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"I just heard the saddest story," the second year Family Practice resident said, with a hint of subdued rage. Her faculty preceptor sensed her need to vent, so he gestured [...]

Being a good parent is at least as difficult as being a good doctor. On Christmas Day, our family drove 700 miles to watch my son's team participate in a [...]

Deals with coaching adolescent female swimmers. Relationships with others versus achievement; Body image.

The poem "A Meditation Near the Eastern Shore," by William Hensel is presented. First Line: Land once a bargain ---; Last Line: scooping us up, casting us back.

To the Editor.—We congratulate Drs Cyr and Wartman1 for defining a more effective clinical approach to screen for alcoholism in ambulatory care settings. We do, however, question their premise that "early detection and treatment of alcoholism may substantially reduce alcohol-related morbidity and mortality" and thus their recommendation that "all patients should be screened for alcoholism regardless of their reason for seeking care."Readily accepted screening criteria for any disease require (1) the disease to be common, to be detectable in the presymptomatic stage, and to have important morbidity; (2) the screening test to be both sensitive and specific, safe, inexpensive, and available; and (3) the therapy in the presymptomatic state to be effective in reducing morbidity and mortality compared with treatment after symptoms develop. Screening for alcoholism passes the first two criteria but fails the third.Unfortunately, there is no uniformly effective therapy for presymptomatic or symptomatic alcoholism.