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How social distancing affects vulnerable nursing home residents

Palak Patel

Conditions and Diseases

May 11, 2020

On a cold evening in early March, my grandpa and I queued outside a nursing home in rural California. He pulled an insulated lunchbox, filled with hot chai and pureed rotis, to his chest and sighed. There are at least eight families in front of us, and if we don’t move fast, my grandma will fall asleep before she’s had dinner.

Twenty minutes later, we’ve reached the threshold: a nurse takes …

Stop calling health care workers heroes and do something to help them

Deborah Edberg, MD

Physician

May 11, 2020

The narrative that paints health care workers as “heroes” makes me uncomfortable. I may not have a right to an opinion as I am third-string back up not currently working in an overwhelmed ER or ICU. I also feel uneasy about the sea of gratitude and cheers of support, though I know they are uplifting to the people on the receiving end.

Yet, while watching these stories of appreciation, resilience, and …

We must protect the most precious scarce resource required for the next phase of the pandemic

Jessica Turnbull, MD

Physician

May 10, 2020

“Good news! You have antibodies, so you’re immune to COVID-19.” How relieved would we be to hear that? I could move throughout my place of work, or my grocery store, with added security. I would muse about a vetted cohort of immune providers to care for patients with COVID-19. PPE could be conserved so that it could be plentiful for the providers who volunteered themselves to remain in the fray …

Deploring racism isn’t enough: Addressing white privilege in medical school

Jessica Cranston

Medical Education

May 10, 2020

If you ask a group of medical students to raise their hands if they are, in fact, racist, I’d venture to guess that not a single hand would shoot up. And I don’t think they would be lying. I am sure that no student believes that he, she, or they are a bigot.

Many of us have committed our lives to care for patients regardless of race, gender, or socioeconomic status. …

Should we stress about stress? Protecting ourselves during the pandemic.

Reut Gruber, PhD

Conditions and Diseases

May 10, 2020

COVID-19 has exposed us to a wide variety of different stressors. In the short term, our stress response is useful as it helps us respond quickly and effectively. But when the stress lasts longer, we have to identify and acknowledge the “downside” risks.

We should not stress about stress but protect ourselves against it.

Intense, prolonged stress has a negative impact on our immune system. Stress increases the …

After COVID-19, there’s no turning back from a digital clinical workforce

Muthu Alagappan, MD

Physician

May 10, 2020

Novel coronavirus (COVID-19) has challenged our health care industry in profound and irreversible ways, creating massive pressure that has exposed system-wide inefficiencies and inequalities. It has also fundamentally shifted the way first responders, health care providers, hospitals, health systems, and even the federal government are using digital health technologies.

The current pressure test that our industry, economy, and global community is withstanding has forced health organizations—both large and small—to rapidly adapt, …

Incorporate art therapy into healing spaces

Sonali Mantoo, MD

Physician

May 10, 2020

Art is a way to find yourself and lose yourself at the same time. When troubled, we experience the monkey mind, thinking of worst outcomes, or replaying past events. A creative pursuit helps stall that process by helping us actively practice mindfulness. There is no wrong brush stroke in art; you simply incorporate that into the painting and create something beautiful out of it. A good philosophy for life too, …

The hidden wounds of COVID-19

Andrew Trotter, MD, MPH

Physician

May 10, 2020

By the time we started to have a significant number of COVID-19 patients in our hospital, I was working as the attending on the inpatient infectious disease service. Along with the rest of my infectious disease colleagues, we had all been tracking the evolving COVID-19 statistics and mounting predictions that we would eventually become inundated with COVID-19 cases. We were in that “waiting for it” phase. Although it gave us …

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The hidden wounds of COVID-19

Responding to medical students’ concerns and anxieties during these unprecedented times

Kali Chiriboga

Medical Education

May 9, 2020

Everyone is in the same situation across the country in these unprecedented times.

What a statement. A statement that every medical student has undoubtedly heard in utter multitude during these times of virtual medical curricula in place of clinical curricula — of canceled steps, levels, CKs, PE, and CS. It has no doubt been challenging on everyone, with some feeling stripped of their opportunity to help and serve their mentors and …

My living will during COVID-19

Gayle E. Woodson, MD

Conditions and Diseases

May 9, 2020

I am not afraid of being dead. Our four grown children are thriving, each in their own way making the world better. If I am wrong in my faith that Jesus is preparing a wonderful place for me, I will never know it.

I do dread the process of dying, and COVID-19 would be an awful way to go. Most people have mild symptoms, but mortality skyrockets above the age of …

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My living will during COVID-19

A reasoned response to the PPE debacle

Robert Frolichstein, MD

Conditions and Diseases

May 9, 2020

The lack of adequate supplies of PPE is deplorable, inconceivable. This has been made abundantly clear through both social media and traditional media. Post after post on various social media outlets have exposed the appalling shortages and, at times, blame and attack those that are obliged to provide us the PPE. Those posts, in part, have spurned movements among nonmedical personnel to donate and make masks. Heartwarming, and it feels …

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A reasoned response to the PPE debacle

How to liberate doctors from EMRs

Erin Palm, MD, MBA

Health Technology

May 9, 2020

We talk a lot in critical care medicine about liberating patients from ventilators. Vents are getting a lot of deserved attention for saving lives in the COVID-19 era. But the machine has downsides that get worse the longer the patient needs it.

Because we’re obsessed with taking great care of our patients, we in ICU medicine obsess about ventilator liberation. There are thousands of publications on the topic. Vent weaning protocols …

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How to liberate doctors from EMRs

A medical student asks: Are we just cartoon heroes?

Jake Eggett

Physician

May 9, 2020

The one thing about the coronavirus I keep coming back to is how much SketchyMicro let me down.

Out of all the mnemonic cartoons SketchyMicro has produced, their entry for coronavirus is among the most simple: a kingly figure is blowing his nose into tissue paper beneath a blazing sun, his towering castle perched atop a hill in the distance. His regalia include a golden crown (to remind us of corona) …

Addressing mental health needs for our frontline responders and health care providers

Ton La, Jr., MD, JD

Conditions and Diseases

May 9, 2020

Coronavirus. Doctors. Nurses. PPE. Social distancing.

Sound familiar? Our entire conversation about the COVID-19 pandemic surrounds those words and phrases. We see celebrities, companies, coworkers, family members, and friends donating PPE and money to organizations and local hospitals, trying to do some good. No one wants our front-line health care workers to get sick. If that happens, the public will be at even greater risk.

For the past several weeks, all that …

When doctors weren’t needed anymore: a short story

Judy Salz, MD

Physician

May 9, 2020

Annie’s brows drew together at the unfamiliar word in her third-grade history lesson. She swiveled from her screen to face her mother.

“What are doctors?”

“They were people specially trained to care for sick people.”

Annie was still perplexed. “What’s sick?”

Her mom patted the place next to her on the sofa. “Come here, and I’ll explain it to you.”

With her daughter settled in, she began.

“Do you remember when all your goldfish died?”

“Yeah. Goldilocks …

Learning to cope with the pandemic from palliative care patients

Rob A. Ruff

Conditions and Diseases

May 8, 2020

I’m a palliative care chaplain who provides spiritual support to patients with serious, life-changing, and for some, life-threatening, illnesses. A common story they tell is an illness, like a storm, blew them off their life’s map. They find themselves lost in the unfamiliar territory of sickness. The future, once certain and promising, is now uncertain and ominous. Plans they’d made are on hold, possibly canceled. The specter of death looms …

A journey through time with a very modern foe

Frank Han, MD

Conditions and Diseases

May 8, 2020

Come with me on this journey, this very ancient journey.

To experience the age-old story of a very modern foe. This foe is invisible; it is neither living nor dead. You cannot smell it, and you cannot taste it. While it is not alive, it can become alive, with a flick of the right kind of switch. While it is not dead, it can masquerade as the dead, until the perfect …

It’s so important to just take another moment with your patients

Alec Kellish

Medical Education

May 8, 2020

Medical schools around the country remain closed due to the current COVID-19 pandemic, swapping hands-on learning experience on wards and within the operating room for Zoom lectures and telehealth visits. Ten months ago, this was the furthest thing I imagined as I began my third year of medical school, filled with nervous excitement to move on from the relentless studying required for Step 1 and start seeing patients. …

Post-COVID medical education must teach the real reasons for health disparities

Irène P. Mathieu, MD

Medical Education

May 8, 2020

Jason Hargrove, a 50-year-old Detroit bus driver, died from COVID-19 after being turned away from care multiple times while visibly cyanotic. Rana Zoe Mungin, a 30-year-old teacher in Brooklyn, was sent home several times until she was ill enough from the disease to require intubation and ventilation. She has since died. While there are many reasons for these and other racialized …

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