Conditions and Diseases

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.

Coronavirus is a crisis. And an opportunity.

Harsh Bhavsar, MD

March 23, 2020

I’m bombarded with emails of rapidly changing policies to prevent infections and identify COVID-19 patients (in the course of writing this, I’ve already received three more emails), I’m having a hard time finding masks because the nurses are hoarding them in some corner or taking them home, I feel regret for previously telling friends when they asked me that the coronavirus outbreak is likely not to cause this much death, …

Coronavirus has slowly but surely made its way to Middle America

Lisa Sieczkowski, MD

Conditions and Diseases

March 23, 2020

Coronavirus disease (COVID-19) has slowly but surely made its way to Middle America, stowing away on well-meaning citizens who have traveled to the coasts or overseas for one reason or another. It has sneakily hitchhiked its way into Creighton University basketball games, pub crawls, and several area Walmarts. A few patients have been seriously ill, but the majority of the physical, intellectual, and emotional time, effort, and energy spent in …

We don’t have the luxury of losing health care workers at this critical juncture

Bhavika Bhan, MD

Conditions and Diseases

March 23, 2020

What prompted me to write this essay is seeing a chest X-ray of a physician fighting the COVID-19 disease, and it did not look promising. I wish for the speedy recovery of this unknown physician. With the current state of affairs that our country and many others in the world are in, we need to take a pause and think about how we arrived at this place.

Every day the number …

Coronavirus made simple by your friendly neighborhood emergency physician

Gavin H. Inglis, MD

Conditions and Diseases

March 23, 2020

I have been answering a bunch of questions about this virus. There is a lot of confusion, and there are a few questions that I seem to hear over and over. So, here is a simple primer.

1. Why is personal distance of 6 feet a thing? The measles virus can be spread through the air because it can literally float on the microscopic dust in the air. …

It’s the R-word again: rationing

Therese Zink, MD, MPH

Conditions and Diseases

March 23, 2020

Here in the U.S., we slip and slide around the reality of rationing. We like to believe we can have it all, do it all, that there are no bounds. And if you have money in the U.S., that is more or less true. Until now.

Personal protective equipment and test kits for COVID-19 are in short supply. I won’t explore the myriad of reasons of why …

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It’s the R-word again: rationing

Hospitals run on much more than doctors and nurses, so spread the love

Craig Bowron, MD

Conditions and Diseases

March 23, 2020

As a hospitalist in Minnesota, my colleagues and I are busy preparing for the coming viral storm. It is starting to rain. We read the harrowing front line stories from overwhelmed hospitals in China, Italy, and now here in the U.S., and reach for a sublingual Zofran tablet to calm the nauseous dread.

The smart and intuitive “flatten the curve” graphic has made a strong case to the public for why …

I don’t want to risk my life to keep my job

Anonymous

Conditions and Diseases

March 23, 2020

There’s an intruder in our relationship, and her name is COVID. Every night I come home, and she’s lurking around the corner on an Amazon box, in the crevice of my couch perhaps, or her scent is lingering on my husband’s scrubs. A physician-physician marriage is hard enough, but when put under the microscope of a life-threatening pandemic, well, it is disjointed to say the least.

My husband is an orthopedic …

Doctors will die. My friends will die.

Joanna Bisgrove, MD

Conditions and Diseases

March 22, 2020

I looked at the door. Standing there, in a paper gown, my hair tucked back into a ponytail, mask, and shield across my face, gloves on, boot covers over my shoes and legs. Behind that door was a woman I had known for years, whose youngest I had delivered, whose children I still cared for. And her father had just died.

Under normal circumstances, as her long time family physician, I …

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Doctors will die. My friends will die.

Are administrators disciplining doctors who wear masks too often?

Mia Marietta, MD

Conditions and Diseases

March 22, 2020

We are in crisis. Hospitals have become, in addition to repositories for the pandemic, infectious with moral illness.

From an emergency medical physician:

I have been told not to wear a mask in every room, only in rooms of people with infectious symptoms. And we are talking about [just] a surgical mask. I have emails saying this, and they go on to say no outside masks from home unless they are simple …

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Are administrators disciplining doctors who wear masks too often?

Infection preventionists are true heroes, and other things we’ve learned so far

Michael Edmond, MD, MPH

Conditions and Diseases

March 22, 2020

We are in the early stages of the COVID-19 pandemic, but it’s already very clear that the infection prevention community in the U.S. has never faced such an enormous challenge. Reflecting back on the past two weeks, we have learned many things that will make us better prepared for the long term. My goal is to keep track of these in this blog. So here we go:

We are far too …

Ignaz Semmelweis and why we wash our hands

Robert L. Dilenschneider

Conditions and Diseases

March 22, 2020

Count me among those who apparently didn’t …

Living at the top of our humanity: a patient’s plea

Christine Bechtel

Conditions and Diseases

March 22, 2020

I often hear professionals talking about “working at the top of their license” – contributing their highest skills according to their training. To overcome this pandemic, now more than ever, every single one of us will need to work and live at the top of our humanity. Patients, families, nurses, doctors, front desk staff, administrators, lab techs, health plan executives – everyone – must find even small ways to create …

The hospital census calm before the COVID-19 storm

Steve M. Grant, MD

Conditions and Diseases

March 22, 2020

I’m a proud member of our hospital’s Jewish All-Star team, which means I work every Christmas. One great thing about working Christmas is the hospital is never full. No one wants to be hospitalized on Christmas. If patients can go home, they do, sometimes even against medical advice. On top of that, there are no elective surgeries, chemotherapy admissions, or surprise calls from clinic. All is calm, if not bright.
Of …

We are not expendable. We are not replaceable.

Mercy Hylton, MD

Conditions and Diseases

March 22, 2020

Health care workers’ lives are not expendable. Yet, we are being asked to battle a microscopic enemy with disgracefully inadequate personal protective equipment (PPE).

We know that using PAPRs (powered air-purifying respirators) would be the best practice when working with highly infectious air-borne diseases. But, PAPRs are uncommon in our institutions, so the guidelines were relaxed. An N95 disposable mask was suggested as the next line of defense even though we …

Our collective struggle to fight COVID-19 coronavirus

Anonymous

Conditions and Diseases

March 22, 2020

I hope we eventually study the COVID-19 event after a sober period of analysis and reflection as an example of a societal panic attack. This is not Ebola, with a mortality rate of over 50%, or even SARS, with a 10% death rate. We’ve seen this movie before, figuratively and literally.

A new viral disease appears (like the swine flu in 2009), people die, the fear and misinformation spread like wildfire. …

COVID-19: 5 tips for psychiatrists

Garrett Rossi, MD

Conditions and Diseases

March 22, 2020

In February, I had my first patient ask about my thoughts on the coronavirus. At that time, I was aware of the coronavirus and cautiously optimistic about the situation. My advice to the patient was to have a healthy level of concern about the virus, given the medical communities limited data on the virus. I instructed the patient on proper handwashing techniques since this is an issue, even for many …

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COVID-19: 5 tips for psychiatrists

A guide for mental wellness while distancing: a psychiatrist’s perspective

Aryeh L. Goldberg, MD

Conditions and Diseases

March 22, 2020

One week ago, a mere glance at my phone between patients would have sufficiently caught me up on 30 minutes of disconnect from both social and mainstream media. Today, as I closed one virtual appointment and waited for my 9 o’clock follow-up to join me on-line, I was met with 16 texts, 148 WhatsApp messages, and four breaking news alerts from a variety of apps. Yes, I was thinking about …

Would Medicare for all help us combat COVID-19?

Rani Marx

Conditions and Diseases

March 21, 2020

In 2009, when more than $35 billion was invested in expanding national electronic health record (EHR) uptake, one of many advantages touted was its value as a tool for managing population health. This promise has failed to materialize due to a chaotic rollout of non-communicating systems. Today, as we confront COVID-19, the coronavirus wreaking international havoc, the need for such a tool is exquisitely evident.

How could …

An interruption from an evangelist

Raymond Abbott

Conditions and Diseases

March 21, 2020

Charles looks older than his sixty-one years; he is very thin and quite stooped, and his eyes are what I guess are described as “lazy.” One goes one way, and one another. He is badly in need of dental work. He has emphysema, though he continues to smoke heavily. His coloring is not right, and overall, he looks unwell.

But for the almost ten years I’ve known him, he has never …

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An interruption from an evangelist

I am a physician and I am not isolating emotionally

Mara L. Schenker, MD

Conditions and Diseases

March 21, 2020

I am a physician, and I am not isolating. Like the Vietnam War defined my parents’ generation and World War 2 defined the generation before that, the COVID-19 pandemic will likely define mine. My father and grandfathers went to battle – I am now called to be a soldier. My small group of orthopaedic trauma surgeons agreed this morning to rotate in and out of hospital shifts every two weeks. …

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