An excerpt from South Eight.
There is little similarity between the stillness of the archer, or of Arkin’s former self on the rifle range, with the organized chaos of a dozen nurses and respiratory therapists and lab technicians pouring into Room 326 of the PCU. And yet there is something of …
When the cardiac arrest algorithm comes into focus
Not too long ago, a circumstance occurred. I have experienced similar circumstances several times in my career. However, this time, my response was different. It was like a switch in my brain flipped. I was ready to leave clinical medicine. It was time for the next chapter.
Wow! It was a moment of surprise, relief, and excitement, quickly followed by a WTF? Where was this thought coming from? There was …
What it means to leave clinical medicine
On July 25, 2022, dozens of medical students at the University of Michigan School of Medicine walked out of the school’s White Coat Ceremony when the keynote speaker, Dr. Kristin Collier, an assistant professor of medicine, approached the podium. Dr. Collier is pro-life and has expressed her anti-abortion views in tweets and interviews. She was chosen as keynote speaker by a vote by the university’s Gold Humanism Honor Society. A …
On the boundaries of medicine, medical education, and political passion
“What does it mean when there are two pink lines?”
Her voice is hesitant, eyes searching to find mine across the counter. She knows what it means. I know what it means. I turn to the test to confirm and slowly put on a mask.
When I was pregnant with my daughter, my brother-in-law took to calling her “Miracle” because, despite none of us having any particular tie to organized religion, that’s …
The story of keeping my daughter safe
Within the last two weeks, I’ve read several studies pertaining to provider burnout. Since the beginning of the pandemic, I’ve lost count of the number of articles I’ve come across addressing this issue as well as potential root causes and expert suggested remedies.
One study suggested over 50 percent of us have fallen victim. Another suggested our so-called “creative” administrators and governing bodies, who are supposed to have our backs, actually …
ICU psychosis is a common phenomenon in hospitals. Most of us as clinicians deal with it well.
However, the ordeal changes when your loved one is struck with it. My grandmother, always admired for her storytelling skills, is now admitted with intestinal obstruction, and her worsening Parkinson’s has just escalated the intensity of her psychosis.
Now she tells me a story of a woman carrying knives, seeing blood everywhere, selling half the …
Remembering my grandmother in the ICU
This episode was during my elective time in India in the late winter of 2017. It was a patient-centered learning opportunity for students around the world who has an interest in medicine. I was excited about this because of my earliest clinical exposure to patient encounters as a medical student. I was excited to meet the patients, talk to them, and help them despite the uncertainty and emptiness in my …
Does patient-centered care really meet human-centered care?
On May 2, 2011, a few minutes past 1 a.m. Pakistan Standard Time, a U.S. Navy SEAL Team Six left the Bagram Air Base in the Parwan Province of Afghanistan and headed for the compound of a high-value target in Abbottabad, Pakistan, located just a few miles away from that nation’s military academy.
It was an operation that lasted 38 minutes, following which U.S. forces returned to Afghanistan with the slain …
Ayman al-Zawahri: the doctor who dispensed death
There have been countless references to the art and science of medicine over the years. I, for one, certainly have embraced both in my long career as a physician in internal medicine. However, I have always had a special connection to the art part.
My late mother was an artist, so I grew up with …
Early one morning in 1996, after a sleepless night on call, I stood with my team in the VA hospital, outside room 102. I was a 28-year-old intern in the general medicine service. We were making rounds on twelve patients that my intern partner, myself, and our supervising resident had admitted overnight. We would walk room to room, and the intern would present the information regarding the patient by gathering …
An experience of shame in training
I was warned about it before we walked into the room.
So when I did walk in, I made sure my eyes stayed focused on his eyes, my gaze high and attentive. I smiled, possibly more than normal, to make sure he felt comfortable. Like a puppeteer holding up his doll, I knew it wasn’t time for me to drop down my eyes yet.
The resident with me began the routine visit …
How privileged a physician’s knowledge is
There are two valuable reasons why all physicians, especially medical students, should obtain or demand from their medical school academic business education.
About 98 percent of physicians and medical students have never had an academic business education. About 30 to 50 percent of graduating medical students prefer private medical practice—which requires business and marketing knowledge to reach their optimal potential in private medical practice as described below.
Private medical practice is a …
Financial survival for physicians in private medical practice
I read a superb commentary in STAT, “Value-based payment has produced little value. It needs a time-out,” that reviews the failures of “value-based care” and the failure of its promoters to acknowledge those failures. Ideas conceived, tested and found lacking, and used as the basis for more of the same. Distracting from real health system reform.
So I thought, wouldn’t it be terrific if the originators of flawed health …
A health economist acknowledges how financing experiments failed our health system
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“As I looked across the boxes on my screen, I saw the gleaming faces of my peers. Just as it did then, and as it has for countless of my peers since, involvement in the Student Osteopathic …
A medical student’s advocacy journey [PODCAST]
From medical school to residency, I’ve worked with colleagues who don’t prescribe pain medications for their patients who truly need them. Or they are just very hesitant about doing so. Some simply don’t believe in them. Others fear the legal implications like being named to a med mal or wrongful death lawsuit. And several avoid pain meds, specifically opioids, like the plague because of possible addiction risk even when their …
How every doctor should address a patient’s pain
Congratulations on our leading academic medical institution (LAMI) yet again making it to the top ten list of the U.S. News & World Report!
You have taken the reins in perilous times (globally and domestically), and what you do and what you stand for will determine if this great hospital will not just survive but survive with its brand and reputation intact. Getting hired as a physician who grew up in …
Thinking back to 2020, concerning the emergence of COVID-19 and the first hard lockdowns all over the world. Individuals from all walks of life were frightened, locking themselves in their homes for fear of being infected. Yet, frontline providers and health care workers had to carry on with their daily jobs. Were they less scared than the nonmedical layman or immune to the virus? Unfortunately, they weren’t. They were just …
Trauma and burnout among frontline health care workers
I spent a year as a UCSF postdoc with the leaked tobacco documents. And this article is taken directly from the tobacco-control playbook. In the tobacco wars, we learned that: when a disease is caused by a for-profit industry, the only successful approach is regulation first, followed by treatment.
Here is exactly how and why doctors should regulate EHR and regain control of their cognitive …
How doctors can regain control of their software
I didn’t know her name until it was over, much too late. What I knew was she was thirteen and that on this winter day, someone in her family had been pulling her behind their car on a sled. No doubt laughing and looking in the rear-view mirror, the person driving had whipsawed around a corner, and the young girl — probably screaming (fear? delight?) — held onto the sled …
I didn’t know her name until it was over
Picture this. A patient in a hospital or rehab facility has just finished exercising with therapy. He is thirsty, and he thinks he might as well ask for a snack now because he will be hungry in 30 minutes. His therapist sets him up in his wheelchair (brakes locked), tray table with all necessities positioned in front of him, with his call bell within reach. As she approaches the door …
A pervasive culture of time constraints in health care
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