Pocket Medicine


To my parents, Matt and Lee Sabatine, to their namesake
grandchildren Matteo and Natalie, and to my wife Jennifer

Written by residents, fellows and attendings, the mandate for Pocket Medicine was to provide, in a concise a manner as possible, the key information a clinician needs for the initial approach to and management of the most common inpatient medical problems.

The tremendous response to the previous editions suggests we were able to help fill an important need for clinicians. With this fifth edition come several major improvements including a thorough updating of every topic, the addition of several new topics (including treatment of anaphylaxis, approach to inpatient nutritional issues, chemotherapy side effects, and workup of a fever in a recent traveler), and inclusion of additional photomicrographs. We have also added a new section on Consults in which non-internal medicine specialists provide expert guidance in terms of establishing a differential diagnosis for common presenting symptoms and initiating an evaluation in anticipation of calling a consult. As always, we have incorporated key references to the most recent high-tier reviews and important studies published right up to the time Pocket Medicine went to press. We welcome any suggestions for further improvement.

Of course medicine is far too vast a field to ever summarize in a textbook of any size. Long monographs have been devoted to many of the topics discussed herein. Pocket Medicine is meant only as a starting point to guide one during the initial phases of diagnosis and management until one has time to consult more definitive resources. Although the recommendations herein are as evidence-based as possible, medicine is both a science and an art. As always, sound clinical judgement must be applied to every scenario.

I am grateful for the support of the house officers, fellows, and attendings at the Massachusetts General Hospital. It is a privilege to work with such a knowledgeable, dedicated, and compassionate group of physicians. I always look back on my time there as Chief Resident as one of the best experiences I have ever had. I am grateful to several outstanding clinical mentors, including Hasan Bazari, Larry Friedman, Nesli Basgoz, Mort Swartz, Eric Isselbacher, Bill Dec, Mike Fifer, and Roman DeSanctis, as well as the late Charlie McCabe and Peter Yurchak.

This edition would not have been possible without the help of two individuals in the TIMI Study Group Chairman’s Office. Melinda Cuerda, my academic coordinator, was an invaluable resource for this edition. She shepherded every aspect of the project from start to finish, with an incredible eye to detail to ensure that each page of this book was the very best it could be. Pamela Melhorn, my executive assistant, expertly manages the Chairman’s Office, miraculously coordinating the complex clinical, research, and educational missions.

Lastly, special thanks to my parents for their perpetual encouragement and love and, of course, to my wife, Jennifer Tseng, who, despite being a surgeon, is my closest advisor, my best friend and the love of my life.

I hope that you find Pocket Medicine useful throughout the arduous but incredibly rewarding journey of practicing medicine.