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 …
An interruption from an evangelist
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. …
I am a physician and I am not isolating emotionally
A few days ago, a good friend revived an email thread that routinely circulated among our social cohort of 17 aspiring doctors during our final two years of medical school. The subject line read: qThurs HH. Translation: happy hour every Thursday.
Back then, the goal of the email was to establish a standing opportunity for any available recipients to vent about 5 am rounds and difficult attendings or to share stories of fascinating cases and …
Residency training in the time of COVID-19
The summer of 1979 is permanently etched into my memory. I walked into the intensive care unit as a newly minted intern. I walked over to ICU-Bed 1 to be introduced to my first patient, a frail teenaged boy who was tethered to a ventilator.
“He is day 30 with respiratory failure from disseminated coccidioidomycosis,” my internal medicine resident informed me. “He is your responsibility now, and don’t f*** it up.”
An …
Coronavirus: the human factor in intensive care
As the United States faces enormous issues regarding the COVID-19 outbreak which has now impacted all 50 states, I would like to refer to a quote from Franklin D. Roosevelt: “Let me assert my firm belief that the only thing we have to fear is fear itself — nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance.” This quote epitomizes a message that should also hold true today both …
Fear paralysis in the world of COVID-19
Physician burnout. Physician suicide awareness. Buzzwords. Words that get tossed around. People in leadership seem to be concerned about. Institutions say they care. “Solutions” get created.
Solutions that look great on paper. Sometimes under the guise of the employee assistance program. The brochure says we care about your mental and emotional health. We get that life is hard. So we’re here to help. We’ll set you up …
Raw thoughts from a critical care physician
I, like many of my physician colleagues, nurses, and healthcare workers, have spent my entire adult life sacrificing everything to help others, trying to serve the sickest of the sick. However, for every patient I have saved, you have seemingly multiplied by thousands your vast net of suffering. It takes me just seconds to visualize my weakest, immunosuppressed, heart transplant patients, who have already given everything to survive, to realize …
God bless us all and help us to destroy you, COVID-19
As we have literally overnight plunged into the world of telemedicine, I wanted to caution everyone to stop and think about something.
As an avid telemedicine provider, I truly believe in helping support our patients and the public. However, if anyone is an employed physician or medical provider, please keep reading.
If your practice did include telemedicine before, this may be a non-issue. But if it didn’t, you need to ask these …
Advice to employed physicians plunging into telemedicine
I want to make this simple so that politicians can understand. Our country will never survive this pandemic without centralized quarantine and widespread testing. This is not the flu, and our current policies and lack thereof will result in millions dead and economic disaster.
What is centralized quarantine? Every person who is tested positive must go to a government-designated housing location and not leave until they are no longer infectious. They …
Is centralized quarantine in our near future?
We are in a bizarre state of limbo within the crisis. We feel hopelessly behind, yet still attempt courageous efforts to be preemptive. My residency program, for example, had a fantasy of identifying which services were essential and which were not, staffing physicians appropriately, and staggering work hours to minimize exposure and allow others to be available for back-up when some inevitably fall victim to either quarantine or the virus …
I am a middle-aged gastroenterologist almost 15 years out of training. I have a chronic medical disease and had a bout with lymphoma two years ago, both of which require me to stay indefinitely on immunosuppressive drugs.
I am certainly not the only health care worker who is scared. Most winters that I will contract the flu or another illness from patients who want their screening colonoscopies performed while sick, from …
Why this immunocompromised doctor wants you to stay home
The coronavirus (COVID-19) is the single-most important topic on the minds of Americans, and it remains the subject of regular updates from health officials. And yet, despite the abundance of scientific facts and guidance surrounding the disease, misinformation abounds as confusion persists.
Avoiding many of the worst consequences and doomsday predictions will depend, in part, …
7 dangerous myths about the COVID-19 coronavirus pandemic
Early data from China and Italy shows that the outbreak disproportionately kills older adults. The rapid spread of these infections in the United States has triggered informal and formal efforts to protect frail and vulnerable populations like those in nursing homes.
Informal recommendations like social distancing have greatly changed the day-to-day lives of most Americans but have played a lesser role for those living in long-term care. …
COVID-19 policy amendments put nursing home residents at risk
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Grocery store shelves are empty. People are fighting over toilet paper rolls. It’s beginning to look a little like Armageddon.
You’ve seen the photos, heard the stories, watched the news coverage. COVID-19 is real. It’s real, and the incredible infectivity of it is scary.
I’m in medicine. COVID-19 is one of the reasons I went into medicine. Not because of …
Practice social distancing so we can #flattenthecurve
I am a pediatrician. Daily I see kids with fevers and coughs who test negative for influenza. Some have pneumonia. I am not able to test them for SARS-CoV2, so I encourage them to self-quarantine. If I find nothing else, I tell them they have a viral illness. They ask me if it’s “the coronavirus,” and I tell them that, contrary to what they are hearing from our government officials …
A letter to politicians: Doctors without PPE is deplorable and must be fixed
This breath is a gift …
This moment is a gift …
This life is a gift …
As with every other person, I am struggling to comprehend the staggering effects that COVID-19 has had on our society in such a short time. Gone are the carefree smiles, the uncomplicated daily lives, and the thought that we and our families are immune to unexpected death. Instead, we are witnessing a collapse in society …
Corona together: Say “I love you” a little bit more to those you love
For most of us, we have never experienced a pandemic as unique and widespread as COVID-19 during our lifetimes. There is ample data suggesting that the novel coronavirus is not only more infectious (R-naught 2-3) but also associated with increased severity of disease (average case fatality rate of 2.3 percent) than the seasonal flu. We are slowly understanding how intelligent and damaging this virus …
Please protect all health care workers: Make PPE a priority
In a time where everyone is looking for answers, I see a lot of health care workers, pundits, sports figures, and talking heads presenting a lot of in-flux data as immutable fact. I’ve seen phrases like “If you go outside, you’ll kill your grandma,” and “Going out to get groceries makes you part of the problem.” I wish people, including my own colleagues and fellow front line health care employees, …
The importance of staying humble in a pandemic
I’m not gonna lie. It’s scary as hell to be a doctor right now. In Italy, which is our projected immediate future, up to 10 percent of infected people are health care workers. Health care workers are also more likely to experience severe and critical diseases. There’s not a great explanation for why this is, other than just higher risk from repeated exposure over and over to infected persons. When …
It’s scary as hell to be a doctor right now
My grandfather was a dedicated physician. To me, he was the caring, attentive doctor depicted in the classic Norman Rockwell paintings. He was a brilliant and religious man of few but powerful words who didn’t greet his patients with a handshake, but yet he was loved by so many. He also happens to be the person who taught me as a young child why cheerios float, how lifesavers …
How a pandemic may kill the handshake
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