The warm rays of the sun serenade me as I drive to work eager to begin another shift. I find a parking spot on the first floor of the garage don my N95 mask and walk towards the hospital. First, I must stop by at the neighboring building and have my temperature checked. Today it is 97.3. I am awarded the sticker for the day; my boarding pass into the …
A few intense hours with a cardiothoracic surgeon
One of the last things my dad said to me before he passed was, “remember to always look at the big picture.” He said this many times throughout my childhood and teenage years, but it never quite resonated until I was thinking about it in retrospect.
As I near the end of my intern year, my dad’s words hold true. As an emergency medicine resident, I am often running on adrenaline. …
Why it’s so important to look at the big picture
In a market economy, business leaders take every opportunity to shrink the cost line of labor on the balance sheet to boost profits and shareholder/investor value. It’s the metric on which they are evaluated, and left unopposed; they will do it more and more.
The core strategy for shrinking labor costs (along with automation and offshoring) is to drive increased “efficiencies” by demanding more and more work from the same number …
3 reasons why doctors don’t unionize
No matter who pulls the plug, divorce sucks.
It does get better, and eventually, you get to a new normal — but the process sucks. I know this because our two-physician marriage ended 15 years ago when our daughters were six and seven years old.
Divorce can be especially hard on physicians, and during these COVID times, additional challenges have surfaced for many divorced physicians. Some on the frontlines have been unable …
10 reasons why divorce is hard for doctors and 5 tips to make it easier
As hospitals everywhere have been using every health care provider available to them in response to COVID-19, the specialty of hospital medicine has shown itself to be uniquely suited for coordinating the effort, to be the front of the frontline responders. I suspect that many people don’t understand what “hospital medicine” is, even though it’s larger than almost any other …
Why COVID-19 is a threat to hospital medicine
I look out at the world through bright blue eyes. Blonde hair. A skinny but shapely 19-year-old’s body. I know six languages. I am educated. I can prescribe medicine that saves lives. I am in love. I am a person.
I look down at the tattoo on my arm. A number— like cattle. My family is gone. My home destroyed. I am living in a small room— …
I always hope that a sense of humanity will supersede the status quo
On the morning of George Floyd’s funeral less than ten miles from our medical center in Houston, I was avoiding the word “Black.” Despite wholehearted pride in the strong Black presence in our community health center’s physicians, staff, and patients, I felt a loss of words that Tuesday morning. There was simply too much pain, grief, and rage in our community.
I was thankful …
Don’t be afraid to say “Black” when asking about someone’s culture
Transitioning from the classroom to the wards is an uncertain and anxiety-provoking time for many medical students. Schedules are constantly changing, as are expectations and learning objectives. Mentorship and advice from upperclassmen, residents, and attendings was an essential tool in my MS3 toolbox. I would go so far as to say that these pieces of insight are the toolbox. The 2020-2021 academic year will provide its own degree of obstacles …
Pearls and pitfalls for medical students entering their clinical years
Recently, a few colleagues and I sat down with our six incoming interns during a welcoming round-table discussion. Being the closest member of the faculty to these residents in age and time from residency, I was best able to relate to them and their current feelings.
I, too, sat in those chairs in a conference room that was last used for graduating our outgoing chief residents. I, too, remember the feelings …
6 tips for success in residency training
An excerpt from The Surgeon’s Obol.
July 1, 8 p.m.
“Isabella Isaksen,” I said with an arm extended. “Most people call me ‘Izzie’.”
“Mike Gunderson,” came the reply. Most people called him Gundy, but he didn’t feel the need to let me, the goddamn intern, in on this. And …
The first night on call as a surgery intern
Growing up in Puerto Rico, “babas” (bottles: biberón/botellas) and “bobos” (pacifiers: chupetes/chupón) were very common among the families and children of the island. I still remember our Abuelita giving us milk in our “babas,” so my younger sister and I were sure to fall asleep better. From the time of our births, to when my sister was three years old, the “bobo” was also consistently being used in our home.
Now, …
Bottles and pacifiers: advice from a Latinx pediatrician
Like many others, I have felt immense frustration in the past couple of weeks. The news surrounding the Black Lives Matter movement, compounded by many other incidents of injustice against minorities, has made me feel constant rage at the society we live in.
I’ve tried to channel my anger into as much activism as I can think of, and I’m looking for more opportunities every day. Beyond donating, protesting, …
Why cultural competency courses should be requisites for medical school
In the United States, there is clear evidence that minority populations continue to be underrepresented in clinical research related to new therapies for common and serious long-term medical conditions such as type 2 diabetes (T2D). This is despite these same populations facing a continuing and disproportionate burden of T2D, which shows no signs of abating.
Black people have one of the highest rates of T2D (13.2 percent), a rate almost twice …
Minorities and medical research: Who is still excluded?
Primary care is on life support. COVID-19’s toll on American health care extends beyond the hospitals and medical workers besieged by infection. An equally insidious but less-visible crisis is engulfing primary care, the long-neglected foundation of our health care system. Given the role of America’s largest corporations in providing health care benefits, the C-suite should be on high alert.
As growing numbers of patients postpone appointments over concerns about …
Primary care is dying: Why that should scare every large employer
“I can’t take this, doc. It’s gonna kill me. I can’t. I just can’t,” exclaims my patient with persistent refusal of his medication. My frustration is met with my patient care team’s hesitation to give him the medication with fear of further conflict and possible escalation to violence. But who’s at fault? Any of us? All of us?
My second patient, lying on the MRI table, shaking his head swiftly in …
What happens when patient capacity and autonomy diverge?
It was a Thursday. It was supposed to be one of those “regular” evening shifts. Then, at 6:15 p.m., my first page went off: Bed 11, Mrs. R., Dr. H. needs to talk to you. The page came from the COVID section of the emergency department.
I immediately called back. It saddened me when I learned that our patient was a young woman health care worker in her early 50s. She …
The emotional side of being a doctor during the COVID-19 pandemic
It’s that wonderful time of year when new interns take their first steps into hospitals as practicing physicians One of us has just completed her intern year and the other quite a while back (but recently enough to still remember some of it), so we wanted to share some tips for the pediatric interns about to start this wonderful adventure.
1. Don’t be overly anxious (as a little anxiety is expected). …
9 tips for new pediatric residents
Yeah.
I said it.
As an anesthesiologist, especially as a cardiothoracic anesthesiologist, there are few things I am more interested in than how well or how poorly your heart functions and why. And a cardiologist can help me obtain a lot of vital information in that regard. But there several things a cardiologist cannot, and I argue, should not do, when it comes to the perioperative care of patients.
First, a cardiologist’s assessment …
I don’t care what your cardiologist says
I feet truly honored to have been asked to speak at your graduation and to have a chance to share on this day with all of you. We are experiencing a truly singular moment, and I imagine you are hoping that I might say something that would be comforting or inspiring, and I really can’t think what that could possibly be.
For the last half of your third year of residency, …
A graduation speech to a residency class
Ever since the COVID-19 pandemic gripped New York City, I have come to dread calling home to my parents. Every conversation ultimately leads to the question: “Is everyone okay?” This is always followed by a pause as my parents consider how much to tell me. Over the past few months, I learned on an almost weekly basis of a new family member, family friend, or neighbor who was hospitalized, transferred …
COVID-19 is a grim reminder of my roots
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