Remember the dark days of the pandemic, when the true risk of caring for COVID patients started to become clear? Remember when you could be censured by a nursing supervisor or administrator for wearing a mask in public areas lest you frighten patients or visitors?
Right around then, a third-year resident at UCLA decided to wear a mask wherever he went in the hospital, as testing wasn’t readily …
Recently, I solved a medical dilemma by changing the medication that seemed to have nothing to do with my patient’s problem.
Ethan Blake is a thin-boned, soft-spoken man with atrial fibrillation and a history of high blood pressure. He lives alone and prefers to shovel his own driveway. He also loves to walk his springer spaniel in the woods behind his house. He is in great physical shape.
At his routine follow-up …
When I decided to leave practice and explore non-clinical career options, I found no shortage of opportunities, ranging from the pharmaceutical industry to the health insurance industry and many points in between. I chose to work in the health insurance industry because jobs were plentiful, and the focus of work remained on the patient.
A typical entry-level job in the health insurance industry is that of utilization …
My Tuesday out of clinic started off like any other Tuesday. I got up (sluggish, still chronically sleep-deprived), scrubbed my face and brushed my teeth, slipped into workout clothes then set to getting my two girls ready for school. After packing lunches, brushing hair, and waiving to the bus, I sat down to do what most of us do on our days out of clinic: check the dreaded inbox. Who …
We have been walking down a long hallway for many, many months. We left the room we resided in pre-COVID, but we have not yet found a room to rest. We are in the liminal space of COVID. This is unsettling and unnerving — liminal space often is.
Liminal space in architecture is the area between discrete, functional spaces, a way of passage, but not the place where beds are placed, …
I broke down crying. Again. — In this cold heart, I can live, or I can die. — It isn’t even on my sad song playlist, so why am I so upset? My scientific brain encouraged me to recreate the environment, remove the variables, and play the song again in isolation. — I believe if I just try, You believe in you and I — Oh no, it’s happening a …
“They are firing me for not getting the COVID vaccine. I can make more money working at Michael’s than I do at this job. I was only doing this because I like to help people. But this is it for me. I’m quitting. I’ll miss the patients, but I cannot be forced into doing something that I don’t believe in.”
The patient care tech said to me after putting my patient …
Not long ago, my patient in a complex thoracic case developed progressive bradycardia followed by a malignant-looking multifocal atrial arrhythmia that didn’t generate any blood pressure.
“Get out some epinephrine!” I said to my resident, who was standing closer than I was to the drug cart. The resident quickly drew up a milligram of epi, but then paused. I could almost see the thought bubble overhead: “Should I print out a …
I received a phone call from an elderly gentleman who was closer to ninety years of age than 80, was taking an aspirin, and had just suffered a fall and hit his head. He did not know why or how he fell. He asked for an appointment the same day to “check me out.”
My staff asked all the pertinent questions and immediately brought the information to me. After reviewing it, …
How many minutes have you given yourself to read this post?
There was a time when none of us could tell time. Imagine not knowing what the ever-moving hands of a clock are trying to reveal. My memories skew, but in that era before I could tell time, all I remember is laughter, effervescence, and the occasional injury. (The first time I hit my “funny bone” was quite the scare!)
Now, we …
“Do you get compassion fatigue when you take care of smokers or patients with obesity or diabetes?”
This was in reply to an article on compassion fatigue I had posted on my Facebook page. The article was written by an exhausted physician caring for unvaccinated COVID-19 patients. My initial reaction was, “Of course not. That’s my job!” But it made me think, why was it that caring for unvaccinated patients seemed …
I was recently coaching a bright, energetic primary care physician in her first few years of practice. She was working through her Life’s Purpose statement, an exercise we often recommend. At the end of her admirable statement, she tagged on “with efficiency.” Naturally, we explored this a bit. Our conversation meandered toward an interesting conclusion: the more she focused on efficiency, the more likely she was to feel overwhelmed and …
“If you think a mother’s pain is unimaginable, you should see her strength.”
You were visiting your mother when, while in another room, you became unresponsive and fell to the floor. She heard the thump of your fall and raced into the room to find you pale and barely breathing. Drug paraphernalia sat beside you.
Your mother screamed. She cried. She fell to her knees and tried to wake you, slapping your …
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Being a doctor is often more about talking to people and communicating than it is about the scientific practice of medicine. This is something that is unfortunately not taught enough in medical school, and it’s left to newly qualified doctors to realize very quickly as they start their careers.
Throughout the busy and hectic day of any hospital-based physician—no matter what their specialty—one of the most common requests we hear from …
Everybody knows how to operate smartphones and understands complex modern phenomena, but many Americans are frighteningly ignorant about basic human nutrition.
I am convinced this is the result of a powerful conspiracy fueled by the (junk) food industry. Here are just a few examples:
Milk has been advertised as a healthy beverage. It is not. No other species consumes milk beyond infancy. Milk-based products like ice cream and yogurt are on top …
I love stories, either told, written, or listened to. Songs tell stories, as does art. Blogs such as the rich content open so many doors for rich conversations. Telling stories is part of who I am. My father loved to tell them, as did my grandfather, whose name I took. They were called bull-sh*tters – and perhaps some refer to me that way at times. In medicine, I find storytelling …
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This morning, while scrolling through social media, I encountered a resounding theme. Multiple physicians posting about being challenged, disrespected, and made to feel worthless by the very people they were trying to help: their patients. Being brought to tears by the disrespect of the patient’s family members. Physician expertise blatantly questioned. Advice ignored.
Patients telling doctors – to their faces – that they “don’t like their tone” and then telling nurses …
She was an ICU downgrade. Hospice care is what they told me. We added her name to our list, and my senior resident told me she was now my patient. I did not have a clear story. Sepsis? Complications? The ICU note was lengthy. Rounds were coming up, and I needed to see all my patients.
I went into her room. She was breathing slow. Oxygen saturation dipping. Unconscious. I asked …
Nothing like a tragic global pandemic to make everyone rethink their careers. This past year and a half have brought a lot of changes to the workplace. Many of us don’t want to go back to the way things were. According to a Pew Research Center survey from late 2020, of the 71 percent of employees working from home because of the pandemic, more than half, given …
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In the past week alone, I have heard the following comments from pediatricians on the front lines: “I’ve been practicing for 21 years, and I’ve never seen things this bad”; “I have been called uncaring because my patient had to wait an hour. But I couldn’t tell my patient that I was running behind because of a suicidal patient”; “I’m considering leaving clinical medicine because it seems like there is …
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