Helpless. That is how I felt when my mother found out she had a fibroid the size of a cantaloupe living in her uterus. In my role as a medical student I might have dismissed the finding as nothing serious, telling my patient, “Don’t worry, it could be much worse.” But as a loving son I was not quite as cavalier. At first my mother resolved to ignore the fibroid, …
Good doctors are those who genuinely care about patients
Over the years, since the early 1990s, I’ve been treated for depression. Initially adjustment disorder, and lately, major depression. Perhaps I’m just getting older, and the “black dog” heavier. Then, I ponder all the changes I’ve encountered and wonder if they haven’t played a part. It may surprise you, but I’m thinking primarily of setting right now, and how much the therapeutic scene has morphed over those same years. I …
The relationship with my doctor has been taken away
It was spring. My medical school class, two years along in our five-and-a-half year endeavor, had earned the “medicinae kandidat” degree. We were now worthy of leaving the basic sciences and research center on the outskirts of town and starting our preparatory clinical, “propedeutic” semester at the University Hospital. In Sweden, at that time, we used a lot of Latin words and phrases. Crohn’s disease was Morbus Crohn, chart notes …
Do you worry about the diseases you learn in medical school?
Electronic cigarettes are here, settling over the country, quite literally, like a fine white fog. Smokers in turn, have been turning to them as a tool to help them quit, though the device manufacturers are not allowed to market them that way in U.S. It seems intuitive that a device that mimics the action of smoking but without the combustion and …
E-cigarettes: Are they effective? Are they safe?
You may not remember me, but when I asked how you were, you said, “alive.”
A few weeks earlier you were afraid of going under anesthesia and not waking up. They said you’d do great; that this was routine; that we’d see you again soon. Then you coded on the table. I’ve never met someone who was grateful for life the way you expressed to me that day.
You may not remember …
You may not remember me, but you changed me
The man who had been seated in room 2 by the medical assistant had been seen 6 months previously for a small, pigmented lesion behind his left ear, which a punch biopsy subsequently proved to be malignant melanoma in situ. He was sent to the Mohs surgeon in the interim who carefully excised just as much skin as was absolutely necessary and …
Melanoma refuses to abide the laws of general civilization
Last week a woman told me that she had a miscarriage in her bathroom. She was terrified. She didn’t know what to do. So she flushed it down the toilet.
A miscarriage is the spontaneous expulsion of a fetus from the womb before it is able to survive on its own. One in five pregnancies ends in miscarriage. Many women don’t know they are miscarrying. Those who know usually suffer grief …
What happens to all the miscarriages?
“Doc, if I have cancer, I don’t want to know. Stop bugging me about this colonoscopy.”
Mr. H said to me, his primary care physician, during our appointment. He folded his arms and nodded his head, indicating that his decision was final.
“Mr. H, as uncomfortable as colonoscopies seem, they can actually find lumps that might grow into cancer, and cut them out before they ever become cancer. That’s why I’m bugging you so much about this.”
I …
For patients, reforming the RUC matters
Hollywood stars, like Glee’s Cory Monteith, aren’t the only Americans struggling with addiction that kills. Monteith, who died of a heroin and alcohol overdose, exemplifies the public health tragedy that is opioid overdose deaths in America. The fact is, there is no greater public health issue.
From as far back as 2008, we have been dying more from poisoning – almost all poisonings …
Drug addiction: 5 things we can learn from Cory Monteith
The specter of loss of choice and freedom to select the doctor you want haunts again. This time it’s being raised on the airwaves with an ad from Americans for Prosperity, a group that advocates limited government and free markets. The ad, an attack on Obamacare, plants doubt in viewers’ minds about whether they can choose their own doctor, a theme that continues to resonate with both the public and …
Limiting your choice of doctors: Is Obamacare to blame?
With Governor Rick Perry signing the restrictive Texas abortion bill into law many news organizations have shed light on traveling to Mexico for abortion and there has been much talk about the “Mexican abortion pill.”
The medication that people typically call the Mexican abortion pill is misoprostol, marketed under the trade name Cytotec. It is a prostaglandin analogue and is used for prevention of stomach ulcers. It also has many uses in OB/GYN …
Is the Mexican abortion pill safe?
The notion that doctors can be replaced by technology has sparked a series of brawls between doctors and technologists over the last couple of years. Today, both sides continue to throw punches in the press and online.
As health care technologies become more sophisticated, the opportunity to automate medical decisions becomes more seductive. Yet, physicians are unwilling to throw in the towel. They point to the importance of human interaction and …
Technologists versus doctors: Who wins?
To the literal-minded, burning out is the fate of light bulbs and matches. But whether you read the popular press or medical journals today, you’re likely to find writers who are deeply concerned about physician burnout.
What defines physician burnout, and who exactly is suffering from it? Is burnout an actual clinical syndrome, a slang term connoting fatigue and boredom, or a hazy …
Burnout: The perfect storm of physician stress
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Hospital transport arrives to take my daughter just after 9am. We’d been told her ultrasound and x-ray were scheduled for 10am, an hour away. Jess and I exchange a look. She’s just about to take another swig of the laxative drink she’s been drinking since 8:30.
“I’ll go with you,” I say.
“We’ll make sure there’s a bathroom nearby.”
Strike one for the Golden Cocoon.
We get to the ultrasound department, and are left …
The gratitude of a terrified parent when kindness is shown
Jenny McCarthy is officially joining The View. “Do I have opinions?” one reporter asked. Yup.
My concerns center around Jenny McCarthy’s past willingness to trade-in her experience for expertise. That is, she widely shared her theories and anecdotes about her son’s experience with learning challenges and falsely placed blame on vaccines for his then-diagnosed autism. I will not discount her private experience.
What I discount …
Jenny McCarthy on The View: Trading experience for expertise
There are lots of generalized complaints out there about insurance companies increasing physician workloads without additional compensation. I thought I would share a specific instance of this so everyone else can get an idea of what we’re up against.
I received the following mailing:
We want you to screen our members for cancer. Please do these things:
- Call the member to discuss colorectal, skin, and prostate …
Why one doctor throws away insurer mailings
When I was a med student, the thing I loved most about primary care was continuity of care. I loved feeling like I had a sense of my patients’ lives, of the intimate details of their day to day, of their fears and dreams. I thought that this connectedness was all I needed to have a successful career as a primary care …
Doctors: Fight burnout like it’s the plague
Guantanamo detainees on a hunger strike are now being strapped into chairs and gagged as doctors push a feeding tube through their nose into the back of their throat and into their stomach as often as twice a day. It’s a disturbing new practice, but one we must examine in full as we consider whether Guantanamo reflects American values.
Anyone who has had a nasogastric tube placed through their throat …
Guantanamo: End forced nasogastric tube gagging
“I don’t want a tube down my nose. I’ve been through it before and I don’t want it again.” Charlie turned his head away from the team and crossed his arms in defiance. “I’d rather be sick.”
I looked at the intern, who looked at the resident, who just said, “Well, think about it. We’ll be back in the afternoon.”
“I’m also hungry and haven’t eaten in days,” Charlie added.
“Maybe some food …
Each patient is still human and deserves to be treated as such
I guess what is so utterly frustrating is that the guys up there don’t see what is going on down here. The march of health care reform continues with little realization of what it feels like to be one of the tiny peon foot soldiers on the ground. We are not deaf. We hear the politicians and policy wonks. We read as non-clinician “doctors,” ivory towered administrators, and the business …
Our patients pay for dumbed down American medicine
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