About Rachel Wolfson

Rachel Wolfson

Rachel is a third-year MD/PhD student at Harvard Medical School. She is originally from Okemos, MI, and graduated from Stanford University in 2011. For her PhD research, she is studying the regulation of cell growth in response to nutrients.

All posts by Rachel Wolfson

Risks and Benefits Associated with High vs. Low Target Blood Pressure in Septic Shock Patients

• April 23rd, 2014

Mr. G is a 59-year-old patient with a history of chronic hypertension who presents to the ICU with septic shock. As his physician, you want to make the best decisions to manage his complicated condition. You recall that the Surviving Sepsis Campaign has guidelines for this very situation, and they recommend reversal of his initial… Read More…

Upper Airway Stimulation: To Help Obstructive Sleep Apnea Patients with Difficulty Complying

• January 8th, 2014

  Despite the numerous medications and therapeutics that have accumulated in the physician’s armamentarium, developing treatments is only half the battle with treating patients. While many drugs or devices work well in theory, in practice, there remains the major hurdle of patient compliance. Interventions may be too frequent or uncomfortable, or they are simply forgotten… Read More…

Easier Breathing When Treating a COPD Patient with Tiotropium

• October 16th, 2013

Mr. C, a 65-year-old male with a 30 pack-year smoking history and a cardiac arrhythmia, comes to your office for treatment of his COPD. He has been well controlled on a regimen including tiotropium delivered by a dry powder inhaler called a HandiHaler. He plans to move to Europe to be near his family, but… Read More…

Another Bench-to-Bedside Story in the Treatment of Asthma

• June 26th, 2013

In the early 20th century, the physician’s toolbox for asthma included adrenergic stimulants and belladonna alkaloids derived from the thorn-apple plant. Fifty years later, corticosteroids were added to the repertoire. (See the NEJM 200th anniversary review article on asthma.) But the next 50 years witnessed much more accelerated changes as basic science advances inspired the… Read More…

Meniscal tear: Operate or PT?

• May 1st, 2013

Mr. Richardson is a 55-year-old man who comes into your clinic complaining of knee pain. He used to enjoy going on long jogs, but as the years have gone by the pain in his joint has increased and he’s lost a lot of mobility. He’s frustrated by the weight that he’s put on due to… Read More…

New evidence that high-frequency oscillation not beneficial for ARDS patients (and may even be harmful)

• February 27th, 2013

In the 1980s, a paradigm shift in the treatment of acute respiratory distress syndrome (ARDS) occurred: researchers found that decreasing tidal volumes provided by mechanical ventilation still allowed for adequate ventilation while, perhaps, avoiding excess lung injury. Based on this principle, high-frequency oscillatory ventilation (HFOV), which provides very small tidal volumes (1 to 2 ml… Read More…

21st-Century Smoking Hazards and the Benefits of Quitting

• January 23rd, 2013

In 1964 the U.S. Surgeon General Report provided the first warning that smoking has adverse health effects. This statement has had a profound impact on both our society and our health care system. Despite this warning, many have continued to smoke over the past 50 years. Now, with 50 years of data from long time… Read More…

Physicians’ Warnings for Unfit Drivers

• September 26th, 2012

Bill, an eighty-two-year-old patient whom you’ve been seeing for years comes into your clinic one afternoon. It’s been a few years since he was diagnosed with Parkinson’s, and his health has been consistently declining. You decide that now is the time to advise Bill to stop driving. Before you do so, Bill’s wife tells you… Read More…

Starch or Ringer’s Acetate in Severe Sepsis

• July 11th, 2012

When a skydiver is falling through the air at 50 m/s, he needs to make a snap decision: pull out the parachute now, or later? The choice needs to be made quickly and he needs to be sure about it—it’s the difference between life and death. Treating a patient with sepsis can feel like skydiving… Read More…

Prednisone, Azathioprine, and NAC for IPF

• May 21st, 2012

In your office is a 54-year-old man with a non-productive cough and months of worsening dyspnea. He has inspiratory crackles and clubbing. His chest x-ray and CT scan show the patterns typical of interstitial lung disease. After a long work up, you decide he has idiopathic pulmonary fibrosis (IPF).  Now comes the crucial question: what… Read More…