I was in my fourth year of medical college in psychiatry electives. I remember my professor discussing a young boy, an A-grade engineering student diagnosed with depression one year back and now was admitted in the psychiatry ward with severe depression with psychotic symptoms. I saw the boy, a tall, dark, handsome face — just like my brother. A different kind of fear hit me that day. I saw my …
Wood art
The taxing journey of going through an illness often has the turning point of hearing a “diagnosis.”
Diagnosis locks a person inside a sick body. Diagnosis is a label that dictates certain behavior in an individual and the whole circle of people around that person, including family members, workplace, health care providers, and insurance companies. Diagnosis is a journey from diagnostic …
An excerpt from The Real Drama—Incredible Medicine.
It was an ordinary day in my family medicine practice many years ago. A variety of patients, many longstanding and from various generations of whole families, were filling the waiting room. Back then, I had four very efficient and nice women working for me, with various duties. We had 3 examining rooms and a …
Terror in the family medicine office
An excerpt from Animals of Undetermined Significance.
The “LIC-man” was at his usual post at the “Ultra Fastest Ever Laser Cassette Inscriptor 2XFL” known as the UFELCI- 2XFL, which was on a side counter near the Miami Beach grossing station. He was a tall, thin man who had never really wanted to work in the field of lab and medical equipment …
Scenes from a pathology resident’s day
“I don’t know if I can keep doing this”
“I can’t see a way out.”
“I feel stuck – trapped.”
What is it like? That feeling of being exhausted, stuck, not feeling like there is a way out. I think of it as running a marathon where you can’t stop. You are tired, it’s 90 degrees and humid, and you are miserably hot. You keep pushing towards the finish line so you can …
National Physician Suicide Awareness Day: Break the silence
An excerpt from Physician Betrayal: How Our Heroes Become Villains.
A mass casualty event begins with one act of betrayal. By one person. A person with power. In medicine the assault weapon—doctor’s orders.
One act of betrayal by one doctor may lead to an unstoppable cascade befalling all colleagues downstream in rapid succession.
Physician betrayal always begins with self-betrayal—the act of …
Medicine’s culture of betrayal
As a pulmonary and critical care doctor and the mother of three children too young to receive a COVID-19 vaccine, life has been harrowing. At the beginning of the summer, however, I was beginning to breathe a sigh of relief. My children had been in school last spring, and by the heroic efforts of their amazing teachers and staff, completed the school year free of sickness or quarantine from COVID-19. …
Clearing the air our kids share: a prescription for healthy schools
“The weapon of the advocate is the sword of the soldier, not the dagger of the assassin,” according to journalist and writer, Alexander Cockburn.
The sword of the advocate, whether used for oneself or a loved one, may also end up opening doors that can benefit others. My work involves promoting the importance of family involvement in patient advocacy. But on occasion, I have needed to advocate for myself; I hope …
The advocate’s sword stands polished and ready
As third-year medical students, we recently stepped out of the classroom and onto the wards, eager to provide the quality care we had been working towards for the better part of the last decade. We were, however, quickly met with a stark reminder of how climate change can jeopardize our ability to do so. We entered the ER in the midst of a blistering heatwave to find two patients waiting …
What the latest IPCC report means for physicians: There is no time for climate despair
“Are there specific ways empathy will be tested in the standardized patient exam?” a medical school classmate of mine earnestly asked following a lecture years ago. I laughed, thinking that teaching empathy was impossible. As an optimistic and naive medical student, I had thought of myself as naturally empathetic. During those days, I was able to spend hours with patients, gaining their confidence while hearing their stories and concerns. I …
My journey to the root of empathy and why we must try to teach it
On August 25, 2021, the United States achieved two world records: approximately a total of 39 million cases of COVID-19 among our citizenry and approximately 648,000 deaths due to succumbing to COVID. Young, old; male, female; rich, poor — it doesn’t matter. We are all potential victims of this deadly disease.
Our numbers have surpassed the data of countries such as India, Brazil, and China. Haven’t we learned anything in almost …
Americans are dying in ICUs in far greater numbers than would otherwise be if not for a newly misapplied 57-year-old rule banning the only American board-certified ICU doctors available in many cities from providing critical care, leaving only nurses to do the doctor’s job in treating ICU patients.
There is a severe national shortage of only 25 percent of the needed board-certified intensive care unit doctors — known as critical care …
Millions of Americans without ICU doctors due to the “Biden ban”
One day, a primary care physician located about two hours away called my office in a desperate attempt to find a rheumatologist. His lovely 64-year-old patient, very healthy otherwise, recently developed a severe and disabling inflammatory arthritis. After conservative treatments failed, he tried to refer the patient to the traditional medical system. However, they could not get a sooner than six months appointment. This is a symptom of a broken …
The emergence of direct specialty care
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In June 2020, I wrote a short piece about the COVID vaccine that turned out to be prophetic. I said that the vaccine’s immunity might wane over time, that there might be bothersome side effects immediately, and that the public might ignore social distancing and mask-wearing once they were vaccinated. I worried that there would be political pressures to focus more on the economy than on public health.
And I wrote, …
A person-to-person strategy is needed in the pandemic war
“I feel like I have to educate my doctors about my gender identity and transgender health-related needs, including insurance coverage,” my transgender male patient, V, told me on interview. A series of interviews with V for a community outreach project during medical school elucidated a plethora of health care barriers for transgender individuals. V’s list of unmet needs includes transgender-friendly mental health care and LGBTQ+ educated physicians, including complex gender-diverse …
Advocacy for better transgender health care
When you enter medical school, you put your trust into an unspoken promise: Work hard, pass all your classes, and you’ll come out as a doctor after four years. While mostly true, this perception doesn’t take into account the residency application process and the possibility of graduating without a position as a physician-in-training. This thought didn’t cross my mind until I decided to apply for otolaryngology, one of the most …
Unsolicited advice from unmatched residency applicants: Hope for the best, plan for the worst
A few weeks ago, my longtime friend and personal physician refused to grant any more prescription refills for the two medications that I have taken regularly for close to a decade. In a very professional tone, he firmly (and appropriately) pointed out that it had been more than three years (please don’t judge me) since I had been examined or subjected to any routine screening lab work. Having now been …
How to heal and revitalize our beloved profession
Unfortunate outcomes are inevitable even when practicing quality medicine. Most are random events, but some are medical errors. The majority of physicians have been sued and those, who have not, will be. Common to all defendants is that the lawsuit is totally fallacious.
To be fallacious, the outcome of a medical intervention must be an unpreventable random mal-occurrence. This is the only alternative to a medical error. Nevertheless, there is a …
Your best defense? Don’t play by the rules in a medical malpractice case.
I’ve faced this disease since it arrived. I flew into the storm in order to face it head-on, leaving behind my family and a hospital filled with denial and petulant resistance to the horror that was to come. While in New York, I worked alongside men and women who were working at the edge of their capabilities in a heroic and inspiring way. I watched what can happen when a …
COVID and Afghanistan: a war on 2 fronts
An excerpt from All Bleeding Stops.
42nd Surgical Hospital
Phu Bai
Republic of Vietnam
August 1967
They hear them before they see them, the deep, thudding whump of the rotors pounding in their brains, booming in their chests. The choppers come at them, rising over the wall of trees, leaking oil, dripping blood, enlarging, becoming darker, louder, filling the sky with their deafening roar. They …
Exposure in surgery is everything
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