It is a common experience to feel that our body has let us down when we get sick. We may feel it is broken or flawed in some way and if only it was better designed we wouldn’t have to suffer illness and disease. Likewise, we tend to consider illness and disease as something bad that has happened to us and which we associate with suffering of some kind, be …
The way we are living is killing us
Today I have a practical exam; that means doctors are shadowing me. It’s my turn to talk with patients about their diagnoses, and I’ve been looking forward to that part of medicine.
It’s my second patient; she’s here for vaginal discharge. I go in, introduce myself and explain my role. I’m still mediocre at documentation, but I’m good at putting patients at ease, so we make small talk. She just moved …
A medical student encounter turns into something much more
This Medcomic highlights some of the main features of multiple sclerosis (MS). Although the exact cause of MS is unknown, the disease is thought to occur as an immune-mediated attack on the central nervous system (CNS). As you can see in the illustration, the white blood cells are attacking the neuron and causing inflammation, demyelination, and axonal degeneration that can manifest through …
Learn multiple sclerosis with the power of comics
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The other day while having my lunch in the doctor’s lounge, I ran into one of the older physicians who works at the hospital. He had a weary look on his face, and so I inquired if he had a tough call night.
“Actually, I haven’t slept well in a few months,” he quietly responded. It turns out he was being sued by a family who had only seen him once …
Society doesn’t allow doctors to be human
Patricia Bach, a geriatric psychology colleague who is active in social media, recently emailed me a question: How to encourage more clinicians in geriatrics and long-term care to use social media?
In particular, she asked me “What do you feel is the ROI for geriatricians to use social media/networking in their professional roles?”
This is an interesting question to consider. After all, we have a limited number of geriatricians available for a growing older …
Making the case for social media to geriatricians and other physicians
On February 3, 2016, many physicians on social media took a moment to celebrate the first ever National Women Physician, timed to coincide with the 195th anniversary of the birthday of pioneer, Dr. Elizabeth Blackwell.
I began the day with a Facebook post wishing all my fellow women physician friends and colleagues a happy #nwpd and adding, “May today be the last day someone says to any of us ‘you look …
The gender gap persists in medicine. What can we do about it?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 49-year-old man is evaluated during a routine examination. He is asymptomatic but is concerned about his risk for cardiovascular disease. Medical history is notable for hypertension. He is a nonsmoker, and he works as an executive at a highly successful company. Family history is noncontributory. His only medication is hydrochlorothiazide.
On physical examination, the patient …
MKSAP: 49-year-old man is evaluated during a routine examination
The first time I cried as a doctor was in residency.
I was taking care of a patient who had terminal lung cancer. The first time I met him, his wife was at his bedside. The couple displayed such a positive outlook on life and seemed to have accepted the poor prognosis.
He was one of the first cancer patients I took care of. Being a cancer survivor myself, I felt a …
Death is part of medicine. I will never get used to it.
Mamas don’t let your babies grow up to be surgeons.
Really. Don’t.
As the mother of a soon-to-be fellowship-trained surgeon, I know what I’m talking about. Listen to me. Ignore Willie Nelson. You don’t want your babies to be doctors; you want them to be cowboys.
Really.
Yeah, yeah, I know, your daughter is a whiz at all things mathematical and/or spatial. And your son is a science prodigy. Their eye-hand coordination is legendary …
5 tips for parenting a future surgeon
Part of a series.
I have advocated in this series of posts on direct primary care in one form or another (i.e., membership, retainer-based, concierge and various other incarnations and conceptions) because it works well for both patients and primary care practitioners. Direct primary care allows the doctor the opportunity to give the type of outstanding care that each of us needs, whether currently healthy or beset with multiple …
How else can we improve our primary care system?
No matter how early I rise with the intention of getting my workout done before my children wake up, I’m rarely able to do it alone. Most days my 3-year-old daughter climbs out of bed and comes straight down to our home gym and watches me do my workout.
Often times she’ll sit quietly in the corner, but sometimes she’ll join in and follow the trainer on my workout DVD and …
How to talk with your kids about exercise
Like many of you, I have a fairly long commute. Recently, as I was driving and scanning the channels on Sirius, I landed on a talk program hosted by Dr. Laura Schlessinger — a certified marriage and family counselor (her PhD is in physiology) with many decades of experience, a stack of best-selling advice books, and a very long running radio show.
The caller was a young woman with a cheating husband and a …
Amplify your message with social media and change the world
As part of my pediatrics rotation, I recently spent a week taking care of patients at juvenile hall. The patients were physically healthy for the most part; I saw them for screening physicals that they receive while incarcerated. However, these encounters were far more than a typical physical. Instead of focusing on medical issues, we primarily talked about health behaviors and general well-being.
It was a rare opportunity to interact with …
An eye-opening week in juvenile hall
Every month or two I see a patient, usually a man with prostate cancer, who is concerned that if he has intercourse with his spouse, he will give her cancer. The question is asked with sincerity, and I can see the worry in the man’s eyes. His spouse is often equally worried but she often looks embarrassed too, almost as …
Shame and stigma in patients with HPV-related oral cancers
When I introduce myself as a plastic surgeon, I am often greeted with surprise. Between the slightly quizzical looks, the concerned head tilts, and the explicit queries, the question is clear: How could a woman of substance find herself in that line of work?
The truth is that real plastic surgery (in my world, at least) is nothing like its media representations. The nipped and tucked patients with outlandish requests, the …
I’m a woman and a plastic surgeon. This is what beauty means to me.
The United States far outspends peer countries on health care. When American politicians complain about these high health care costs, they often vilify pharmaceutical and insurance companies for profiting at the expense of the general public. As I wrote earlier, such vilification is misguided, pushing too much of the blame on individual actors rather than on the system that incentivizes individuals to act those ways.
So what it is …
Who do presidential candidates blame for high health costs?
As emergency physicians, we write prescriptions for patients that we discharge home for all manner of presenting complaints. I used to believe that the overwhelming majority of these prescriptions would be filled by the patient after discharge.
It turns out I was wrong.
Research estimates that patients discharged from emergency departments (EDs) fail to pick up their high urgency prescriptions, like antibiotics, nearly 35 percent of the time.
This is problematic because failure …
Why don’t patients pick up their prescriptions?
Almost two years ago I went to the funeral of a medical school classmate. A little more than three weeks before he had jumped from a parking garage after finishing his clinic. He had a loving wife and three young children. He had the respect of his colleagues and the love of his patients. There was nothing out of the ordinary in his financial or personal life. It didn’t make …
How many more physicians will we lose to suicide?
Sedated by Oxycodone, Ted slept despite the rhythmic ruckus of his breathing machine. He never felt quite rested in the hospital. While awake, his gaze often lingered on a snapshot that captured him in the past: full of laughter and radiant joy with his little granddaughter, Tara. The grandfather in the photo — muscular, mischievous — barely resembled the emaciated elder in the bed who silently mouthed short answers to …
Who should bear a dying man’s burden?
A few years ago, the hospital where I work started new residency programs in internal medicine and family practice. Many of the residents do rotations in anesthesiology and surgery where I have an opportunity to meet and talk with them. They are eager to learn medicine of course, but they are also interested in the perspective that many of us who have been practicing medicine for many years have to …
New doctors should listen to this advice if they want to last
