul Manson, MD, Johns Hopkins University School of Medicine

My approach to clinical care involves making a dual diagnosis for each patient: identifying the problem, and understanding how that problem affects the patient psychologically and emotionally.

The author with teammates.

August 30, 2018 | 1 min read

The Importance and Psychology of Facial Expression

By Patrick Byrne, MBA, MD, Johns Hopkins University School of Medicine

Carefully noting your patient's facial expression consciously helps you "be" with your patient more effectively, to meet them where they are in their emotional state.

March 13, 2024 | 1 min read

How writing helps me as a clinician

By Jason Han, MD, Penn Medicine

Writing helps me reflect on the surgical decisions I make each day.

October 27, 2022 | 2 min read

Connections Accelerated

By Jamie Schwartz, MD, Johns Hopkins Medicine

Some clinical encounters require establishing a patient-doctor connection quickly. Providing emotional support may improve your ability to create trusting relationships. 

February 24, 2021 | 2 min read

“Make you feel my love” (archives 2021)

By Amy Vinson, MD, Boston Childrens Hospital

Seeing the love in a patient’s life can be moving. It can also remind us just how important close relationships are in life.

September 19, 2022 | 1 min read

What I’ve Learned as an ESL Physician

By Ming-Hsien Wang, MD, Johns Hopkins Medicine

Growing up with non-English speaking parents, I know first-hand the challenges that these patients face. Being able to communicate is imperative for connecting and creating effective treatment plans. 

Blowball With Seeds Flying To The Sky

March 7, 2024 | 1 min read

Co-opting feelings

By Bessie Liu, medical student, Johns Hopkins Medicine

After my cancer treatment, I felt pressured to turn my trauma into personal growth—when what I needed to do was grieve. This has allowed me to validate whatever feelings patients are experiencing.

April 12, 2023 | 1 min read

Still Working After All These Years

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When I empathized with my older patient about the hardships of colon cancer, she began sharing many of the good things in her life, like still being able to work. 

June 13, 2024 | 2 min read

Lightening the load 

By Susan Lehmann, MD, Johns Hopkins Medicine

Clinicians can prioritize patient well-being by discussing the burden of engaging in care. Collaborate with patients to ensure recommendations are feasible and consider alternative approaches if necessary. 

"I was so excited to go home, be with my infant twins, sleep in my own bed, and eat homemade food."

November 30, 2020 | 2 min read

I Didn’t Know it Was You

By Rohini Harvey, MD, Baystate Health, Springfield, MA

My experience as a patient who didn’t get attention until I was identified as a physician is a reminder that every patient is important and deserves respect.

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.  

The Rolling Stones in concert at the British Summer Time Festival in Hyde Park, July 6, 2013. Wikimedia, Public Domain.

January 2, 2020 | 1 min read

A Commonly Uncommon Patient

By Jeffrey Trost, MD, Johns Hopkins Medicine

Asking colleagues for help and re-reviewing data are essential in identifying clues to an accurate diagnosis.

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.  

"When a patient is riding the wave of anger, instead of defensively explaining your kind intention and clinical justification for decisions, validate their experience."

March 3, 2022 | 1 min read

Listening to my Patient’s Anger

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When encountering an angry patient, validate feelings rather than becoming defensive.  

American Huey military helicopter formation flying over the jungle at sunset during the Vietnam War.

November 19, 2024 | 2 min read

Fellow humans: lessons from Dr. White’s “Seeing patients” 

By Richard Schaefer, MD, MPH, Johns Hopkins Medicine

Providing humanistic, equitable care benefits patients, medical practitioners, and society.  Reminding ourselves that we are all in this together may help decrease stigma and bias in clinical settings.

July 13, 2021 | 1 min read

4 Things to Consider When Supporting Patients Through Difficult Times

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When breaking the news to a mother that she had only a few weeks to live, I discovered that empathy was be the most impactful and meaningful way to serve.

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.   

August 7, 2018 | 3 min read

When Decision-Making Isn’t Clear: A Patient-Centered Approach

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

When faced with a difficult choice, making a Punnett's square decision-making tool with your patient might help.

November 29, 2021 | 3 min read

Being Your Patient’s Advocate

By Sabrina Chen, medical student, New York University

Some supervising physicians may occasionally seem annoyed by medical students’ questions. As a trainee, I’ve learned to speak up anyways, as my question can make the difference between life and death.

October 30, 2019 | 13 min read

Partnering With Parents—An Appraisal of Familial Feelings

By Monique Webber

The clinically excellent clinician understands that each family responds to and copes with chronic illness or disability differently. Being open-minded when partnering with families, and especially parents, is critical for ensuring a trusting relationship and providing support.

March 27, 2023 | 10 min read

Ever forward: caring for patients who are transgender and gender-expansive

By Paula Neira, JD, MSN, RN, CEN, FAAN, Johns Hopkins Medicine

Treat all patients with dignity and respect and ask how they’d like to be addressed. 

April 11, 2022 | 6 min read

Effective Partnering With Medical Interpreters

By Cecilia Murach, Medical Interpreter, Johns Hopkins Medicine

A medical interpreter can support successful communication between limited English proficiency patients and the other clinical team members. This collaboration helps build cross-cultural connections with patients and improve care. 

July 1, 2024 | 3 min read

The power of honesty

By Keshav Khanijow, MD, Johns Hopkins Medicine

Prioritizing clear communication with patients and using plain language to explain clinical information helps to build trust.

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.

September 10, 2018 | 2 min read

Defusing Patients’ Emotional Stress

By James Black, MD, Johns Hopkins Medicine

I believe it's my first responsibility to recognize my patients' emotional stress and start to defuse it. I do this by framing the ongoing issue in a way that is understandable to the patient and their family.

July 7, 2020 | 1 min read

Curbside Care

By Marianne Fingerhood, NP, Johns Hopkins Medicine

Whether seeing patients in-person or virtually, one of the most important aspects of care is the human connection.

March 22, 2018 | 7 min read

Fundamentals for Caring for Transgender Patients

By Paula Neira, JD, MSN, RN, CEN, FAAN, Johns Hopkins Medicine

Improve your skills as you work to support your transgender patients and interact with your transgender colleagues.

March 11, 2025 | 4 min read

When sex isn’t binary 

Providing exceptional care to intersex patients requires us to shed the outdated idea of sex as a binary. Instead, we should normalize diversity in sex presentation and encourage families to unconditionally love, support, and listen to their loved one. 

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