What could go wrong with the coronavirus vaccine? I have opinions. I am not a virologist or an infectious disease specialist. I am just a doctor who has been following the pandemic in the journals and in the newspapers. But I am worried because there is a lot that could go wrong.
There are the usual problems that we all know about. The vaccine will not work because it does not …
What could go wrong with the coronavirus vaccine?
By profession, Donna Dillon is a photographer. She wouldn’t like to be described as a “professional” anything, but the quality of her photos make her deserving of the term.
But disarray and inertia characterize Donna now, by her own description. “My life’s work is stuffed into little places, and I sit relatively immobile, before the prospect of the bequeathment. I have set up a will, but it is sort of desperate, …
A social worker remembers a tortured soul
Opiates relieve pain and can transport people to their apparent happy place. So does marijuana. Lyrica, the seizure-turned-pain medication, caused enough of a buzz in early study participants that it became a controlled substance. The anesthetic ketamine is now used for treatment-resistant depression.
Years ago, we had to be very specific about the location and classification of our patients’ pain. When pain then became a self-reported vital sign and chronic opioid …
There’s a code for pain, but what’s the code for suffering?
The sirens wail as the ambulance approaches, bouncing off New York City skyscrapers and empty storefronts. They swirl around one building, sweeping up old paint chips and dust from centuries-old stairs. Inside on the third floor, a family paces around in panic. Their matriarch fights for air. The youngest holds her hand and softly sings her favorite song in her ear. She tries to stay calm, focusing on the walls …
We can’t breathe: black and brown trauma in COVID-19
Many states are beginning to reopen, and hospitals are once again scheduling elective surgeries. The question on many patients’ minds is, “Should I undergo elective surgery right now?” Although 31 percent of people have chosen to delay care and 50 percent of people over 65 have decided to wait to receive care during COVID-19, according to a Kaiser Health News roundup, making this decision will depend …
Questions you should ask before elective surgery during the COVID-19 pandemic
Looking back on the COVID-19 pandemic in the United States, I hope that we are able to take away several lessons.
Immediately after the virus showed up in the United States, many physicians without access to virus testing seemed to go straight to imaging for an answer. While a few imaging tests proved to be useful in the most typical radiologic presentations of the disease, the evidence supporting this specificity or …
Why we must keep learning from the coronavirus pandemic
The severity of COVID appears to be increased in people with obesity. This may represent an opportunity to discuss the benefits of lifestyle change with overweight patients. However, if not done appropriately, the opportunity becomes transformed into just one more damaging, body-shaming experience for the patient.
There has been much written and little done about body shaming in the health care setting: “Stigma …
Body-shaming in the time of COVID
“Why is my disease less important than COVID?” Donna asked me toward the end of our phone call.
Two years ago, after celebrating her 65th birthday, she was diagnosed with acute myeloid leukemia—an aggressive type of blood cancer—which turned out to be refractory to conventional chemotherapy. After spending hundreds of hours with doctors and social workers, she was scheduled to enroll in a clinical trial in May 2020. But COVID-19 postponed it.
She is …
What about the mental health of clinical trial participants?
We have all seen the memes and picture frames on social media. I can’t stay home – I am a health care worker.
I am a health care worker.
But I have been mostly home the past eight weeks, and the thought of returning to the office full-time has left me grappling with anxiety and fear.
As a nurse practitioner in dermatology, I have had the luxury of dramatically changing the way I …
I can’t stay home. I am a health care worker.
In the film Silver Linings Playbook, the protagonist Pat struggles to control his bipolar disorder, which triggers violent outbursts leading to hospitalization in a locked psychiatric unit. Upon discharge, Pat commits to a new outlook on life, embodied by the Latin word “Excelsior”—”ever upward.” Emboldened by this new mantra, he endeavors to reframe crises as opportunities … or silver linings. His psychiatrist cautions that attitude alone is an incomplete solution: …
The Silver Linings Playbook for COVID-19
In 2014, an emergency medicine resident opened a personal email and was shocked to see it briefly mention the death of another resident physician from a different training program. Unofficial group chats ensued amongst her co-residents, discussing the vague email. Suspicion arose that the resident has died of suicide. His particular death was never addressed outright in a formal or public manner at the hospital, department, or residency level. All …
We need improved mental health care for physicians
I have a major issue with MAC.
To be more specific, I have a major issue with how we communicate the concept of MAC to our patients, anesthesia care team members, and proceduralist colleagues.
MAC stands for “monitored anesthesia care,” and we tend to throw it around and use it interchangeably with a lot of other terms:
The fact is, these entities are not …
Why this anesthesiologist has a problem with monitored anesthesia care (MAC)
The coronavirus has taken a major toll on virtually all aspects of our lives, especially for those of us who live in urban areas. As many others have rightfully pointed out, the dangers of the disease extend well beyond the physical complications caused by the SARS-CoV-2 virus. The virus has also sent a psychological shockwave around the globe, and even those who have not become sick have felt the burden …
The widowhood effect and COVID-19: What seniors need to know
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Imagine answering a call from an unknown number. A stranger announces you may have been exposed to coronavirus; you may or may not get seriously ill, and either way, you have to isolate yourself for two weeks while everyone else carries on. What goes through your mind? Are you scared? Who will take care of the kids? Will your boss give you sick leave if you feel healthy? Wouldn’t it …
How to make COVID-19 contact tracing work
Before the world was crippled by the spread of COVID-19, physician burnout was already taking an alarming toll on our health care system. Physicians were working more hours, more days, in high-pressure circumstances with excessive charting requirements and administrative burdens, on too little rest with too few healthy stress-relief outlets.
Flash forward to the last four months: unfathomable circumstances of inadequate PPE, short-staffed hospitals, overloaded emergency rooms, and very sick patients …
Providing clinician support in times of calm and chaos
It was the morning after Thanksgiving, 2012. My parents and I were sharing a suite at the Four Seasons Hotel in Beverly Hills, where we were camped out after the holiday dinner. We were not here because it was a family tradition or even because we wanted to notch it up this year. My family loved our paper plate style event, the air thick with the scent of turkey baking …
A physician’s story: “Please come quickly. My brain is bleeding.”
In early February, I was on my family medicine rotation. This was around Chinese New Year, when many East Asians travel extensively. The hospital I worked in serves a large Chinese community, and rumors about a new pneumonia emerging out of Wuhan, China were spurring patients to seek our reassurance that they didn’t have it. One patient thought their stuffy nose might be ominous, while another was worried about a …
The trouble with medical experts
I am an ICU nurse. I love what I do; It’s not just a career: It’s who I am. No other job could offer me the intimate opportunity to support and guide a total stranger through the worst (and occasionally best) days of their life. Nowhere else would I leave feeling humbled by what I do every day. Nothing compares to that. Simply put: You don’t find that sense of …
I am an ICU nurse. We are drowning.
How did coronavirus become so widespread? By the time Dr. Zhang Jixian first reported the cases, it is thought that 180 patients were already infected.
The problem with this is that SARS-CoV-2 and the disease it causes, COVID-19, presents in many different ways and spreads in patients with no symptoms. By the time we were even able to identify that a novel virus was infecting humans, it was already too late. …
Coronavirus is an elusive enigma
To contain COVID-19 and re-open the economy, the U.S. should be performing 500,000 tests per day. We are nowhere near that number.
Widespread implementation of CRISPR-based testing would address deficits in the current testing landscape. The most common method of testing for COVID-19—reverse transcription-polymerase chain reaction (RT-PCR)—costs $100 per test, takes four-six hours to run, involves Read more…
How CRISPR technology can solve our COVID-19 testing problems
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