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There Are Many Ways to Kill a Resident: Try House Officer's Headache or Intern's Neck

Robert E. Cilley, MD
JAMA. 1985;254(14):1905-1906. doi:10.1001/jama.1985.03360140057024.
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To the Editor.—  Each occupation has its attendant hazards. We have discovered recently a malady not peculiar to but prevalent among house officers, particularly more junior-level residents. It is described by sufferers as neck and occipital "tightness," "strain," or "tension" and seems to be a variant of a true tension headache, with its major component in the posterior neck muscles. Pain is frequently progressive throughout the day and, as would be expected, is exacerbated by lack of sleep.The occurrence of this headache has been related to wearing a physician's coat laden with the paraphernalia of the ward resident. This frequently includes helpful manuals and articles, diagnostic equipment, drugs, dressings, etc. Onset is usually in July, with the start of residency training. The pain is reliably relieved by removing the white coat and temporized by frequently adjusting the coat's position on the shoulders as well as wearing a well-fitting soft-collared


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