“Mr. Stenson left AMA …”
“Why?” I said out loud to my attending.
“He left with his IVs in …” said his nurse in disbelief.
An hour earlier, before rounds, I sat down with Mr. S to talk about his anxiety attack.
Ten years ago, he was shot ten times in the chest, which left him with PTSD and depression. Not long after, he started having unprovoked panic attacks. What started as once or …
My patient left against medical advice
In my self-righteous youth, I bristled at the thought of physicians unionizing. Certain our collective altruism and professionalism would prevail. Unions were for oppressed laborers, not well-regarded, well-paid professionals. Reading the recent paper in JAMA and 30-plus years in the field have caused me to think again. That, and recently having provided support to a young physician couple with a newborn.
There is nothing quite as messy, all-consuming, and awe-inspiring as …
If a program doesn’t care for fellows, could a union?
“You’re dying.”
I can often visualize the impact of my words as soon as they leave my mouth, the heavy weight sinking into the mind and body of my patient as they sit in the stark white hospital bed.
It usually isn’t the first time they’ve heard the sentiment. After all, we tell them countless times in different phrases we use as physicians, expecting them to understand, but none quite as precise …
Talk about death in plain, simple, easy-to-understand terms
I am a pulmonary-critical care medicine physician. I had a medical issue in 2020 and was on limited call responsibilities. When I came back, it was in the throes of the first wave of COVID.
It goes without saying that the last three years or so have been very difficult for everyone in the medical profession. We lost a truly horrific number of patients to COVID — in the early days, …
Coping mechanisms for medical professionals
The COVID-19 pandemic has taken a profound toll on older adults, isolating them physically and emotionally from their communities and families. Mental health has suffered across generations and, as a practicing geriatric psychiatrist, I have had a front-row seat to the unique conditions older adult populations are facing. Despite rising rates of depression and anxiety, infection control measures have accelerated the adoption of digital health, including telehealth, opening myriad new …
Video visits as clinical touchpoints to improve older adult mental health
How much medical uncertainty can you tolerate? Most patients have not given much thought to this consequential issue, but it hovers over them in their doctors’ offices. This is also an issue for medical professionals. Indeed, how both sides in the doctor-patient relationship navigate this will be instrumental in choosing the path forward.
Medicine is not mathematics. It’s a murky discipline with incomplete data and moving targets. Many of your symptoms …
Drawing the line on unnecessary medical tests
More than two months after he died, his name still adorned the whiteboard of the hospital room he inhabited. As I stood there and gazed, recalling the memories he left me with, the nurse who tended to him entered the room and started to cry. Her love for Eric, she told me, did not enable her to erase his name.
He was disheveled, non-compliant, and plagued with multiple morbidities when first …
A room once full of vitality lies empty
Your plane is about to take off. Like most folks, you are just a little anxious about flying. It is very rare, but you know a lot of bad things can happen to the machine that carries you at 30,000 feet above sea level. Consider this: Would you rather the mechanic who inspects your aircraft be absolutely conscientious to every minute detail, be exquisitely perfectionistic in his examination of the …
Why this doctor prefers perfectionist physicians
An excerpt from The Pain Solution: 5 Steps to Relieve and Prevent Back Pain, Muscle Pain, and Joint Pain without Medication.
In a one-year period, more than 54 percent of Americans report musculoskeletal pain, including arthritis pain, low back pain, and neck pain. The search for …
The COVID-19 pandemic and the resulting shutdown accelerated the adoption of decentralized clinical trials (DCTs). The number of trials with virtual and/or decentralized elements exceeded 1,000 in 2021 for the first time, according to GlobalData. That’s a 50 percent increase from 2020. GlobalData expects the number of site-less and/or virtual clinical trials to jump another 28 percent this year, potentially topping 1,400.
This presents a perfect opportunity for smaller and …
Smaller practices should participate in clinical research. Here’s how they can.
The monkeypox outbreak continues to accelerate worldwide; by some counts, the U.S. now harbors the most significant number of currently known cases. Pathways for the initial spread beyond endemic areas for this current worldwide outbreak are thus far unclear but may be at least in part related to international infected passenger travel. Now, with elevating case counts, there remains an increased risk of infected persons spreading disease …
Monkeypox: Should the hospitality and transportation industries worry?
The COVID-19 pandemic has uprooted our lives, tilting them into imbalance and oftentimes severing our individual sense of inner peace. The newfound public initiative to combat these paralyzing challenges is welcome, especially to me. I’ve coped with major depression for as long as I can remember.
The grinding pursuit of my own inner peace led me to medical school. Medical training, I expected, would make a healer out of me, able …
Medical training and the systematic creation of mental health sufferers
A hallmark of modern medicine involves providing compassionate care through an empathetic doctor-patient relationship. This post describes one powerful technique for developing empathy among medical providers: narrative medicine writing.
What is empathy?
A basic definition of empathy involves your ability to understand someone else’s perspective by putting yourself in their (metaphorical) shoes. Empathy can involve cognitive aspects (i.e., understanding why a person is feeling sad or happy) or emotional aspects (i.e., sharing …
Narrative medicine develops empathy among physicians
Have you ever felt as if your doctor wasn’t really listening to you or was just rushing through your appointment? Have you ever felt as if your doctor didn’t understand the pain you were in or didn’t take it seriously?
Most health care providers are evaluated based on the experience their patients had, and their payment is often based on those patient experience scores. A major component of patient …
It’s time to address pain despite the opioid crisis
At her Supreme Court confirmation hearing in front of the Senate Judiciary Committee, Judge Ketanji Brown Jackson recounted a story from her time as a college undergraduate. She recalled being a freshman at Harvard after having attended public school in Miami, Florida, and her transition to life at the university had been challenging, causing her to question if she belonged at the school and if she could succeed. She was …
Last winter, when the Build Back Better Act (BBBA) was declared “dead” after Senator Joe Manchin of West Virginia revealed that he would not support it, health care reform advocates were disappointed. Hopes that important legislation would finally be passed to bring down the price of prescription drugs, bolster funding for home health care and expand subsidies to more Americans to afford health insurance were dashed.
Therefore, when we heard that …
Why the Inflation Reduction Act is a win for health care
I am hanging up my stethoscope and exiting the ambulance bay doors for the last time. I chose emergency medicine to care for critically ill and injured patients, and I’m leaving because this has become near impossible.
I believe it imperative to share some of the reasons that I, and many like me, are leaving a field we once loved, as their ramifications will sooner or later impact you and those …
Why I’m leaving emergency medicine
It was 2:21 a.m., and the pager exploded in my ear like I had forgotten to turn the volume down before plugging in my headphones. The nurses told me your heart rate was getting faster, and your oxygen was dipping lower. When I made it to your room, you were laying in urine because you were too weak to stand. Your breathing was rapid and shallow, like you were caught …
The art of medicine is born in the unforeseen
My sister didn’t want to die from breast cancer. In the six years since her diagnosis of stage 4 breast cancer, she fought valiantly to stay healthy and to continue to live. A superb oncologist put her cancer into complete remission, which lasted for some time before it reappeared in distant lymph nodes but not in any viscera.
One weekend she complained of severe stomach pain and sought help at a …
“They may say I can’t sing, but they can never say I didn’t sing.”
– Florence Foster Jenkins.
I was a bachelor over the weekend. My wife Beth was in Columbus at a horse show, just killing it, while I languished at home in The Land with the dogs. Much of what a summer typically includes has been stolen by the traitorous behavior of my “good hip.” Where my left hip only …
When the time comes, be sure there’s something to retire to
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