To first-generation college pre-medical students: Your future patients need you

Physician
July 22, 2019

Being a first-generation college student is hard. Being a first-generation college student and being pre-med is even harder. And since education and income are closely linked in the U.S., it’s no surprise that many first-generation college students also come from a low-income background.

I fell into this category.

My parents did not finish high school, and money was always tight. I had never heard of pre-med until I got to college. I …

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To first-generation college pre-medical students: Your future patients need you

Reduce health care’s carbon footprint to save our patients

Health Policy
July 22, 2019

I would like to explore a typical American health care experience through a different lens: energy.

Upon entering a hospital, I would see bright lighting and hear the gentle hum from ventilation. If I were to get an MRI, this requires significant energy often supported by fossil fuels. For blood work, there would be medical waste generated from my stick. While grabbing a quick bite to eat in the hospital cafeteria, …

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Reduce health care’s carbon footprint to save our patients

Dealing with the pressures of learning as a physician-in-training

Medical Education
July 22, 2019

The other day, I happened across a YouTube video called the “Try Not to Look Away Challenge.” There were some obvious video clips, such as a person vomiting, a spider, and a spooky video game. What struck me was a clip from a movie in which a middle-aged woman forgets where the restroom in her house is located. After letting her husband know that she was headed to the restroom, …

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Dealing with the pressures of learning as a physician-in-training

Alternative cancer therapies and the promise of false hope

Physician
July 22, 2019

How do you respond when patients with a good prognosis want to delay chemotherapy to try an anticancer diet for a few months or visit an unregulated clinic for unproven therapies? I’m asking because of an alarming finding of ASCO’s 2018 National Cancer Opinion Survey: “Nearly 4 in 10 Americans believe cancer can be cured solely through alternative therapies …” Clearly, we have a problem in today’s discussion about cancer treatments. …

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Alternative cancer therapies and the promise of false hope

Art therapy and the intersection between chronic illness and mental health

Patient
July 21, 2019

An excerpt from My Beautiful Detour: An Unthinkable Journey from Gutless to Grateful.

Managing chronic illness can leave a person susceptible to emotional and mental health issues that can further exacerbate their physical symptoms.  Post-traumatic stress disorder can often accompany managing a physical illness, and often is the …

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Art therapy and the intersection between chronic illness and mental health

A physician writes for catharsis

Physician
July 21, 2019

After finishing the pitch for my book at a recent Harvard Writers’ Conference in Boston, I felt relieved and encouraged by the judges’ comments. As I waited for my turn at the podium, I glanced above my notes over the faces of 300 of my fellow attendees who had accomplished so much in their respective fields of medicine, nursing, and counseling.

The pitches made by these would-be authors revealed an amazing …

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A physician writes for catharsis

Doctors, listen up! You’ll be a patient soon.

Patient
July 20, 2019

As I age, the probability of acquiring yet another health condition seems to, unfortunately, increase. There’s always one test or another that is on my to-do list, be it bloodwork, X-ray, MRI, or maybe a CT scan thrown in for good measure. I comply usually with a sense that it is for the benefit of my health, i.e., to enable my doctors to determine the best mode of treatment for …

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Doctors, listen up! You’ll be a patient soon.

Why doctors should never practice self-primary care

Physician
July 20, 2019

I am a mid-40s female rheumatologist. Fortunately, I consider myself to be fairly healthy; my diet and weight are OK, I run 30 to 35 miles per week, and my only medication is a low-estrogen oral contraceptive that I have been self-prescribing for years. Work and life are busy, and my health maintenance could be better. I have been getting regular mammograms since age 40 (some self-prescribed), maybe I see …

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Why doctors should never practice self-primary care

4 Beatles playlists for your residency emotions

Physician
July 20, 2019

I recently graduated from residency and fellowship. The last week in-house was a second adolescence. My moods have been up and down. I’d giddily return a parking pass, then surrender IT access in tears. No one could feel this — my — moment as deeply, specifically, or correctly as I could. What word is there for that? There’s song.

Influenced by the new film Yesterday, I melodramatically equated my break-up with …

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4 Beatles playlists for your residency emotions

MKSAP: 38-year-old woman with fever and flank pain

Conditions and Diseases
July 20, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 38-year-old woman undergoes follow-up evaluation in the office. She was evaluated in the emergency department 3 nights ago with fever and flank pain following 2 days of dysuria.

A urine culture and two sets of blood cultures were collected. She was given intravenous ceftriaxone and discharged with a 7-day …

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MKSAP: 38-year-old woman with fever and flank pain

The secret to ending cynicism in medicine

Physician
July 19, 2019

To fill an assignment in an undergraduate medical sociology class, my friend and I made an appointment with the assistant administrator in a local hospital. After the interview, we proceeded towards the exit by cutting through the obstetrical wards. We passed an exhausted young doctor with a stethoscope draped over his neck and hunched over a stack of charts. He glanced up as we passed, and we introduced ourselves as …

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The secret to ending cynicism in medicine

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Medical board tests are worse than airport security

Physician
July 19, 2019

A lot has been written about board recertification requirements. Physicians have grumbled and moaned for years. The objections have caused changes. Some specialty boards have abandoned the tests. And yet — for most specialties, we still find ourselves turning over our credit card numbers, blocking off a day of our incredibly busy lives and heading for a professional testing center.

On the surface, the process is absurd.

Oh, I get that we …

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Medical board tests are worse than airport security

The scourge of the pediatric urgent care fellowship

Physician
July 19, 2019

I am one of those lucky souls who actually likes their job. Since I completed my pediatrics residency two years ago, I have been working in urgent care settings. What’s not to like? I get to see a wide variety of patients, I’m always learning something new, and I get to finish my encounters with a high-five from an overeager toddler. If you’re a general pediatrician like me, that’s the …

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The scourge of the pediatric urgent care fellowship

What is the best way to care for a dying patient?

Physician
July 19, 2019

Every morning, after rounding on Mr. Gregory, I felt like an imposter. As I reported on the worsening crackles in his lungs, his decreasing urine output, the mottling of his hands, we continued to simply give him Dilaudid for pain and continued to ensure that he was “comfortable.”

In this case, I was at a loss for what this “comfort” meant. Mr. Gregory was the first hospice patient I had. And …

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What is the best way to care for a dying patient?

Don’t lower the voting age, says this neurosurgeon

Conditions and Diseases
July 19, 2019

On several occasions, most recently during a press conference in March 2019, Speaker of the House Nancy Pelosi has advocated changing the voting age to 16. Pelosi told reporters that lowering the voting age would increase engagement in politics among younger Americans and would help drive a higher level of voter awareness and turnout.

Speaker Pelosi is not the only prominent lawmaker to advocate for a lowered voting age. Also in …

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Don’t lower the voting age, says this neurosurgeon

Medicine is my passion. I love my job, but I am human.

Physician
July 19, 2019

I am a small-town family physician, and I am blessed enough to be living my dream.

You see, I have always wanted to be a doctor. I cannot think of one other occupation choice that has ever entered my brain. I have wanted this since I was four-years-old, and I can remember in vivid detail telling the world this was what I was destined to be.

So what happens when your dream …

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Medicine is my passion. I love my job, but I am human.

How to rekindle your love of medicine

Medical Education
July 18, 2019

Recently, thousands of new residency and fellowship graduates have earned their wings and will be, mostly metaphorically, hanging out their shingles. Sadly, though, as the excitement of finally finishing training after decades of schooling wears off, even great work can become routine.

There is a parable about three men laying bricks. When asked what they were doing, the first man said, “Laying bricks.” The second man said, “Building a church.” And …

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How to rekindle your love of medicine

The uphill battle for scholars in elderly care

Conditions and Diseases
July 18, 2019

Cognitive decline in older adults has been accepted as a normal part of aging. Recall, episodic memories, processing speed, and divided attention are all expected to decrease with time, but the implications of this decay are rarely discussed. Elderly scholars, or individuals who have sought to learn about the world or facets of the world through books, articles or newspapers, often are devastated by this cognitive decay. But, what if …

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The uphill battle for scholars in elderly care

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