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.

COVID-19’s biggest threat is to the health of our economy

Josh McKinney, MD

March 6, 2020

“Made in China.” Words ubiquitous throughout the products we use every day and now, ironically, applicable to the virus that has laid siege around the world. Illness and death have spread across borders and continents, as well as fear and panic. Illness and death we can quantify in numbers, however, fear and panic are less easily measured than felt in our news feeds and social media posts. It is the …

A great nurse shares their knowledge and does not judge

Rachel Basham, RN, CCRN

Conditions and Diseases

March 6, 2020

As a new nurse, I was constantly overwhelmed. I had spent four years of my life learning how to become a nurse, and then here I was, being “a nurse” and wondering all the time whether I was even any good at it. My heart was in it. But every moment of every shift, I felt anxious about my understanding of the information presented to me. I remember conversations with …

An infectious disease doctor answers your COVID-19 and coronavirus questions

Paul Sax, MD

Conditions and Diseases

March 5, 2020

Being a specialist in infectious diseases right now is an interesting experience. Added to the usual challenges of our everyday practice — caring for people receiving transplants or chemotherapy, those with HIV, surgical infections, tropical diseases, and others — we now must manage a deluge of coronavirus-related questions from friends, family, and colleagues.

Here are a few recent examples in bold, along with my responses.

Frequently asked questions

My baby …

6 months of probation: Taking care of someone with alcohol-related liver disease

Pooja Yerramilli, MD

Conditions and Diseases

March 5, 2020

“Are you my doctor?” Mary* asked me, as I, a resident physician, approached her bed.

“Yes, I am one of the primary medical doctors taking care of you here,” I confirmed with my standard, pre-scripted introduction — with little appreciation of the implications of these words.

Mary was a 30-something-year-old woman who transferred to our hospital due to worsening alcohol-related liver disease. She had struggled with anxiety and depression since her teenage …

Do patients addicted to drugs truly have capacity?

Gregory Jasani, MD

Conditions and Diseases

March 4, 2020

Is it time to rethink how we determine the capacity of our patients who are addicted to drugs? I recently began debating this question after I took care of a young woman with endocarditis. She had a long history of IV drug abuse that had led to the development of endocarditis. She had been admitted one week earlier and was being prepared for surgery, but she left against medical advice …

A doctor’s COVID-19 advice to physician leaders

Maria Yang, MD

Conditions and Diseases

March 4, 2020

I work as the medical director for a non-profit agency that serves people who are currently or formerly homeless. I am trained as a psychiatrist and have previously worked in local government. I live in the county in Washington State, where people have died from COVID-19.

Here are my recommendations for other physician leaders in other regions, particularly those who work in outpatient, non-profit settings. I hope this information can help …

Seattle is at risk for explosive coronavirus growth

Helen Branswell

Conditions and Diseases

March 4, 2020

The coronavirus outbreak in the Seattle area is at a critical juncture and could see explosive growth in cases much like Wuhan, China, if public officials don’t take immediate, forceful measures, according to a new analysis of genetic data. The author of the analysis, a computational biologist named Trevor Bedford, said there are likely already at …

A physician’s chilling COVID-19 diagnostic journey

Timothy Hlavinka, MD

Conditions and Diseases

March 3, 2020

We watched as the new viral outbreak happened in a remote place in China, wondering if this would be a quick flameout or if Mother Nature would again exert her majesty on us mortals.

My associate, Madilyn, and I watched with more interest, knowing that her sister was in South Korea teaching English. She was due to return in late February, …

More worried about the coronavirus than the seasonal flu? Here’s why you should be.

Tom Duszynski, MPH

Conditions and Diseases

March 3, 2020

The spread of the new coronavirus, which has infected over 80,000 people worldwide and resulted in the death of more than 3,000, has raised alarms around the world.

At the same time, the seasonal influenza, known as the flu, causes severe illness in between 3 million and 5 million people, with hundreds of thousands of deaths every year worldwide.

With …

The alarming risk of COVID-19 in nursing homes

JoNel Aleccia

Conditions and Diseases

March 3, 2020

An outbreak of coronavirus disease in a nursing home near Seattle is prompting urgent calls for precautionary tactics at America’s elder care facilities, where residents are at heightened risk of serious complications from the illness because of the dual threat of age and close living conditions.

As of Monday afternoon, the emergence of the novel contagious illness at the Life Care Center of Kirkland, Washington, had left four residents dead and …

How many people have coronavirus? We don’t really know.

Elisabeth Rosenthal, MD

Conditions and Diseases

March 3, 2020

It has been nearly three months since the first cases of a new coronavirus pneumonia appeared in Wuhan, China, and it is now a global outbreak. And yet, despite nearly 90,000 infections worldwide (most of them in China), the world still doesn’t have a clear picture of some basic information about this outbreak.

In recent weeks, a smattering of scientific papers and government statements have begun to sketch the …

Why does Generation Z require so many workplace accommodations?

Martha Rosenberg

Conditions and Diseases

March 3, 2020

Recently the Wall Street Journal reported on how many young people are now seeking “accommodations” at work for their anxiety, PTSD, depression, and other mental conditions.

The article provoked a lively discussion split largely on age lines. While older people accuse Gen Z members of being “emotional hemophiliacs,” Gen Z members often say they have real, palpable “mental illnesses” and need extra time to complete their …

Empathy is a crucial component when working with older adults

Mahesh Moolani, MD

Conditions and Diseases

March 3, 2020

An excerpt from Tough Decisions In Care Of Elderly Loved Ones (A guide for caregivers).

Empathy is more than just loving an elderly loved one. It is more than simply making the decision we may feel is best for our loved one. Empathy is different …

Our seniors deserve better. It’s time we all paid more attention.

Carole A. Estabrooks, PhD and Yuting Song

Conditions and Diseases

March 2, 2020

Most Canadians are familiar with nursing homes or long-term care facilities that provide 24-hour care to seniors who are no longer able to care for themselves independently – but we don’t spend a lot of time thinking about them. Given our rapidly aging population, and the likelihood that someone we love, or maybe even ourselves, will be living there one day, maybe we should.

What might surprise …

COVID-19 and coronavirus FAQs

Molly Walker

Conditions and Diseases

March 1, 2020

A case study seemed to confirm the presence of asymptomatic transmission within China, where a woman was afebrile with no chest CT abnormalities or laboratory abnormalities. She did not develop the virus, while five of her relatives did.

An earlier report out of Germany found a woman traveling to Germany from China with …

Read more…

COVID-19 and coronavirus FAQs

Too many scans is bad medicine

Raj Waghmare, MD

Conditions and Diseases

March 1, 2020

A medical diagnostic company recently posted the following tweet: “The best way to beat cancer is early detection. A full-body scan will provide you with a look inside your body and peace of mind.”

I wanted to type a reply, but I like to tell stories, and Twitter will only allow 280 characters.

***

A young woman sits on the examining table. Texting. As I approach her, she dangles her legs and checks …

Read more…

Too many scans is bad medicine

When a patient planned to kill a social worker

Raymond Abbott

Conditions and Diseases

February 29, 2020

It all began on Valentine’s Day when I arrived at my office and listened to my messages from the afternoon before. There was only one from a nurse at the state mental hospital. She had just seen, she said, a Mr. Lonnie M. and was calling to alert me (there is a law to this effect) that Lonnie had expressed very hostile feelings toward me, quite specific in nature.

He planned …

COVID-19 will expose EMTALA and the physician shortage

Edwin Leap, MD

Conditions and Diseases

February 29, 2020

Coronavirus, a.k.a. COVID-19, is lurking on the edges of the United States. What it will do here has yet to be seen. I was initially very concerned since I work on the front lines in community emergency medicine. For the last week or so, I have felt a little better after reading several articles. I suspect it will not have a high lethality among otherwise healthy individuals. But I’m no …

As the coronavirus spreads, should unvaccinated people be allowed to fly?

Christopher Robertson, JD and Keith Joiner, MD, MPH

Conditions and Diseases

February 28, 2020

As the coronavirus spreads, the nation’s leading health official told a Senate committee on Feb. 25 that “we cannot hermetically seal off the United States to a virus.”

The comments from Alex Azar II, head of Health and Human Services, heightened concerns about the effects of the coronavirus in the U.S., which so far has sickened a relatively small number – 57 – of people in the …

The problems with testing for novel coronavirus

Anna Maria Barry-Jester and Rachel Bluth

Conditions and Diseases

February 28, 2020

Just weeks into the federal government’s efforts to contain the novel coronavirus, a new California case has exposed weaknesses in the testing procedures that could be masking more widespread reach of the disease.

A woman in Solano County, California, who hadn’t traveled abroad or had contact with another known patient with the illness was diagnosed with the virus Wednesday, raising concerns that cases are going undetected because of the federal government’s narrow …

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