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A pediatrician’s healing spirit: treating depressed, anxious, and suicidal teens

Conditions and Diseases

July 3, 2018

I had not one, but two suicidal teen patients today. This is only one day after I had an eight-year-old suicidal patient come to see me. Three weeks ago, a 17-year-old female walked in, she had hung herself in her closet one month earlier — saved only by the timely breaking of the crossbar of her closet — passed out on the closet floor by her mother. A 16-year-old male …

A difficult situation a resident faced in the emergency department

Anonymous

Conditions and Diseases

July 3, 2018

As I begin my overnight pediatric emergency department shift, there is one patient waiting to be seen: a six-year-old male with autism who is alleged to have experienced sexual assault. In my first year of pediatrics residency, I haven’t yet managed a sexual assault case, but it’s time for me to learn. I sign up to see the patient and move to find them in the sub-waiting room.

As I round …

How Anthony Bourdain and Kate Spade could change mental health

Marie Casey Olseth, MD

Conditions and Diseases

July 3, 2018

Many people in our country, or I should say in this world, have been shocked and devastated by recent celebrity suicides. Many wonder how can someone whose life looks so perfect be depressed? Well, people are starting to recognize that anyone, no matter how successful, how rich or how attractive can experience severe depression.

Many of our well-known adages acknowledge the fact that anyone can be vulnerable to depression. We have …

5 ways to show empathy in medicine

Jennifer Bradley, FNP-C

Physician

July 2, 2018

As medical professionals we often see people at their worst: battered and broken, bothered and in pain, no make-up, bad hair day, naked and too ill to even care about modesty. At those critical moments, in our patients’ hour of desperation, they hand over their lives to us … and the lives of their family. All that they are — they willingly place at our mercy. At times, burnout, and …

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5 ways to show empathy in medicine

The difference between care and service is significant

Michelle M. Kittleson, MD

Physician

July 2, 2018

My father, recently retired, spent over 40 years in private practice. After dinner, he would sift through piles of paper charts and call patients with their lab results. As a grade schooler, what impressed me the most was that he knew many of his patient’s phone numbers by heart. Of course, this was in the days before HIPAA and caller ID, so scattered charts on the dining table and calling …

The caregiver’s mantra: doing the best I can

Patricia Williams

Patient

July 2, 2018

If one more person tells me to be sure to take care of myself, I’m going to bury my face in a pillow and scream.

“Go for a walk, take a vacation,” they advise. I know they’re trying to help, but really? Giving me one more thing to do? Oh well, they’re just doing the best they can.

I moved my folks across the country, from Florida to Washington State, and into …

A physician’s personal experience with gun violence

Farah Karipineni, MD, MPH

Health Policy

July 2, 2018

Like many of us, I have been struggling to reconcile my love for everything good about this country with the senseless gun violence that terrorizes us today. In the wake of each shooting, I vow to do more — to speak up as a surgeon, as a former victim of gun violence and simply as a fellow human — but the words escape me. How do we make meaning out …

Attending time: That’s just a myth

Time for Money, MD

Physician Finance

July 1, 2018

One of the great myths amongst residents is that once they become attendings, they’ll have so much more free time. I’ll never work this much again, they think. This is the most time-intensive phase of life, and everything after residency is easy in comparison.

Unfortunately, they are usually wrong.

Statistically, working about the same number of hours in residency and as an attending is the norm. In one study, attendings work 59.2 …

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Attending time: That’s just a myth

Treating mental illness: Quality of life matters

Kristin Puhl, MD

Conditions and Diseases

July 1, 2018

Quality of life matters.

This straightforward assertion gets complicated when we discuss the treatment of depression. Depression is common, part of a family doctor’s daily schedule; it can affect anyone, although certain groups are at higher risk. There have been many hypotheses as to why we as a species are susceptible to depression (and its frequent companion, anxiety), but in the day to day practice of medicine, those proposed etiologies end …

Education as an intervention for the chronic pain epidemic

Talal Khan, MD

Conditions and Diseases

July 1, 2018

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

Chronic pain is a silent epidemic

Chronic pain is a significant public health burden, but one that is not talked about enough. In 2011, the Institute of Medicine estimated that approximately 100 million Americans suffer from chronic pain. But chronic pain is not just …

We need the time to apply our noticing skills to our patients

Fred N. Pelzman, MD

Physician

July 1, 2018

Noticing.

If you think about it, that’s really a lot of what we do a lot of the time. As clinicians, we are trained as observers to notice, to use our eyes, our ears, our hands. To notice.

We notice that our patients seem different today. More tired. A little pale. Notice a change in their gait. Notice they are in pain.

We notice swelling in their legs, a new heart murmur, a …

Why more physicians should enter industry

Ayden Jacob

Health Technology

June 30, 2018

Attend any biotech or health informatics conference and one thing becomes clear: the scarcity of physicians. Entrepreneurs, businessmen, angel investors, and software engineers swarm these conferences — and their encompassing companies — all the while the imperative persona in this realm remains tied up behind a dysfunctional EHR or in an overbooked operating room. Why?

Certainly, inculcating these dynamic players in the health care space is integral to the successful evolvement …

The choice between medicine and nursing

Shirie Leng, MD

Physician

June 30, 2018

An excerpt from The Choice: Medicine vs. Nursing.

An extensive amount of data now exists in the science of choice. Social researchers such as David Kahneman and Dan Ariely have conducted numerous experiments which suggest a number of ways in which humans are led astray when making choices. An understanding some of these pitfalls is critical as you embark on the process of …

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The choice between medicine and nursing

Celebrity suicides make the irony of our era clear

Riddhi Shah, MD

Conditions and Diseases

June 30, 2018

These recent weeks have been hard for me, and I suspect for a lot of other people as well. Not because I spent it in a board review course listening to lectures for 12 hours a day, and not because I drank enough coffee to practically burn a hole in my stomach, but because the world lost two amazing people all too soon.

I didn’t know either Kate Spade or Anthony …

MKSAP: 70-year-old man with a transient ischemic attack

mksap

Conditions and Diseases

June 30, 2018

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

A 70-year-old man is admitted to the hospital with a 1-hour episode of left arm and left leg weakness. He is diagnosed with a transient ischemic attack. The patient has a history of hypertension and type 2 diabetes mellitus and a 30-pack-year history of smoking. Family history is noncontributory. His medications are metformin and lisinopril.

On …

10 tips every young physician should read

Sasha K. Shillcutt, MD

Physician

June 29, 2018

How do I balance my home life with physician life?

I really want to do a research study. How do I start?

How do I get involved in my specialties society?

I am overwhelmed with clinical duties. How do I negotiate for nonclinical time?

My manuscript was rejected. What should I do next?

I had a bad clinical outcome, and I can’t seem to recover. How do I move forward?

Joining this committee will be a …

A patient is left with a choice: financial devastation or blindness

Rob Lamberts, MD

Physician

June 29, 2018

That statement from a recent patient was a summary to me of what is bad in our health care “system.” It’s a terrible summary of what is seen all over this country with people who must make the choice between financial solvency and health.

Here’s what happened: It was a new patient I saw, who is a veteran who owns two businesses. He went out on his own when he “kept …

Advice for first-year medical students

Jamie Katuna

Medical Education

June 29, 2018

A few days ago I received a message: “Any advice for incoming med students?”

As an old, wise, seasoned, now-second year medical student, I know everything. Just kidding — I fumbled my way through first year like everyone else, and just like you will too. No piece of advice allows you to opt out from the challenges of medical school year one.

My advice isn’t the “normal” recommendations incoming medical students receive. You …

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Advice for first-year medical students

A physician on timeshares: Who are they right for?

Cory Fawcett, MD

Physician Finance

June 29, 2018

Timeshares, for those who might not know, are a way to own the right to use a vacation resort. It comes in two forms, owning points or owning a specific room in a complex for a specific week. It’s like a partial ownership of a condo at a resort. These units can be traded for other timeshares all over the world. If you own a week, it can be traded …

The art of medicine is needed to prevent migraine headaches

Hans Duvefelt, MD

Conditions and Diseases

June 28, 2018

He spoke with an aura of superiority, in a slightly nasal voice, and his topic was migraines. It was in the late 70s, a time when there were few options to treat migraines.

“Most people who claim to have migraines just have simple tension headaches,” he scoffed. And in a move that seemed unorthodox at the time, he disclosed that he suffered from “real migraines,” so he knew all about this …

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