I am no longer terrified of COVID.
I’ve seen its death. I’ve seen it take the breath from someone’s lungs. I’ve watched it shut down kidneys. I’ve walked the halls of an ICU with pumps outside the room, and patients turned upside down. I’ve heard the code blues. I’ve passed an endotracheal tube through vocal cords. I’ve squeezed air into suffocating lungs. I’ve broken ribs doing chest compressions. I’ve sent electricity …
I am no longer terrified of COVID
Last week, someone referred to me online in the most shocking terms: a liberal. As I read the phrase, I gripped the pearls around my neck and coughed down my scalding afternoon tea. How could this have happened to me?
With all its newsworthiness to the public, last week was still an ordinary one in the intellectual life of a doctor: Read journal articles, understand new guidelines, disseminate via recommendations. By …
The political backlash to evidence-based doctors’ recommendations
I learned a valuable lesson about mentoring medical students during clinical rotations amid the COVID pandemic, and it’s not as easy as you think.
I have been in medical education, either in it or teaching it, for 20 years. I have spent countless hours doing lectures, giving hospital grand rounds, or leading bedside teaching rounds to those who want to follow in my footsteps as a clinical expert. But some are …
Medical student rotations amid COVID: Welcome to medicine little grasshopper
Dear medical student:
I was in your shoes twenty years ago. At that time, I thought that becoming a doctor was all about gaining medical knowledge. When I started my clinical rotations, I was convinced that the “history of present illness” is the most important aspect of patient evaluation. As a resident, I felt that navigating through the differential diagnosis and treatment options is all that medicine is about. Now, being …
A medical student’s guide to taking a social history
If you are confused about delta and how well the vaccines protect against infection right now, I don’t blame you: We are learning and updating data in real-time, and it is hard to keep track of it all. So maybe this analogy will help.
Think of the vaccines like an umbrella, and it’s raining outside. Before delta, the rain was maybe a drizzle. Most people who had an umbrella were not …
Think of the vaccines like an umbrella, and it’s raining outside
Even those of us with a meditation cushion and a gong app are likely to recoil when mindfulness practices are suggested as solutions for physician burnout. Sure, these practices are important. No, they do not address the causes of physician burnout.
Certainly, a more genuine effort by organizational leaders would be to respond to the data. There’s lots of it. The burnout — now “wellness” — data is collected endlessly and …
The business school mindset doesn’t mind physician burnout
Dear resident physicians:
Soon you’ll finish residency, and you may be wondering what’s next. Some of you will start fellowships, but most of you will practice your specialty. You may be looking for opportunities that are a good match with your needs and wants. Virtually all of you are looking forward to greater income. I hope that this ending is also a beginning – a renewal of your commitment to the …
Physicians and the importance of servant leadership
An excerpt from Hey! I Could Use a Little Help Here! My Story of Healthcare Workplace Violence.
This chapter is dedicated to the memory of Lynne Sausse Truxillo, RN, who died on April 11, 2019 from injuries sustained during a patient assault while on duty at Baton Rouge General Hospital.
It is not my place to intrude on the privacy of people …
In memory of a nurse who died from injuries sustained during a patient assault
Pyrography
Medicine bottles are mundane objects tightly woven into our daily lives, with the promise of happier moods, better sleep, and lower blood pressure. Nevertheless, nothing on these objects correlates with hope, faith, or a feeling of healthiness. I aspire to affix a face on these bottles to create conversations among medication manufacturers, prescribers, and dispensers, allowing them to explore what really happens …
Colorful pills don’t paint my world
Given the devastation wrought by the COVID-19 pandemic, many are asking why people would be hesitant to be vaccinated against it. That’s the question that bounces around the skulls of countless physicians, public health experts, journalists, politicians, and others. But before trying to answer the question, it might be reasonable to ask why people do, or fail to do, other things that negatively affect their health.
Why does a patient with …
I apologize in advance if the following lines sound full of frustration, disappointment, or anger. That is not my nature. I am optimistic; I like to see the light at the end of the tunnel and believe that goodness exists. But, after reading the news this past week, I don’t feel positive. I feel dismayed and heartbroken. I just continue asking myself: Where are the leaders?
Going to medical school and …
Physician suicide: Where are the leaders?
Even as COVID-19 is found in apes, big cats, minks, domestic cats, other small mammals, and now in U.S. deer, some don’t want to let go of the insultingly simplistic “lab leak” theory. Do they really think the 1918 influenza and AIDS pandemics (or Ebola, MERS, and SARS ) needed lab mendacity to exist? We won’t even talk about the prehistorical plagues!
Giving COVID-19 political not animal origins ignores its disturbing …
COVID’s lab leak theory obscures zoonosis and progression
What do you want in life?
I mean, really want in life. Not just a nice car, a house or kids — although those are important and genuinely gratifying things to have. But I am talking about what is the purpose of your life? Have you ever thought of that? It seems that many times we associate this question with having a midlife crisis. People then begin doing things differently because, …
What do you really want in life?
The nurse called: “The patient wants to leave AMA.”
These calls come, fortunately not often. Typically the patient is not terribly ill, but they really miss their cigarettes or alcohol. Spending another day or two in the hospital would be wise, but leaving against medical advice is not actually jeopardizing their life.
This was different. This patient was very ill, but competent to make his own …
“Trust and confidence in any product — and here the vaccine is the product — starts with confidence in the process and safety.”
-Payam N., Vaccine Outreach Supervisor
While training over 1,800 vaccine outreach workers enrolled in the California Virtual Training Academy’s Vaccine Communications Training, the UCSF Center for Excellence in Primary Care developed a practical guide for engaging people who are skeptical of the COVID-19 vaccine in meaningful …
Try this new technique when talking to vaccine skeptics
“You will be asleep for your surgery,” anesthesiologists often reassure their patients. Just before the start of anesthesia, a patient may hear the nurse saying, “Think of a nice dream as you go off to sleep.”
While these statements are intended to soothe patients during a stressful time, they gloss over this critical fact: Anesthesia is not like normal sleep at all. That’s why you need medical doctors – anesthesiologists – to take …
You are not “asleep” under anesthesia
Hidden in the epigastric region of the abdomen concealed by a curtain of peritoneum is a moody, often forgettable little organ. Of course, the term organ is a somewhat generous description for this rather overqualified gland. The pancreas has its own set of rules as it mischievously lurks behind the stomach waiting for its cue for chaos.
In a moment of theatrical exaggeration, it can go from completely forgettable to a …
Last year, a physician friend began experiencing what she believed was burnout. She felt constantly overwhelmed, had difficulty sleeping and eating, and began to dread going into her office. She worried excessively about patient outcomes, decisions she had made, and whether she was actually a good doctor. She even began to cry unpredictably. Like so many physicians who struggle with these kinds of symptoms, she avoided seeking help until she …
Why physician-specialized private counseling practices are important
Is your health care organization reeling from a bad EHR implementation?
There have been rumblings from hospital leadership and congressional committees about the Veterans Administration (VA) Hospitals’ implementation of the Cerner Corporation electronic health record (EHR) replacing the VistA EHR. The $10 million EHR overhaul has been controversial since the staggered rollout started in Spokane, Washington. One report noted that months after the go-live, fewer users knew how to operate the …
How to recover from a bad electronic health records implementation
An excerpt from Becoming Doctors 25 Years Later: Twenty five physicians sharing the journey from medical student to retirement.
If I get out of bed now, I can squeeze in that ten-minute morning yoga routine on YouTube. But it feels so nice lying here, sunlight streaming in, sips of coffee warming my body and boosting my heart rate up a notch. If …
Primary care: I love the variety and the intimacy of the problems that are placed before me
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