The mood hung in the air like a clenched jaw, a clenched fist, and slumped shoulders. I watched a fellow patient shuffle by the nurses’ station with his little paper cup. You know, the ones that are an inch or two tall and wide with a slight lip; the kind you see strictly in hospitals. I knew it was brimmed with multiple meds the colors of the rainbow. And, of …
A physician hung himself. That could have been me.
I am an orthopedic surgeon, and I only take cash. When I tell people this, it usually conjures up images of some money-grubbing doctor eager to make a dollar any way they can. Personally, I am not incredibly incentivized by money in and of itself. I try to live a reasonable lifestyle and keep my expenses under control. I started a cash-only practice not for the love of money but …
I am an orthopedic surgeon who decided to stop taking insurance
The corporatization of medicine has destroyed primary care as a specialty. The primary care physician is supposed to be your go-to doctor, your advocate, the coordinator of your health care. Now that corporations buy out hospitals and private practices in an almost predatory fashion, the priority is turning a profit for the corporation at the expense of not only patient health but also the health and well-being of the primary …
As I write today, COVID-19 has killed more than 380,000 people in the United States. The country is averaging close to 200,000 cases per day and has a record number of patients hospitalized at this time. This trend shows no signs of abating. Unfortunately, this only means that the number of hospitalized patients and the number of patients dying will continue to trend up in the coming days and weeks.
Amidst …
Can we stop wasting the COVID-19 vaccine?
Those were the headlines in one of the Sunday papers.
He was around fifty years old and with his wife. They stood in front of me in the supermarket. He was in shorts and a light blue t-shirt, wearing beach flip-flops. Standard casual wear for the holiday beach town where I work at Netcare Kingsway Hospital in Amanzimtoti, on the KwaZulu-Natal South Coast of South Africa.
I could see him reading the …
I was an assistant nurse manager (ANM) in a 24 bed ICU in my younger, energetic years. Before that, I was a manager in a very small emergency department. I must say, I loved it. I loved the thrill and the challenge. I was able to work with the Joint Commission; I ordered EKG monitors and defibrillators, any equipment needed for the emergency department. I worked with the health department …
Create a positive light in nursing
As I watched the vaccine rollout take place over the past month, all I can say is that I am not surprised. I watched hospital executives who never see patients jump the line, doctors having their healthy nannies vaccinated, and health systems trusted with vaccine doses have essentially no plan. It’s like we didn’t have 9 months to figure this out. All I can say is that this is the …
Vaccinating athletes will show us if the vaccine works
It was Friday night, and after a long day of grossing, I was ready to leave the hospital when the department’s door opened, and the nurse shouted, “we have a frozen for an emergency liver transplant.” Without hesitation, I took the specimen and called the attending on call. After a few minutes, the surgeon arrived anxiously to our reading room. “We flew all the way from Pennsylvania to get this …
My first clinical rotation as a third-year medical student was in orthopedics. I remember the excitement of being scrubbed into the OR, with the gloried task of suctioning while the fellows did the real work. About 30 minutes into the surgery, when things were getting underway, a male physician scrubbed in and took the tool away from me — I grabbed it back, letting him know I had the …
As both patients and physicians, women face discrimination
It is stressful enough to live with heart disease. Now, with a global pandemic, access to health care providers has shifted from in-office to telemedicine in many instances. There are challenges for patients with heart disease in this context:
Pandemic challenges for patients with heart disease
This week at work, I had a patient in the hospital who had been through a pretty challenging illness, and he was going to have to be discharged to a skilled nursing facility (SNF) to rehab for a few weeks. Sadly, SNFs in my area do not currently allow any visitors due to the pandemic. The patient is very close to his daughter, who lives out of state, and she …
A real-life example of irrational health care spending
Developing the COVID-19 vaccine was the first monumental milestone on a long and arduous journey to achieving the entire U.S. population’s vaccination.
One of the barriers to achieving this task is the absence of a reliable, scalable way to uniquely identify each individual before or after they receive the vaccine. Furthermore, in the absence of this unique identifier, it is extremely difficult to reliably use existing state or regional data repositories …
A national patient identifier would make vaccinating the entire U.S. population easier
The highly anticipated A Promised Land was the first book I could not wait to crack open over my two-week break for the winter holidays. Former President Barack Obama explains in his introduction that this work is the first of two autobiographical accounts covering the period from his state legislature run in Illinois through his presidency. This masterwork takes you through every decision he makes and helps illustrate just how …
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Canadians breathed a huge sigh of relief when the federal government approved the first COVID-19 vaccine and saw the first immunizations take place. The end of the pandemic and the prospect of a return to normal, whatever that means, became a real possibility.
Rolling out a national vaccination program will be no small feat. In addition to the basic logistical challenges of moving volatile product throughout the …
Not all frontline health workers who need priority vaccination are doctors and nurses
With this third surge and our ICUs at zero capacity in Los Angeles, I spent New Year’s Eve alone at my apartment, recovering from a wards rotation I had completed the night before. No revelry or celebration for me this year. For months, this virus has been wreaking havoc on our lives and slowly, then rapidly chipping away at our health care systems. I’ve seen the …
Family lore recalls that my grandfather, succumbing to stomach cancer in the mid-1960s, “died addicted to morphine.” Decades before the AIDS crisis sparked the hospice and palliative care movements, the confluences of pain, dependence, and addiction were confused and regrettably moralized. Since then, the science has excelled, but our clinical understanding of how pain and addiction intertwine remains limited by stigma, assumptions, and the separation of the underlying science …
Merging the wisdom of pain medicine and addiction medicine to optimize outcomes
I am at a loss. While trying to explain the events to my children since January 6, I feel profound sadness and fear. Our country is built on freedom, yet the latest in a parade of crisis’ is being used by those in power to remove our freedoms at an alarming pace and divide our country further.
Less than one percent of the people who went to Washington, DC for a …
The answer to hate speech or false speech is not censorship
She shook her head no, eyes brimming with tears, chin quivering with emotion. Again, I told her that without further care, her son would never have use of his arm and possibly would die. Her voice trembling, she told me her husband would beat her if she returned home without the boy. She placed her son on their horse, his newly bandaged arm in a make-shift sling. I gave her …
A witness to desperate poverty and ever-present hopelessness
December is typically busy in the ICU. Flu and respiratory viral pneumonia cases start trickling into the ICU, interspersed with cardiac arrests, strokes, pulmonary emboli, septic shock, and COPD exacerbations. The ICU census starts creeping up.
December 2020 has been unique and challenging. There were seemingly endless days of patients coming to the ICU, only to die. People with COVID-19 and the usual ICU ailments seemed sicker than usual. Patients have …
Why this critical care doctor got the COVID-19 vaccine
This is not what I signed up for.
Have you ever said this when you are rushing home 1.5 hours after the last patient left and you still haven’t finished all your charting? You grab a handful of forms to take home with you with the hopeful expectation that you will get them done tonight too. After you have done “enough” to appear to be a present parent and prepared supper …
You didn’t sign up for this. You don’t have to drown in the paperwork.
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