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Before you embark on a journey of revenge, dig two graves. –Confucius


The primary work of a professor of medicine in a medical school is in the wards, teaching his pupils how to deal with patients and their diseases. –William Osler


Learn from your mistakes, and the mistakes of others. –Warren Buffett


Years of study and training is of no use unless it is applied properly. The question that puts your skill into action is “How can I help this patient in front of me?

Little details

When I was a resident, I once took care of a patient with lung cancer. He had had chemo and radiation and was doing fine but the tumor was not shrinking. He was taken to the OR and they did an excisional biopsy. The mass was benign.

When I told him, he was so shocked and upset. During his treatment he had lost his job. He had spent all his savings and a few years of his life. He had suffered every variation of complication–neutropenic fever, line infection. He had depended of the compassion and charity of people in his community. When I think about this man, I remember that a diagnosis made in error can be as bad as a missed one. I try to assess my own certainty in every decision I make. Do I need help? Another opinion? The physician should be able to say, with confidence, how confident they are of every judgment they make.

Pick you battles

Never argue with a patient over their symptoms. You will seldom convince someone that they are not feeling what they are feeling.


The diagnosis is seldom in the ROS. It is usually found in the chief complaint. But the ROS can help you make a diagnosis that has otherwise eluded you.


I learn nothing from my successes. My failures are professor, lecture and laboratory.


Medical school tests are multiple choice because that’s how good medical practice is done. Make a list. Pick the best answer.


Few things will rekindle your optimism for the practice of medicine like interviewing medical students for residency spots!