Ed is not from Kentucky. I believe he told me he is from West Virginia and from a very low-income family. At about 15, he was hit by a car and paralyzed from the waist down. He’s now about 30.
But for a guy in a wheelchair, he is nothing short of remarkable for what he gets done. He goes everywhere, either by his own strength or by bus, even on …
Can a rehabilitated sex-offender make positive change?
109.
This is the number of people who died each day from firearms in the U.S. in 2017, the most recent year for which the CDC has published data. It is a staggering number, one that deeply damages the fabric of communities and tears families apart.
What’s perhaps most disconcerting is that this number – 109 – may not come as a shock. We have become so numb …
Gun violence requires medical intervention
Currently, in America, there are only three legal groups of prescribers, the physicians (which include MDs, DOs, DPMs), the nurse practitioner (NPs), and the physician assistant (PAs).
The first class of physician assistants, in 1965, was also the year of the first class of nurse practitioners. Today there are nearly 300,000 NPs In America and 123,000 PAs.
PAs are outnumbered almost three to one, and the trend, with the rapid rise, and …
What’s the future of the physician assistant?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 36-year-old man is evaluated for a 10-day history of abdominal cramping, diarrhea, malaise, and nausea. Diarrhea is watery without mucus or blood. He returned 2 weeks ago from a 7-day trip to Lima, Peru.
On physical examination, temperature is 37.7 °C (99.9 °F); the remaining vital signs …
MKSAP: 36-year-old man with abdominal cramping, diarrhea, malaise, and nausea
“I wish this were not the case, but I am concerned that your disease is getting worse, and your time may be very short.”
“I know you are angry and upset at how you were treated — I will do my best to make sure that does not happen again.”
“I am sorry, but I cannot write a prescription for your pain medication.”
“I know you are confused — I will try to …
A dam about to burst: The job of “doctor” places too much stress on one person
Nearly 100,000 pop culture fans flocked to Emerald City Comic Con in Seattle last year, including many dressed as superheroes, aliens, and robots. But something scarier than a comic book villain is roiling the conference this year — the spread of the coronavirus.
Ten people have died from novel coronavirus in King County, Washington, where Seattle is located, according to the Washington State Department of Health. At least 70 people have …
Is the conference cancelled? How coronavirus is upending the conference industry.
In the dark radiology reading rooms, only the gentle hum of the computers and the quiet chatter of residents dictating radiology reads break the silence. Among the computers sits Dr. Exner, a senior radiology resident at Hospital Woeisme. He has recently become known for a peculiar habit – he has begun adding Rorschach interpretations into every radiology report he completes.
The Rorschach test, created in the 1920s and sometimes referred to …
Resident adds Rorschach reads to radiology reports
When first responders answered roughly ten calls from a long-term care center in Kirkland, Washington, over the course of a week, they did not expect to become patients themselves.
Entering the Life Care Center of Kirkland last month exposed them to the novel coronavirus that sickens people with an illness known as COVID-19. Because the emergency calls came before authorities realized the virus was circulating in the community, some of the …
COVID-19 showcases the bravery of first responders
Recently, revelations indicated that the Iran missile strike on the U.S. base in Iraq actually did cause head injuries. So why did the U.S. initially claim no “casualties”? From the limited reports available, it appears that most of the soldiers’ symptoms were consistent with concussions. Let’s define terms: In the wars of the 20th century, our soldiers would have been labeled with “shell shock.” In the past, diagnosing concussion required …
The casualties of the Iran missile attack: not your father’s concussion
“Should I cancel my business trip?”
That is not the kind of question that patients typically ask their doctors. For most people, that’s not even a question they can ask their doctors, at least, not without an appointment, a co-pay and an anxiety-inducing wait in a crowded doctor’s office.
As U.S. cases of coronavirus rose this week, I fielded some version of this question from countless patients via telemedicine. Technology and experience-based …
What coronavirus is teaching us about telehealth
1. What can I do to prevent becoming infected?
When people are sick with a respiratory disease like COVID-19, they cough or sneeze particles into the air. If someone is coughing near you, the virus could easily land on your eyes, nose, or mouth. These particles travel only about six feet and fall out of the air rather quickly. However, they do land on surfaces that you touch all the time, …
How to prevent coronavirus: Your COVID-19 questions answered by a public health professional
“Made in China.” Words ubiquitous throughout the products we use every day and now, ironically, applicable to the virus that has laid siege around the world. Illness and death have spread across borders and continents, as well as fear and panic. Illness and death we can quantify in numbers, however, fear and panic are less easily measured than felt in our news feeds and social media posts. It is the …
COVID-19’s biggest threat is to the health of our economy
As a new nurse, I was constantly overwhelmed. I had spent four years of my life learning how to become a nurse, and then here I was, being “a nurse” and wondering all the time whether I was even any good at it. My heart was in it. But every moment of every shift, I felt anxious about my understanding of the information presented to me. I remember conversations with …
A great nurse shares their knowledge and does not judge
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In medical school, physicians learn how to diagnose and treat medical conditions. We learn about all the different presentations and revel in catching a complex or rare diagnosis. In essence, we learn to categorize disorders based on a cluster of symptoms and match them with appropriate treatment plans.
Of course, you want this quality in your physician. This system works well until you enter independent practice and learn quickly that patients …
System failure: We need a reboot to better handle intersectionality
Finances were reported as the second leading cause of physician depression for men and women in 2018.
Doctors, like anyone else, face normal challenges that life throws at them. Additionally, they carry a huge weight on their shoulders as they go through rigorous training, are trained to put patients first, and are expected to increase …
Here’s why doctors are financially depressed
I was busy running around the ER on a particularly busy shift when my phone buzzed, and a text message from Jane’s ex-boyfriend David popped up on the screen. I was surprised since I had not talked to him in over three years; therefore, I ignored it until I had a moment to myself an hour later and finally opened the message.
The first line of his message got straight to …
My first physician colleague who died by suicide
Being a specialist in infectious diseases right now is an interesting experience. Added to the usual challenges of our everyday practice — caring for people receiving transplants or chemotherapy, those with HIV, surgical infections, tropical diseases, and others — we now must manage a deluge of coronavirus-related questions from friends, family, and colleagues.
Here are a few recent examples in bold, along with my responses.
Frequently asked questions
My baby …
An infectious disease doctor answers your COVID-19 and coronavirus questions
“Are you my doctor?” Mary* asked me, as I, a resident physician, approached her bed.
“Yes, I am one of the primary medical doctors taking care of you here,” I confirmed with my standard, pre-scripted introduction — with little appreciation of the implications of these words.
Mary was a 30-something-year-old woman who transferred to our hospital due to worsening alcohol-related liver disease. She had struggled with anxiety and depression since her teenage …
6 months of probation: Taking care of someone with alcohol-related liver disease
Corpses.
A sea of corpses.
The smell of death was unmistakable. Its pungent odor snaked around corridors and made its way to the basement, where we stood in line to go up to the anatomy lab for the first time. My heart was racing. All along the walls were jars of human remains—brains, fetuses, organs. As we made our way through the anatomy library and finally came up to the second floor, …
The physician and the sacred art of medicine
Is it time to rethink how we determine the capacity of our patients who are addicted to drugs? I recently began debating this question after I took care of a young woman with endocarditis. She had a long history of IV drug abuse that had led to the development of endocarditis. She had been admitted one week earlier and was being prepared for surgery, but she left against medical advice …
Do patients addicted to drugs truly have capacity?
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