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The collective consciousness of COVID-19

Conditions and Diseases

April 13, 2020

“Plagues are infrequent but constant, and they do not alter the conditions of mankind (everybody dies) but rather concentrate our misfortunes into moments where everyone thinks for a change that mortality is afoot.”
– Albert Camus

In Camus’ construct, there was no mass media or the internet, yet the fear of imminent death spread like wildfire in a parched California landscape. Nothing is as contagious as that type of fear, as stampedes …

Treating COVID-19 patients in their homes

Bernard Leo Remakus, MD

Conditions and Diseases

April 13, 2020

Anecdotal though it may be, a team of Italian doctors and nurses, led by Dr. Luigi Cavanna, has reported apparent success treating COVID-19 patients in their homes. Realizing too many near-death patients were traveling long distances to the hospital emergency room in Piacenza, Italy from their rural villages, Cavanna reasoned many of these patients might be saved if they were diagnosed and treated earlier. He also reasoned his overcrowded hospital …

The importance of achieving FIRE for the physician in the age of COVID-19

Christopher H. Loo, MD, PhD

Physician Finance

April 13, 2020

Times have definitely changed.

In the month of March 2020, we have seen the global economy shut down almost completely. Businesses shut down. Travel stopped. Millions filing for unemployment.

Crises that used to span out over months, now happen in the time span of weeks to days.

The rate of economic decline from COVID-19 is faster, more pronounced, and more pervasive than 9/11 and the 2008 financial crisis combined. Unlike 9/11 and 2008, the …

Should fourth-year medical students graduate early?

Nitin Agrawal

Conditions and Diseases

April 13, 2020

Graduating medical students early is not a completely novel concept. During WWII, there was a significant physician shortage, and various medical schools initiated a 3-year accelerated MD program to produce more physicians. These programs were eventually discontinued in the late 1970s and early 1980s. In 1918, the influenza pandemic created a similar situation. Third- and fourth-year medical students were enlisted to help …

The moral and ethical dilemmas of COVID-19

Rebecca Elia, MD

Conditions and Diseases

April 13, 2020

In all of my thirty years of medical practice, I have never encountered the degree of moral and ethical dilemmas as those created by COVID-19. None of us has experienced anything like this. At no time in our history has all of humanity been at risk for contracting the same potentially deadly disease. And never in my entire career could I have imagined that we would be so woefully unequipped …

The opportunities for medical students in a pandemic

Pratik Doshi and Megha Gupta

Conditions and Diseases

April 13, 2020

The health care system is broken. Physician burnout is at an all-time high. Patients don’t trust us. If you ask any medical student today, they will have heard at least one of these statements from their educators, often coupled with the phrase: We don’t know how to solve it, but your generation will find the solution. While meant as encouragement, these statements paint a gruesome future for the health professions …

Stolen checks and maybe some forgiveness

Raymond Abbott

Conditions and Diseases

April 13, 2020

It took some getting used to in dealing with Mae. My main function soon became acting as her bookkeeper. Each month, I would write checks for her. She was illiterate, and signing her name was about all she could do.
Mae was a fairly ordinary looking lady past 50 by several years. But what was most striking about her was her mischievous personality — in short, she was a flirt.

I found …

Why you should remember your anesthesiologist’s name

Tiffany Pouldar, MD

Conditions and Diseases

April 12, 2020

If you’ve had surgery before, you almost certainly remember who your surgeon was. You’ve probably thanked them countless times for getting you through a scary time. Whether they excised your cancerous tissue, repaired your ACL, or removed your inflamed gallbladder, you have likely sung their praise, time, and time again.

But do you remember who your anesthesiologist was the day of your surgery? Probably not, and that’s okay. You may recall …

Even during a global pandemic, the human connection remains present

Reina Patel, DO

Conditions and Diseases

April 12, 2020

As I drove into work this week, I felt the elephant standing on my chest with its heavy foot in the pit of my stomach. Amidst this current global pandemic due to COVID-19, I reminded myself to breathe. The idea of getting closer to the hospital made the adrenaline surge through my anxiety-ridden heart.

I think back to a time many years ago, when I was a pediatric resident, preparing to …

Understanding science means realizing that science doesn’t always have all of the answers

Cory Michael, MD

Conditions and Diseases

April 12, 2020

The impact of science on the well-being on our planet has never been more important than it is now. We are all looking to science and technology in a search for answers and resources. We keep watching television in search of these answers, but we are left unsatisfied because we don’t understand medical science.

A great deal of what we know as doctors comes from other doctors. …

A medical student about to graduate. And a lack of closure.

Emily Masterson

Conditions and Diseases

April 12, 2020

In this isolated and new existence, we are experiencing a collective grief. A deep, poignant distress caused by bereavement. Apart physically, but together mourning the loss of the world we once knew.

Life has distinct stepping stones. Birth, death, marriage, graduation. Proof that one phase of existence has ended, and another will soon begin. Traditionally, these occasions are marked by gatherings, festivities, celebrations. In the unprecedented age of COVID-19, so many …

We must support nursing home residents during COVID-19 trauma

Harsh Moolani

Conditions and Diseases

April 12, 2020

Two months ago, I kneeled next to Sarah – an avid drinker of chocolate milk, ex-journalist, and new hospice resident – in a nursing homeroom. We had a knack for discussing emotions, and that day, our conversation reached the idea of suffering.

Her pain-stricken voice shared, “Did you know that we notice? When someone’s health turns for the worst, we notice. There is a special whispering that flutters throughout the building. …

Changes are needed to help today’s health care heroes

Cole Edmonson, DNP

Conditions and Diseases

April 12, 2020

On 9/11, firefighters and other first responders rushed in to protect others, and for that, they will always be heroes. Today, health care workers are rushing in to heal those with COVID-19 – at great risk to themselves. Health care workers are the true heroes of this crisis.

On routine days, clinicians caring for patients at the bedside are at far greater risk than most people in …

During the pandemic, faith keeps us together

Uzma Syed, DO

Conditions and Diseases

April 12, 2020

With the world more or less at a standstill, how do we cope with our needs as human beings? So much has changed in our world in such a short amount of time. For most of us, our rather predictable and standard routines have come to a complete standstill. It’s as if someone hit the pause button on the movie called life.

Learning the new normal in these unusual times has …

Genetic testing: Could there be unintended consequences?

Miles J. Varn, MD

Conditions and Diseases

April 12, 2020

Both clinical and direct-to-consumer genetic testing have become significantly less costly and more common, providing people with access to a wealth of information about everything from their ethnicity and family lineage to their risk for certain diseases and how they will respond to medications such as blood thinners and antidepressants.

But before you decide to take the plunge into your gene pool, there are a number of issues you should carefully …

An oncologist’s prescription for managing fear and chaos in the COVID-19 pandemic

Douglas B. Flora, MD

Conditions and Diseases

April 12, 2020

When physicians present at medical conferences, we usually start with a slide disclosing any potential conflicts of interest to our audience. I probably need to disclose two things here. First, I’m an infuriating and inexhaustible optimist. Second, I’m a cancer doctor but also a recent cancer patient myself, and I understand intimately how it feels when your world unexpectedly spins out of control.

With the arrival of COVID-19 on our shores …

The opportunity cost of the liver organ shortage in the United States

Omar Haque, MD, Khalid Khwaja, MD, Bapu Jena, MD, PhD

Conditions and Diseases

April 12, 2020

The first five liver transplant recipients were all dead within 23 days. The year was 1963, the surgeon was Dr. Thomas Starzl, and the operations were actually deemed a success for their surgical complexity. Since then, liver transplant (LT) has evolved from an experimental, often fatal procedure to the standard of care for end-stage liver disease (ESLD). Compared to the 0% 30-day survival rate of LT in 1963, the most …

Please don’t make physicians choose

Gregory Jasani, MD

Conditions and Diseases

April 11, 2020

I took an oath when I graduated from medical school. The ancient, powerful words of the Hippocratic Oath are seared into the brain of every physician: “First, do no harm.” I, along with every physician who has come before me, hold myself to that standard. Every time I go to work, my goal is to deliver the best treatment to any patient who seeks my care. Yet I worry I …

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Please don’t make physicians choose

During the pandemic, it’s OK to be a “good enough” parent

Shayla Sullivant, MD

Conditions and Diseases

April 11, 2020

The social media posts exhaust me. I see parents with colorful schedules for children to abide by during this pandemic and others who have made a zillion fabric masks to donate. Meanwhile, I’m trying to test the technology to see patients from my new home “office” and train my children that they cannot join the visits (not successful so far). The constant barrage of emails notifying me how my children …

CMS needs to permanently eliminate barriers preventing routine use of telemedicine

Magdalena Bednarczyk, MD

Conditions and Diseases

April 11, 2020

On March 6, 2020, the Centers for Medicare and Medicaid Services (CMS) provided a temporary waiver to expand telemedicine services, whose use was previously limited to specific circumstances. However, as the United States grapples with the unprecedented impact of the COVID-19 pandemic on our nation’s health care system, CMS should permanently eliminate barriers limiting the routine use of telemedicine.

As clinicians, we can …

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