An excerpt from It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation.
On that night when the desperate call came to pick up the critically ill baby with MAS, I felt very fortunate that Dr. Cunningham was my supervisor.
When I arrived at the hospital in New Jersey, it was apparent that the tension in the room …
Is there a right way to break bad news?
The recent pandemic has confined people all over the world to the indoors to try to keep the virus from spreading. Older adults have been the most commonly affected age group with the virus, but more recently, a strange presentation of COVID-19 has been seen in children.
New York City first reported 15 similar cases that occurred between April 16 and May 4 for the first time in the United States. …
A pediatric hematologist explains multisystem inflammatory syndrome in children
Recently, I was part of a virtual panel discussing ways to help kids and teens manage their digital technology use. The audience, parents from around the world, felt blind-sided about how all of this extra time at home has led to significant increases in screen use for most people.
On top of everything else, this pandemic has dumped on our personal and professional lives as physicians, many of us are also …
A child psychiatrist’s tips for digital parenting during COVID
In the 1800s, smallpox ravaged the world. Fortunately, a vaccine had been developed that could protect individuals. This vaccine left a scar at the site of injection and identified the individuals as “immune.”
As we look towards the future of the COVID-19 pandemic, unless the virus burns out or an effective therapeutic intervention becomes available, the only way out of our current situation will be immunity – …
A digital vaccination scar for the 21st century
Around three weeks ago, my 72-year-old patient, Mr. J., woke up feeling severely short of breath. He felt unusually tired, noticed a dry cough, and felt achy in his arms and legs. Suspicious of COVID-19, he and his wife called an ambulance and went to the nearest New York City emergency room.
At first, the doctors too thought it was COVID-19. However, a chest X-ray, CT scan, and a series of …
Cause unknown: the burden of diagnosis
Many years ago, I was given a literary award from the Mary Roberts Rinehart Foundation. It was for $175 and was an encouragement to finish an American Indian novel I was then writing. “Not enough to quit your job,” I remember was a line from the letter I received from the foundation’s rep, Barbara.
And from thereafter, Barbara and I kept in touch for many years. Mostly we wrote letters, and …
Breaking the rules to give a bit of hope in a desperate situation
COVID-19 is taking a toll on my mental well-being in a way I had not expected. I have a rather high distress tolerance. I am a pediatric emergency psychiatrist. Now I am a wounded healer battling anxiety and fears from the constant unknown taking place inside my body.
In early March, before New York State went on pause, I woke up to an intense headache, followed by malaise, chills, throat soreness, …
The unremitting adventure of COVID recovery
For weeks, our health care workforce has been on the frontlines of the COVID-19 pandemic staring straight at mortality – their patients and their own. They have been single-mindedly focused on the task at hand, doing what needs to be done while instinctually suppressing their emotional response. The job requires this, and they have done it well.
Yet, the tragic suicide of Dr. Lorna Breen has brought focus in a devastating …
Flattening the curve of COVID’s emotional impact
As of May 17, 2020, there are approximately 1.5 million documented cases of COVID-19 in the United States. Of those infected, 90,000 have died.
The current population of the United States is estimated to be 331 million. This means COVID-19 infections have only been confirmed in less than one-half of 1 percent of Americans.
This number does not include those who have acquired the virus but not had their infection verified by …
Back to school in the pandemic era
The chart for the first patient of the morning states, “elevated blood pressure for two weeks.” As I enter the room, I see a frail, elderly woman perched gingerly in the chair. She has on large sunglasses and a fabric mask. She looks apprehensive, so I introduce myself quickly. Before COVID-19, I would shake her hand, but times have changed. Before I even sit down, she immediately shows …
Is everyone anxious? The mental toll of the pandemic.
On Friday, March 27, 2020, California went on lockdown in the face of the COVID-19 pandemic. It changed every Californian’s life, including my own. As the newly appointed chief scribe, the possibility that I would be jobless by the time Monday rolled around, was the last of my worries. What would happen to the patients who depended on our care? Or the physicians, nurses, and administrators that kept the center …
Charting in uncharted territory: Scribing during COVID-19
Astor lies in a reclining wheelchair, surrounded by community, gathered for morning prayer. A rosary, woven between folded fingers rests upon her belly.
Astor murmurs: “Help me. Help me. I am all alone.”
Today, the last Friday in March, I am assisting another resident as he leads the Divine Mercy Chaplet, a meditative Catholic prayer using the beads of the rosary as a guide. In younger years, Astor found this prayer to …
A chaplain’s reflections in long-term care in the early days of COVID-19
In January, we learned of an emerging threat in China, a variant of the frightening SARS virus, but worse—more infectious. Since then, we learned China, the first to both see and successfully manage its outbreak, seriously under-detected the disease. According to a widely circulated computer model study, true cases were probably around seven times greater than the official count. Calculations published a …
In this pandemic, the reality is bigger than any headline
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Death. Mortality. End of Life. Something inevitable, yet rarely discussed and a source of intense discomfort for most. When mentioned, it is considered inauspicious and rude in many cultures. Death is an integral part of the workday for a critical care physician like me. But it was never a topic of discussion in medical school or training.
Death is inevitably encountered by every physician at some point and by every human. …
I remember Jake Mattolli as a pioneer in heart surgery. He certainly didn’t wish to be one. I believe he had a valve replacement, and it was done in the early ’60s. I remember the Boston surgeon termed the operation a success, but as Jake’s lungs gave out on the table, he, the patient, died.
That sort of success most of us wish to avoid.
The thing I remember about Jake, aside …
A social worker remembers a fire chief
An excerpt from The View From The Wrong Side Of The Day: A Story About Nursing, PTSD And Other Shenanigans.
I’m not exactly sure when things first started to get bad for me. Thinking back, it was all rather like the analogy of the frog in the …
An emergency room nurse diagnosed with PTSD
I am an internal medicine doctor on the frontline of the COVID-19 pandemic in Oakland, California. Before the first confirmed case at my hospital, I could sense the fear and anxiety of the impending disaster with every interaction I had with colleagues and my patients. This was largely due to the uncertainty of what was to come, and we were mainly looking towards the overwhelmed health …
COVID-19 isn’t the great equalizer
It was the morning of the last trauma shift during my surgery rotation. It was a seemingly normal early Sunday morning. However, when I arrived in the trauma charting room, there was no one to be found. After placing my coffee and protein bar down next to a computer, another medical student walked in, and he looked just as puzzled as I was at the sight of an empty room.
“Where …
How do you tell one of your best friends that his dad may have an incurable brain tumor?
There are so many. As health care providers and as a nation, we have been acutely aware of the impact of COVID-19 on communities of color and, more specifically, on the African American community.
In April, nearly three-fourths of patients who died from COVID-19 in Chicago were African American. But what I have seen more and more at my hospital is a shift toward a different (but also often marginalized) demographic: …
The impact of COVID on the Hispanic community
“My partner doesn’t want me to come back home now that I’ve come to the hospital. He is worried I’ll come back and infect him and his parents. I have nowhere to go”. Fear and guilt were palpable in the young woman sitting before me. She had decided to follow the recommendation of the psychiatric crisis response team and come to the Emergency Room for worsening thoughts of suicide.
This dilemma …
How COVID-19 is hurting the most vulnerable mentally ill: observations from the frontline
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