That was Virginia’s second visit to the hospital in the ten days of the new year. It also ended up being the last.
Virginia was a patient we all knew. She came to the hospital frequently. The aphorism of our intern year was, if you had not taken care of Virginia once, you were not going to graduate out of internship. And that was hardly an exaggeration- almost no one in …
A patient who’s the very reflection of our healthcare system
Growing up, I rarely had a steady primary care physician. Every school-physical, immunization, sports injury, and sore throat was addressed with care and diligence at a family clinic affiliated with a major suburban hospital.
I opted to visit the clinic a few weeks ago for a minor concern but as I drove-in, I was attuned to the fact that the clinic I visit—my clinic—is a teaching site.
Before entering medical school I …
Medical students need to learn to be patients
Since the days of Sir William Osler, medical education has been done in much the same way by everyone everywhere. Doctors and academics slave away for hours and hours preparing lectures for students and trainees, all the while being locked away in their own isolated little silos. An anthropologist from Mars (to borrow an image from Temple Grandin made famous by Oliver Sacks) would find this remarkable. Could it really …
The flipped classroom might just be the future of medicine
I have the paradoxical privilege of being an emergency medical contact for dozens of people. Have you completed a healthcare medical directive with durable power of attorney? While reviewing a DPA with others, I strive to understand their choices in delicate life-or-death situations. This has me confronting death more often than many people.
They still talk to me
Triggered by seemingly insignificant events, fond memories of friends and relatives enter my mind …
How do physicians cope with the emotional aspects of death?
The gall, you might think to yourself as you click on this link in disgust.
Before you write that brutal retort which I may/may not deserve, some simple disclaimers before we tackle this subject:
5 reasons why you shouldn’t go into medical school
In 1804, Frederich Serturner experimented with opium and created something new—morphine—named after the Greek god of sleep and dreams, Morpheus. More than 200 years later, at least 8 million Americans fall asleep at night under the influence of an opioid. Every morning, 40 of them don’t wake up.
As described in a previous article on this subject, the United States is in the grip of a prescription opioid disaster: with 2 …
Why long term use of opioids is not the answer
A version of this column was published on February 3, 2013 in USA Today.
I’m seeing more patients than ever consume so-called “energy drinks,” a rapidly emerging class of beverage which promise to increase energy, improve alertness, and boost attention span. The energy drink business is booming, with more than $12 billion sold last year, eclipsing established beverage categories like iced tea …
Why energy drinks should be considered stimulant drugs
I recently read a very good article in the New York Times about a patient found to have the classic incidentaloma, a small mass in the adrenal gland. This is estimated to be seen in 4% of abdominal CT scans, and is rarely serious but typically leads to recommendations for additional testing and follow up CT scans to assure that it is not either a metastatic cancer …
Incidentalomas: The real cost of ordering tests
My first night shift in a stretch of 7 was almost over. It was 6:15am and I had to keep moving otherwise the minute I would stop, my eyelids would drop like two ton shades and I’d fall asleep. That never makes for a good drive home after a night shift.
“Got time to see one more?” asked Jenny the nurse.
“Do I have …
The baby had a seizure: Why was the mother smiling?
I work part-time.
Some people think that women who work part-time are ruining medicine and contributing to the physician shortage. So I want to present my very reasonable list of reasons why I work part-time in a flexible job:
1. I am sick constantly. Constantly. My kids are petri dishes. And it always lasts forever. Even as I’m writing this, I’m coughing, and …
Doctors who work part time: I’m sorry that I’m ruining medicine
There’s a lot nurses can learn from doctors.
There I said it.
But I’m not talking about clinical ability or medical knowledge. I’m talking about expectations. I’m talking about basic behaviors that dictate a predictable response.
Nurses don’t feel valued. Much of this is warranted, but I argue that some of it is self-inflicted. I said this once to a colleague and she responded, “But that places the blame on the nurse.”
I disagree. …
What can nurses learn from doctors?
You might be surprised to know that I’m lying here in bed still thinking of you two weeks after you’ve died.
During the month that I watched you die, I often wondered what it felt like to be you, with your deep, husky voice, rounded belly and stubborn anger. You’d once owned your own mechanic shop; now you were sitting here in a hospital bed, staring up at the medical team …
I tried to find peace in the loneliness that comes after a death
According to George Orwell, “serious sport has nothing to do with fair play. It is bound up with hatred, with jealousy, with boastfulness, with disregard for all rules, and with sadistic pleasure in witnessing violence: in other words it is war minus the shooting.”
Ok … sounds pretty much like the Super Bowl, but the Tour de France? Lance Armstrong? Ergogenic aids? Cancer …
It is time for us to succeed by being the best that we can be
ADVERTISEMENT
Dad didn’t feel like dying. He felt full of life and longing to live. He had more to do, more to say, more to feel, to taste, to write, to experience. He was angry and sad, disappointed and confused, scared and brave, unaccepting and, finally, accepting.
For the past three years, I talked to him daily to be as close as I could. I listened as he told me everything he …
Accepting the inevitable: The last days with my Dad
There are plenty of things we don’t know about health and illness. Sure, we know a lot more than we did fifty or a hundred years ago—but every day, still, I have questions that aren’t yet answered. I read a dozen or so journals each month. (I know. Nerd.) Each one has at least ten or so good quality studies—good, …
Sending your child to the chiropractor: Be very careful
An excerpt from When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests.
One Friday, Jerry got the scare of his life.
Jerry is a 48-year old mechanic who is in good health. His parents are healthy, and he recently got a “clean bill …
What happens if the doctor isn’t sure?
First in a continuing series.
With as much detail as is useful, and as descriptively as I can manage, I’d like to relate what it’s like to do an operation, from before laying knife on skin to after placing the bandage. I’m a general surgeon, so I choose sigmoid colectomy as my prototype; it’s always been one of my favorites, although the particular …
This is what it’s like to do an operation
To state the obvious: 1) most advanced cancer patients have pain, and 2) we have excellent pain medications which can effectively treat more than 90% of cancer pain. Therefore, most patients with cancer receive proper prescriptions for pain. Obvious, yes? True? No.
In Europe, Australia and North America narcotic analgesics are widely available, and frequently prescribed. While there is access, many patients, particularly those in certain groups such as seniors and …
Do most patients with cancer receive proper prescriptions for pain?
An excerpt from Pet Goats and Pap Smears.
My dad is eighty-eight years old. He finally retired from medicine at eighty-six. I call to check on him. “What are you up to, Dad?”
“I just returned from synagogue a few hours ago. Right now I’m catching up on my reading. I’m finishing up the fiftieth anniversary issue of Medical Economics.
That’s Dad living it up on a Saturday night.
“It …
The solo family doc isn’t extinct: I’m proof of that
I have a colleague who has lost his capacity to continue practicing pediatric critical care medicine. It didn’t happen suddenly; it came on gradually over a year or so. It also didn’t follow from a single event or bad experience. It was just a creeping uneasiness that culminated in his unwillingness, after two decades, to go on doing this. Even though I’ve been practicing pediatric critical care for thirty years, …
What doctors and Abraham Lincoln have in common
Get free updates delivered free to your inbox.
