When I first landed this job as a case manager (social worker), I was given Robert R. as a client. He was at his worst then, soiling himself virtually every day, with no change of clothing available. I remember him wearing a piece of colored cloth around his waist, which served as a belt.
When he would come in in such a condition, sometimes even tracking in feces on his shoes, …
This patient is more than just a street person
I have been getting lots of requests for my opinion about where we are and what is coming.
The first question is: How bad will the coronavirus epidemic be in the U.S.?
The short answer is, we don’t know – but it could be pretty nasty. An important point, though, is that we are not helpless here. This is not like predicting a weather event where we cannot control where the hurricane …
A doctor’s coronavirus straight talk
Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy in which the body’s immune system attacks peripheral nerves. Clinical and epidemiological evidence seems to indicate that most cases are preceded by an infection such as Campylobacter jejuni enteritis, but in many cases, no cause is identified.
GBS is characterized by symmetrical muscle weakness that begins in the legs and ascends. The degree of weakness can vary from mild difficulty with ambulation …
Learn about Guillain-Barré syndrome with a Medcomic rap
While it’s well known that China and Iran have under-reported their COVID-19 statistics, Italy has been fully transparent. What we are learning is very concerning. The Lombardy province alone has experienced a surge in deaths due to the coronavirus— from 20 to 66 deaths in just one day. Analyzing data for the country as …
COVID-19: Why I’m very concerned
Susan Desmond-Hellmann has a unique set of experiences. Until February, she was the CEO of the Bill & Melinda Gates Foundation, where part of her job was thinking up new ways to battle infectious disease. Before that, she was the chancellor of the University of California, San Francisco. In the 2000s, she was one of the …
Should you panic about coronavirus?
The Harvard historian Jill Lepore recounted recently in The New Yorker magazine that when democracies sink into crisis, the question “where are we going?” leaps to everyone’s mind, as if we were waiting for a weather forecast to tell us how healthy our democracy was going to be tomorrow. Quoting Italian philosopher Benedetto Croce, Lepore writes that “political problems are not external …
How big will the coronavirus pandemic be? An epidemiologist answers.
As the U.S. battles to limit the spread of the highly contagious new coronavirus, the number of health care workers ordered to self-quarantine because of potential exposure to an infected patient is rising at an exponential pace. In Vacaville, California, alone, one case — the first documented instance of community transmission in the U.S. — left more than 200 hospital workers under quarantine and unable to work for weeks.
Across California, …
Self-quarantines will lead to health worker shortages
The arrival of the novel COVID-19 to the U.S., and the inevitability of its eventual spread, raises an interesting question: Should we avoid exposing residents to the virus?
Before we try to answer this question, we should start with some important qualifiers. While a good deal about this novel virus remains unknown, the majority of cases appear to be low risk, particularly for the …
Should we avoid exposing residents to coronavirus?
Being an oncologist in New York, having recovered from the trauma of flooding from Hurricane Sandy and the aftermath that ensued when hospitals were flooded in 2012, my anxieties are now heightened again over the global threat and uncertainties surrounding the novel coronavirus.
Daily emails from administrators at my institution seek to both reassure as well as prepare us on the front line of health care to deal with the specter …
Practicing oncology during COVID-19
I came back from a family vacation to Italy one day before the first case of novel coronavirus was reported there. Two days later, the CDC issued a Level 3 travel warning for visitors to Italy. Eight days later, and six days after returning to work, I got a fever.
I live in Indiana, where no cases have been diagnosed, and our protocols are still green. When I self-reported my symptoms to …
What COVID-19 taught me about autonomy
COVID-19 is here, and it isn’t going away. The SARS-CoV2 virus, and the disease it causes, has entered the ecosystem of human pathogens and is running up numbers that make it appear to be heading into the realm of the pandemic.
Let’s look at how health care workers and patients alike can mitigate the damage …
What prevents coronavirus? A pathologist grades COVID-19 precautions.
“The weak would never enter the kingdom of love.”
― Gabriel García Márquez, Love in the Time of Cholera
As the medical community grapples to come up with an appropriate response and protect our patients from this latest pandemic, I cannot help but wonder how the mighty COVID-19, measuring all of 0.1 microns has come to affect us doctors on an individual level.
Unlike the high acuity inpatient setting, clinics are more easygoing and give …
Love in the time of coronavirus
1. Wash your hands like your life depends on it. Because it does. Not only for Corona, but for the many germs you’ll acquire from touching elevator buttons, doorknobs, or somebody else’s hand. Or the dirtiest thing on earth: money: Everybody handles it, and nobody washes it. Except for the mob. And me, when I forget it in my pockets.
2. Stay home if you’re sick. Same with your children.
3. Disinfect frequently touched …
The idiot’s guide to coronavirus from an emergency physician
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 36-year-old man is evaluated for a 10-day history of abdominal cramping, diarrhea, malaise, and nausea. Diarrhea is watery without mucus or blood. He returned 2 weeks ago from a 7-day trip to Lima, Peru.
On physical examination, temperature is 37.7 °C (99.9 °F); the remaining vital signs …
MKSAP: 36-year-old man with abdominal cramping, diarrhea, malaise, and nausea
Nearly 100,000 pop culture fans flocked to Emerald City Comic Con in Seattle last year, including many dressed as superheroes, aliens, and robots. But something scarier than a comic book villain is roiling the conference this year — the spread of the coronavirus.
Ten people have died from novel coronavirus in King County, Washington, where Seattle is located, according to the Washington State Department of Health. At least 70 people have …
Is the conference cancelled? How coronavirus is upending the conference industry.
In the dark radiology reading rooms, only the gentle hum of the computers and the quiet chatter of residents dictating radiology reads break the silence. Among the computers sits Dr. Exner, a senior radiology resident at Hospital Woeisme. He has recently become known for a peculiar habit – he has begun adding Rorschach interpretations into every radiology report he completes.
The Rorschach test, created in the 1920s and sometimes referred to …
Resident adds Rorschach reads to radiology reports
When first responders answered roughly ten calls from a long-term care center in Kirkland, Washington, over the course of a week, they did not expect to become patients themselves.
Entering the Life Care Center of Kirkland last month exposed them to the novel coronavirus that sickens people with an illness known as COVID-19. Because the emergency calls came before authorities realized the virus was circulating in the community, some of the …
COVID-19 showcases the bravery of first responders
Recently, revelations indicated that the Iran missile strike on the U.S. base in Iraq actually did cause head injuries. So why did the U.S. initially claim no “casualties”? From the limited reports available, it appears that most of the soldiers’ symptoms were consistent with concussions. Let’s define terms: In the wars of the 20th century, our soldiers would have been labeled with “shell shock.” In the past, diagnosing concussion required …
The casualties of the Iran missile attack: not your father’s concussion
“Should I cancel my business trip?”
That is not the kind of question that patients typically ask their doctors. For most people, that’s not even a question they can ask their doctors, at least, not without an appointment, a co-pay and an anxiety-inducing wait in a crowded doctor’s office.
As U.S. cases of coronavirus rose this week, I fielded some version of this question from countless patients via telemedicine. Technology and experience-based …
What coronavirus is teaching us about telehealth
1. What can I do to prevent becoming infected?
When people are sick with a respiratory disease like COVID-19, they cough or sneeze particles into the air. If someone is coughing near you, the virus could easily land on your eyes, nose, or mouth. These particles travel only about six feet and fall out of the air rather quickly. However, they do land on surfaces that you touch all the time, …
How to prevent coronavirus: Your COVID-19 questions answered by a public health professional
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