The first signs are often subtle — missed appointments, unpaid bills, or a once immaculate home that now has an unmowed lawn and dirty dishes on the counter. It’s easy for adult children of aging parents to miss these first signs that their parents need help with tasks they once handled easily on their own. In fact, many older people take great pains to cover up these problems and insist …
When an aging parent says no to much needed help
We were told to wear masks before entering this patient’s ICU room. Entering his room, you could smell his rotting flesh. He was 92 years old.
His skin would slough off if you dared to bathe him.
His decubitus ulcers were raging with infection.
As long as I’ve been an ICU nurse, this was the worst — the smell, the neglect, the disrespect for this man.
He was VIP status.
I always had a problem …
When a wife won’t let her husband die
I remember lying in my bed after my second delivery in severe pain. With my first delivery, I had already endured a C-section. Four years later, I wanted to experience a “natural” delivery, so I opted for a vaginal delivery after C-section (VBAC).
The VBAC quickly turned into an emergency where the maternal-fetal medicine (MFM) physician gave me two options: Get this baby out now or undergo an emergent C-section. My …
Confessions of a bed-sharing pediatrician mom
I know you want to. I know you would rather have anything other than dementia—even cancer. I know you are happy with your life and want it to continue as it is. If it has to change, I bet you’d like to slowly become more frail until one night you just die in your sleep. You do not want to slowly become more confused. You don’t want to live …
When your doctor says you have dementia, don’t argue with her
Happiness doesn’t always come easily. Some people seem naturally happy, like they inherited the right gene or were born into the right circumstances. Many other people struggle to find happiness. Perhaps even more people hope to become happier than they already are. But what kind of plan should people follow if they are hoping to become happier? Or will any kind of plan merely make it harder to thrive?
It …
The key to happiness is not a mystery
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 52-year-old woman undergoes perioperative evaluation. She has osteoarthritis of the right hip since sustaining injuries in a motor vehicle accident 15 years ago and is scheduled for elective hip arthroplasty in the next few months. Medical history is otherwise notable for type 2 diabetes mellitus. She …
MKSAP: 52-year-old woman with osteoarthritis of the right hip
You’re at the top of your game. And you are perhaps thinking that this is not how you envisioned life at this stage in your career.
Many successful physicians are frustrated that they can’t find the time or energy to be present with their family and friends. They haven’t even thought about activities just for fun and creativity. Taking a vacation seems impossible without the practice coming to a screeching halt.
You …
Eradicate burnout with these 2 simple strategies
One of the most important things to understand about heart health is that a woman’s needs change over time. Risk factors for heart disease like high blood pressure and high cholesterol can become more important as a woman ages. Hypertension and high cholesterol are not things we may feel. This is why hypertension is called the silent killer.
Even women who have always maintained normal cholesterol and blood pressure levels could …
A cardiologist’s advice to women: How to keep your heart healthy and happy
The fertility clinic waiting room is a space where many people will find themselves at some point in their lives. In spite of cheery music, shared success stories, infertility awareness weeks, and positive media campaigns, this can be a challenging and sensitive time.
About one in six Canadians experience fertility problems — these range from difficulties getting pregnant to difficulties staying pregnant and experiencing pregnancy loss.
As fertility specialists, we know that …
More is not always better with fertility treatment
The front-desk clerk, Ruth, comes to me and says Rose Henderson wants a cab voucher signed — which guaranteed payment. Rose could not be made to understand, Ruth tells me, that we are not permitted to sign vouchers when the person, the client, comes to our offices solely for the purpose of picking up cash … which is Rose’s purpose.
We are Rose’s payee, which means we handle her money. I …
My patient isn’t doing well. Is it my fault?
In my very first job as a doctor — working in a London hospital in the 1980s. I always took a ridiculously detailed past medical history for every patient I saw. I started to notice how many elderly women had had septicemia, a life-threatening infection in which enormous amounts of bacteria enter the bloodstream.
The neighborhood surrounding the hospital had once been the worst slum in London. And it didn’t take …
What happens when abortion services aren’t available
I am a critical care RN, and I violated my patients’ rights. For decades, every day that I worked in the emergency department or the intensive care unit, I violated my patients’ federally protected rights to participate in their plan of care.
I didn’t mean to, or want to, but my tasks to maintain their life took priority over the obstacles to hearing them when they could not speak.
Almost every day …
As a registered nurse, I do not want to violate my patients’ rights anymore
The chances that you or someone you love will be diagnosed with dementia are shockingly high. By age 65, your chances are already at 9 percent. Make it to age 85, and the chances go up to 33 percent. Of course, if you’re diagnosed with dementia, it will be a struggle for you to think clearly about your diagnosis. So, today, while all of your faculties are still intact, I’d …
Dementia is worse when coupled with inadequate preparation
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I first met JB* when the receptionist at the clinic called to tell me that a patient was asking to see me. His name did not ring a bell, and on a quick review of my patient schedule for the week, his name did not appear. I went to the waiting room to see if I at least recognized his …
The sexual side effects after prostate cancer treatment
Life can be hectic. We all feel the effects of the “busyness” of our daily business, especially with the beginning of a New Year, when we tend to hyper-focus on our “to-do lists” and resolutions. We can often forget to take care of ourselves and the ones we love. For example, when was the last time your adolescent child visited their healthcare provider for a routine physical or well visit? …
Teenagers also need routine annual well visits
By the time I turned 40, I had gained and lost 40 pounds at least ten times. It started with the “freshman fifteen” plus another twenty-five in college. In medical school, I was introduced to sweetened coffee beverages, and I snacked on pretzels and candy to stay awake while studying. I got through overnight call during residency by using my meal tickets to buy chocolate-covered ice cream bars. And once …
The simple step that helped this physician lose 10 pounds
An excerpt from Death Is But a Dream: Finding Hope and Meaning at Life’s End. Published on February 11, 2020 by Avery, and imprint of Penguin Publishing Group, a division of Penguin Random House, LLC. Copyright © 2020 by William Hudson, LLC
Dying in the hospital is …
The medicine that defines hospice care
There is good news and bad news in the world of women’s health.
The good news is that women do not need annual Pap smears. The bad news is that, upon hearing the good news, many women incorrectly assume they no longer need annual pelvic exams, either.
Historically, Pap smears were performed annually, and during the same time as pelvic exams, so it is understandable why women would conflate the two. But …
Cervical cancer guidelines leaves women confused about annual pelvic exams
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 32-year-old woman is evaluated for a 6-month history of loose stools, bloating, and a 3.2-kg (7-lb) weight loss. Her medical history is otherwise unremarkable. Her brother has type 1 diabetes mellitus, and her mother has autoimmune thyroid disease. She reports no other symptoms and takes no …
MKSAP: 32-year-old woman with loose stools, bloating, and weight loss
Every day, children are cared for in clinics and hospitals. And every day, some of them are unhappy about it; some of them deeply unhappy about it.
The contemporary practice of nursing and medical care includes health care providers having to touch their patients. This may include an abdominal exam, listening to their lungs with a stethoscope, or even slightly invasive maneuvers, such as having to put an otoscope into their …
Reconciling consent culture and bodily autonomy with pediatric care
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