Resilience.

Description On one of the busiest parkways, in the midst of a spring drought, despite the lack of soil a sunflower blooms. This tiny beacon of hope represents the enduring spirit of humanity managing to struggle through this recent global pandemic. For me as a program director, it conjures to mind my graduating family medicine residents.

Visual Representation of Cultural and Collegial Collaboration.

Description Our colleagues are those on whom we not only rely to help us with patient care and advocacy but also to establish a meaningful and collaborative relationship. The connection between comrades of different departments and specialties facilitates a deep understanding of the intricacies involved in treating a variety of maladies, and we quickly find ourselves ardently discussing our own life struggles, achievements, woes, and joys with those whom we once considered strangers, which only demonstrates the steadfastness of our professional and collegial relationships. However, for a holistic approach to the discipline of healing, the interconnectedness of other subdisciplines needs to be recognized.

Unity.

Description Community health is vital to increase the lifespan and quality of life of the people on our planet. We must unite to fight disease through education and implementing quality healthcare. This piece was created prior to the pandemic, but its message is so incredibly pertinent in these troubling times.

Sexual Obsessions in a Patient With Schizophrenia.

Description Obsessive-compulsive symptoms in schizophrenia are often initially unrecognized or missed entirely in the diagnostic process. Sexual obsession is common in patients with schizophrenia. Therefore, identifying sexual obsession early in treatment has significant implications for appropriate multidisciplinary management and prognosis.

Pilot Mental Health Offender Program Improves Participant Outcomes and Lowers Costs in a Large Urban County.

Introduction: Mass incarceration, particularly of the mentally ill, continues to pervade our criminal justice system. Jails in many areas have become the largest mental health facilities, especially in large urban communities, despite increasing societal recognition that those with mental illness are not best served behind bars. Misdemeanors are an often-overlooked contributor to mass incarceration, and may be preventable for those with chronic severe mental illness.

Tattoos in Medicine.

Description I am a second-year family medicine resident with a rather large arm-sleeve tattoo. As you can probably deduce by reading the title of this editorial, it will focus on how tattoos in healthcare may be perceived by others. My goal is to illustrate some of my perspectives, opinions, and experiences regarding making my tattoos visible in the clinical setting.

Health Equity in Medicine.

Description Healthcare disparities exist when, due to racial, ethnic, or gender identity differences linked to social, economic or environmental factors, certain populations lack equitable access to quality healthcare and insurance coverage. Such disparities across history carry profound future implications that we have only begun to contemplate as a profession. This special issue of the HCA Healthcare Journal of Medicine examines the critical issue of health equity in medicine and how the medical community can advance health equity through inclusive behavior and interactions in clinical and educational settings, and our communities.

Case of calcinosis cutis associated with Sjogren's syndrome.

Calcinosis cutis is a chronic condition involving skin and soft tissue deposition of calcium and phosphate. It is associated with several conditions including idiopathic, iatrogenic, malignant metastasis, calciphylaxis, and connective tissue diseases. The most common connective tissue diseases it is associated with include systemic sclerosis and dermatomyositis.

For Medical Directors: Case Report of a Missed Wooden Foreign Body in the Forehead.

Traumatic wounds, often contaminated with foreign material, are a common presenting complaint in the emergency setting. Unfortunately, embedded foreign material can go initially undetected or not be fully removed, leading to morbidity and becoming a common cause of medical malpractice claims. Here, we present a case of a missed wooden foreign body, including associated risk factors, potential contributing cognitive errors, recommendations to avoid such errors, and finally, a description of the case's resolution.

Cerebral Venous Thrombosis in a Patient With Smith-Magenis Syndrome.

Smith-Magenis syndrome (SMS) is a complex genetic developmental disorder characterized by distinctive physical features, cognitive impairment, developmental delay, and behavioral abnormalities. It is caused by a microdeletion of chromosome band 17p11.2 encoding for multiple genes including the Retinoic-acid-induced (RAI1) gene.

An Isolated Splenic Hydatid Cyst.

An isolated hydatid cyst of the spleen is a rare presentation of echinococcal diseases, especially in non-endemic areas where it may end up with unnecessary work-up and misdiagnosis. Here, we present the case of a 28-year-old female presenting with generalized abdominal pain, constipation, and early satiety who had a delayed diagnosis of isolated splenic hydatid cyst which was partially treated with albendazole, eventually requiring splenectomy.

A Rare Presentation of Zinner Syndrome.

Zinner syndrome is a rare developmental anomaly of the distal Wolffian duct. It is characterized by a triad of unilateral renal agenesis, cysts in the ipsilateral seminal vesicle, and ipsilateral obstruction of the ejaculatory duct. While some patients are asymptomatic and diagnosed incidentally, other patients may present with symptoms related to obstructed ejaculatory ducts and seminal vesicle cysts.

Acute Onset of Movement Disorders Accompanying Common Emergency Room Neurologic Disease Processes.

Emergency departments (EDs) of hospitals accredited for trauma and/or comprehensive stroke care treat a large volume of high-acuity patients. In this fast-paced environment, the primary focus is appropriate triage, rapid stabilization, diagnosis, and acute intervention for life-threatening conditions such as cerebral vascular accident (CVA). However, this approach may result in subtle or atypical neurologic signs and symptoms being overlooked.

Cerebral Venous Thromboses in a Patient With No Reported Risk Factors: A Case Report.

Stroke is a neurologic condition caused either by brain ischemia or brain hemorrhage, where most cases are a result of ischemic brain injury. Stroke more commonly affects the arterial blood supply of the brain, but in rare cases, it is evoked by the occlusion of the venous sinuses that drain blood from the brain. This phenomenon is known as cerebral venous sinus thrombosis (CVST), also referred to as cerebral sinovenous thrombosis.

Acute Myocardial Infarction in a Young Male With COVID-19 Infection.

Coronavirus disease 2019 (COVID-19) infection is a global health crisis resulting in significant morbidity and mortality. The presentation of COVID-19 infection is variable, ranging from an asymptomatic carrier state to multi-organ failure. While cases of COVID-related myocarditis and myocardial dysfunction are well reported, only a few cases of coronary artery thrombosis resulting in myocardial infarction are noted on literature review.

A National Survey of Job Satisfaction and Workload Among Emergency Medicine (EM) Residency Faculty.

Introduction:  Faculty workload, and its relation to job satisfaction, has not been well studied in Emergency Medicine (EM).  Methods: A cross-sectional survey was conducted among EM physician faculty at 49 residency programs across the United States. We collected information on clinical and non-clinical (education, administration, and research) workload, demographics, and EM department characteristics, as well as job satisfaction measured using the Global Job Satisfaction (GJS) scale.

Lamotrigine-Induced Acute Pancreatitis.

Drug-induced pancreatitis is a rare phenomenon. Therefore, diagnosis requires ruling out more common etiologies of acute pancreatitis. The majority of research on drug-induced pancreatitis is from case reports.