You are a rheumatologist in Texas. You are very well trained. Your mentors included some of the leaders in rheumatology, and you are respected by your colleagues and your patients. You know the devastation of untreated rheumatoid arthritis and lupus. A young woman with recent onset of systemic lupus erythematosus is your new patient. You…
My long-standing patient with CRST syndrome (i.e., calcinosis cutis, Raynaud’s phenomenon, sclerodactyly and telangiectasia) had been losing ground over the past 18 months. BL was 54 and had developed restrictive pulmonary disease without radiographic pulmonary infiltrates. Her mean right heart pressures were moderately elevated by ultrasonography. But the greatest impact on her quality of life…
The glassblowers were in revolt. The island of Murano, in the 13th century, was a perfect home for the glassblowing industry. Connected to Venice through a system of bridges, Murano was surrounded by waters that protected the city from the furnaces that fueled the glassblowers’ craft. The Republic of Venice dominated trade throughout the Mediterranean,…
It’s 11 a.m. on a Wednesday. You see a new patient in your fellow’s clinic with impressive physical findings, including a prominent skin rash and deforming arthritis. The patient has been to many doctors and is frustrated that her condition remains undiagnosed and untreated. You thoroughly examine the patient, present her case to your attending…
Scenario: A patient with rheumatoid arthritis (RA) presents for a follow-up visit. After addressing her inflammatory arthritis symptoms, medications and laboratory results, she is asked if she has any other questions, and she begins describing her chronic low back pain, which has become worse despite physical therapy (PT). She requests stronger medications because her RA…
He just didn’t get it. I love my mechanic. After many years of taking my car to mechanics who took my money without explaining what they were doing with it, I finally found someone who loved to teach. Whenever I bring my car to his shop, class is in session. He gestures for me to…
With the ongoing COVID‑19 pandemic, several tools and strategies have been developed and implemented to reduce the spread of disease. These include social distancing, adequate ventilation, masks, monoclonal antibody treatment and vaccination.1 As of December 2021, 60% of all Americans have been fully vaccinated, and 8 in 10 adults in the U.S. have received at…
“Maria” is a 54-year-old woman with seropositive rheumatoid arthritis, as well as hypertension and hyperlipidemia. She is a new patient in your clinic following a move across the country to live with her children on a farm in a rural area of the Midwest. At her first visit, three months ago, you and Maria agreed—through…
Scrolling through your Twitter feed, a tweet catches your eye: “Great day. Helped anxious patient with poor health literacy understand and come to terms with #SLE diagnosis and agree to start treatment. #RheumTwitter” The tweet, by a well-intentioned physician who cared deeply for her patient, resonated with many others and has been retweeted more than…
On March 29, Brandon Elliot walked up to a 65-year-old Filipino American woman near Times Square and kicked her in the chest. Footage from the security camera of a nearby luxury apartment building recorded the attack: Elliot shoved her to the ground, and then repeatedly kicked and stomped on her, while shouting, “You don’t belong…