Social norms are not the norm in the ER. Things that are regarded as gross in the real world are an everyday occurrence. Our ER especially lived in a special universe where all social graces were stripped away, and the rawness of humanity is what remained.
I begin my night shift. I hadn’t taken a solid nap before my shift, and I am now headed into round 3 of 4. Nights …
Social norms are not the norm in the ER
How do I tell you who I am in a couple of paragraphs?
Well, I was born in 1955, so that makes me 61 years old. My namesake is probably movie star and America’s sweetheart Debbie Reynolds.
My maternal grandfather was straight from Italy; my paternal grandfather was straight from Ireland. Both crossed the Atlantic and landed on Ellis Island in New York Harbor. It was the promised land.
So, that means I …
A nurse shares who she really is
I recently read an article about how the physicians’ lounge, which was once present in every hospital and an important congregating area for doctors during the day, is now mostly a thing of the past. Although the article was not a new one, it peaked my interest because I’ve witnessed the demise of the physicians’ lounge at close quarters over the last several years.
Speaking too as someone who has …
The demise of the physicians’ lounge is symbolic of the decline of the profession
The young woman was curled up in a ball. She was sweating and shivering from pain. As she answered my questions — all my many, many questions — tears fell silently from her eyes.
I was a third-year medical student, and the resident I was working with had asked me to evaluate this woman. She had …
An episode of racism in medical school. Did it affect her care years later?
I was recently at a meeting where some very influential physicians were discussing a question that I’ve been thinking about for a while: how do we find medical staff for rural emergency rooms and hospitals? It’s a tough question, because, increasingly, it seems that young physicians are trained to work in urban hospitals. Those are also the places these young doctors prefer to practice. Big hospitals and teaching centers in …
How can we solve the rural clinician shortage?
I’m three weeks into my second year of medical school, and my classmates and I are sharing feelings of being “old” compared to the first years on campus, who are “bright-eyed and bushy-tailed” — not yet jaded by med school bureaucracy, and (rightfully) excited by all the opportunities that lie ahead of them. I’ve also heard a few of them use an often-judgmental term that has always confused me: “gunner.”
Some …
In medical school, not all gunners are created equal
I have spent the last year doing a deep dive into my personal leadership style. I’ve done this for self-improvement and because some great leaders and mentors have challenged me to take a look at my skills. I’ve read countless blogs and books on leadership, specifically women leaders, and how they have succeeded at the helm.
There are a million different things books will tell you to be if you want …
This is the key to becoming a great leader
America’s opioid crisis is getting worse. The role of prescription opioids has both the medical establishment and the government justifiably worried.
In response, the National Academies of Science, Engineering and Medicine released an official report on the crisis earlier this year. And, on September 21, the National Academy of Medicine released a special publication calling clinicians to help combat the crisis.
As a bioethicist working on …
An ethical dilemma for doctors: When is it OK to prescribe opioids?
When a drug is especially dangerous, or even potentially-maybe-especially dangerous, the FDA requires manufacturers to put a black box warning on the product insert. A black box warning is supposed to very explicitly say “buyer beware,” more than just the typical list of potential side effects mumbled by Mr. TalkFast at the end of a drug ad. It’s easy to ignore the wordy mumbling. The black box: That’s supposed to …
Do physician rating sites deserve a black box warning?
This past spring, I sat in a lecture hall at the Warren Alpert Medical School at the third annual Transgender Conference. A graduate of the Brown family medicine program, Alexis Drutchas, MD was the co-founder. I remember interviewing for residency and asking her what she was working on; she casually mentioned that she was creating a conference for the transgender community and medical community in the Blackstone Valley.
Three years later, …
Physicians should not be gender police
The current conversation regarding health care reform in the U.S. is essentially pointless. It can be boiled down into four statements: Obamacare stinks, so we need to get rid of it; Obamacare doesn’t stink, so we just need to improve upon it; the insurance companies are to blame, so a government single-payer system is the best idea; the government is to blame, and only the free market can fix health …
A health care solution to rival single payer
An excerpt from Born to Be Wild: Why Teens Take Risks, and How We Can Help Keep Them Safe.
According to the National Sleep Foundation’s Sleep in America Poll of 2014, 75 percent of children in the United States have at least one electronic device in their bedroom, with a television being …
A cautionary tale of the dangers of a delayed sleep phase in adolescents
American physicians deserve to be paid well for their work. As a physician, myself, I know what it takes to become a doctor in the U.S. Four years of late nights in the college library in hopes of achieving a GPA commensurate with medical school admission; then four years of medical school, which makes the college work load feel light in retrospect; then, in my case, three years of residency …
Doctors should be paid well. But how much is enough?
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This week is National Primary Care Week, an opportunity to engage medical students and healthcare stakeholders in a national discussion around the tremendous role that primary care plays in our health care system.
With so much debate about the high price of health care in the United States, too often one of the most effective methods of controlling costs is overlooked: primary care. A wealth of research continues to show that …
Primary care makes a difference for patients and the nation
The news cycle over the last several days has been dominated by President Trump’s interjection into the row about NFL players refusing to stand during the national anthem. The media went into hysteria following his curse remarks, and a full-blown row has gone on to develop. Turning this issue into a national political one is a great shame on so many different levels, including not least the reality …
Why this physician thinks everyone should stand for the national anthem
“The fool doth think he is wise, but the wise man knows himself to be a fool.”
– William Shakespeare
I learned about the Dunning-Kruger effect at a medical conference recently. It certainly seems to apply in medicine. So often, a novice thinks he or she has mastered a new skill or achieved full understanding of something complicated, but as time goes on, …
Having a medical license doesn’t mean you’ve mastered the art of medicine
Starting a new job is always stressful — the move from one institution to another, getting hospital credentials, obtaining provider credentialing for various insurances, meeting new staff, and adjusting to a new work “culture”. Having done my share of moves, these are nearly universal experiences. However, as I find myself walking around the hallowed halls …
Saying goodbye shows how strong doctor-patient bonds can be
An eleventh nursing home resident has died after an air conditioning failure following last week’s Hurricane Irma. The Rehabilitation Center at Hollywood Hills, located outside of Fort Lauderdale, was one of 160 nursing homes that had no electricity and no air conditioning, as power lines across the state were decimated by the storm. Yet, it was the only nursing home facility in the state of Florida where multiple deaths occurred …
Poor leadership and disastrous decision-making are to blame for Florida’s nursing home deaths
The day drags on; you hang in there until the job is finally complete. You are exhausted, tired, and sure something is clearly wrong. Arriving in the emergency department is never one of those moments you expect. Staff greetings are quickly followed by people taking your vital signs, pressure on various parts of your body, and placing you under X-ray machines. Symptoms come and go, and verdicts are read. Good …
How the nurse makes it possible
Fatal police encounters can engender PTSD in non-white communities and forever impact interactions with police. In the last few years, we have witnessed in horror the erosion of trust between public servants charged to protect the community and the non-white communities they serve. The killing of Philando Castile and Charleena Lyles compounded the horror, as their violent deaths were witnessed by their young children, spouses and, for Philando, social media. …
Philando Castile, Charleena Lyles, and PTSD: The consequences of fatal police encounters
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