Physicians writing on KevinMD about the diseases they treat and the people who have them: cancer and its screening arguments, pain and the drugs that treat it, diabetes and the obesity argument, mental illness and who gets treated for it, and the decisions at the end of a life. Five maintained records draw on this archive: Cancer: what physicians say, in their own words, Opioids: what physicians and pain patients say, in their own words, End of life: what physicians say, in their own words, Diabetes and obesity: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.

A vaccine alone will not be enough to recover from the impact of COVID-19: Emotional antibodies against it are needed as well

Conditions and Diseases
May 12, 2020

I was seven years old when I first got my heart broken. I was swiftly rebuffed by my second-grade crush, Brett who, upon getting gently pecked on the cheek by me one afternoon following recess, grimaced and began aggressively wiping off the invisible remnants of the kiss with the palms of both his hands, swiping vigorously up and down his cheek while shouting in utter disgust, “ew!” in front of …

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A vaccine alone will not be enough to recover from the impact of COVID-19: Emotional antibodies against it are needed as well

Comparing the preparedness of hurricanes to pandemics

Conditions and Diseases
May 11, 2020

As I stand in line at a Tampa Lowe’s today in the middle of a global pandemic, I cannot help but note the vast differences in people’s behavior around me. There is a complete dichotomy in the ways in which individuals are responding to COVID-19. Some customers who err on the side of safety are sitting in their cars waiting for curbside pickup. Others are carefully social distancing as they …

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Comparing the preparedness of hurricanes to pandemics

Emergency psychiatry during COVID-19

Conditions and Diseases
May 11, 2020

The reaction to the COVID-19 pandemic in the comprehensive psychiatric emergency program (CPEP) began insidiously, with an initial sense of unease. Patients are brought into CPEP when they pose a danger to themselves or others. Often they are brought by police, but occasionally they come on their own or with concerned family members. CPEP is a locked unit, separated via locked double doors that require a valid ID badge to …

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Emergency psychiatry during COVID-19

A psychiatrist crashes into telemedicine during the pandemic

Conditions and Diseases
May 11, 2020

As far as psychiatrists go, I admit I’m odd, even in a field known for its quirks. I’m fast-talking, irreverent, and most patients tell me I’m not what they expected, but they come back.

I’m not for everyone, and that’s OK. I love my field but didn’t always feel the field loved me.

At a conference workshop, as a PGY-III, in a room of 40 other psychiatrists, mostly attendings, the leader pulled …

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A psychiatrist crashes into telemedicine during the pandemic

Everyone agrees nurses are heroes. Why aren’t we treating them that way?

Conditions and Diseases
May 11, 2020

It’s been said that history doesn’t repeat, but it does often rhyme. And as we’re learning during COVID-19, lessons from the past can be a guide to help us navigate a modern pandemic — if we listen to the rhythm of history.

For a little more than two years in the middle of the 19th century, Great Britain, France, the Ottoman Empire, and Sardinia fought the Russian Empire for …

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Everyone agrees nurses are heroes. Why aren’t we treating them that way?

How social distancing affects vulnerable nursing home residents

Conditions and Diseases
May 11, 2020

On a cold evening in early March, my grandpa and I queued outside a nursing home in rural California. He pulled an insulated lunchbox, filled with hot chai and pureed rotis, to his chest and sighed. There are at least eight families in front of us, and if we don’t move fast, my grandma will fall asleep before she’s had dinner.

Twenty minutes later, we’ve reached the threshold: a nurse takes …

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How social distancing affects vulnerable nursing home residents

Should we stress about stress? Protecting ourselves during the pandemic.

Conditions and Diseases
May 10, 2020

COVID-19 has exposed us to a wide variety of different stressors. In the short term, our stress response is useful as it helps us respond quickly and effectively. But when the stress lasts longer, we have to identify and acknowledge the “downside” risks.

We should not stress about stress but protect ourselves against it.

Intense, prolonged stress has a negative impact on our immune system. Stress increases the …

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Should we stress about stress? Protecting ourselves during the pandemic.

A reasoned response to the PPE debacle

Conditions and Diseases
May 9, 2020

The lack of adequate supplies of PPE is deplorable, inconceivable.  This has been made abundantly clear through both social media and traditional media.  Post after post on various social media outlets have exposed the appalling shortages and, at times, blame and attack those that are obliged to provide us the PPE. Those posts, in part, have spurned movements among nonmedical personnel to donate and make masks.  Heartwarming, and it feels …

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A reasoned response to the PPE debacle

Addressing mental health needs for our frontline responders and health care providers

Conditions and Diseases
May 9, 2020

Coronavirus. Doctors. Nurses. PPE. Social distancing.

Sound familiar? Our entire conversation about the COVID-19 pandemic surrounds those words and phrases. We see celebrities, companies, coworkers, family members, and friends donating PPE and money to organizations and local hospitals, trying to do some good. No one wants our front-line health care workers to get sick. If that happens, the public will be at even greater risk.

For the past several weeks, all that …

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Addressing mental health needs for our frontline responders and health care providers

Learning to cope with the pandemic from palliative care patients 

Conditions and Diseases
May 8, 2020

I’m a palliative care chaplain who provides spiritual support to patients with serious, life-changing, and for some, life-threatening, illnesses. A common story they tell is an illness, like a storm, blew them off their life’s map.  They find themselves lost in the unfamiliar territory of sickness. The future, once certain and promising, is now uncertain and ominous. Plans they’d made are on hold, possibly canceled. The specter of death looms …

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Learning to cope with the pandemic from palliative care patients 

A journey through time with a very modern foe

Conditions and Diseases
May 8, 2020

Come with me on this journey, this very ancient journey.

To experience the age-old story of a very modern foe. This foe is invisible; it is neither living nor dead. You cannot smell it, and you cannot taste it. While it is not alive, it can become alive, with a flick of the right kind of switch. While it is not dead, it can masquerade as the dead, until the perfect …

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A journey through time with a very modern foe

COVID-19 blurs the line between physician and patient

Conditions and Diseases
May 7, 2020

The unspoken culture in medicine has been that to maintain objective professionalism – some measure of distance is encouraged between the clinician and the patient. From anatomy lab, students are encouraged to forget patients as fellow human beings but organs and limbs. Medical rounds and board examinations reinforce that patients are diseases to be fixed. In some sense, such distance may be protective, as medical disease manifested in a human …

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COVID-19 blurs the line between physician and patient

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COVID-19? We are not even ready for a hurricane.

Conditions and Diseases
May 7, 2020

The hurricane made landfall during the early morning hours. When I woke up, all I saw was devastation. Highway 288 transformed into a lake. The bayou running underneath was completely flooded with water spilling into the roads. The park, a place where I find solace in every day, was unrecognizable. People had abandoned their vehicles. I could see them all submerged. The garage floor was underwater, and the roads that …

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COVID-19? We are not even ready for a hurricane.

From frontlines to sidelined: a resident’s experience on staying positive

Conditions and Diseases
May 7, 2020

On a gorgeous day in early March, I set out on my usual morning commute to clinic. The recent rain had turned the mountains green, there was some fresh snow atop Mount Baldy in the usually dry Inland Empire of Southern California, and the Lakers had just beaten their rival Clippers the preceding weekend. As I drove in to work, I was listening to coverage of the story I had …

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From frontlines to sidelined: a resident’s experience on staying positive

Patients who slip through the cracks

Conditions and Diseases
May 6, 2020

As my surgery rotation commenced, I fully expected to be immersed in the unfamiliar territory of “scrubbing in” and “sterile fields.” While I discovered the difference between vertical and horizontal mattress sutures, two specific patients I encountered on this rotation opened my eyes to issues beyond the operating room (OR).

After scrubbing out of a four-hour surgery, my attending requested I begin a consult in the emergency department for a possible …

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Patients who slip through the cracks

A physician-mother comforts her frightened, 6-year-old daughter

Conditions and Diseases
May 5, 2020

It’s Monday morning at 7:15 a.m. Our kids, ages 6 and 9, have just finished breakfast, and they know to get their shoes on to go for a walk. We are hand-in-hand, slowly waking up as we put one foot in front of the other. We ambled down our neighborhood streets, listening to birds chirping and squinted as we looked upward to admire their flight.

Out of nowhere, our 6-year-old squeezes …

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A physician-mother comforts her frightened, 6-year-old daughter

An advertisement for COVID 2020

Conditions and Diseases
May 5, 2020

Have you ever felt completely overwhelmed both at work and at home?

Perhaps you’re thinking, my job as an anesthesiologist isn’t anxiety-provoking enough; I should probably homeschool my kids at the same time.

When’s the last time you uttered the phrase, “This is the most stress I’ve ever experienced” multiple days in a row?

Come on over, COVID 2020 has got you covered!

First, we’ll start with the existential threat of a global pandemic—one …

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An advertisement for COVID 2020

The plausible positive alternative to COVID-19

Conditions and Diseases
May 5, 2020

Do you remember those old cartoons with the angel or good guy on one shoulder and the little devil or bad guy on the other? Of course, the good guy was always trying to keep the character out of mischief, and certainly, the little devil was doing quite the opposite. Sometimes, especially now during these uncertain times, it’s easier to see the negative, “hear” that little bad guy over the …

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The plausible positive alternative to COVID-19

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