Let’s take a pediatrics patient as an example. She has a rare genetic disorder, heart problems, is G-tube dependent, and home-bound. The child is also on countless medications and requires 24-hour nursing. The family is rich and pays 100 percent of the child’s medical care.
Parents want what’s best for their children, right? I mean, their child’s care is 100 percent …
VIP medicine: Where patients get bad medical care
I am an avid medical blogger. Without a doubt, the most common theme I’ve encountered during the past several years is embodied in the following op-ed: “We must help physicians at the brink of burnout, depression, and high stress,” followed by: “Health care has crossed into a realm of moral injury and systemic collapse.”
I tackled the second essay first. I wrote a no-holds-barred response …
July 2, 1973, is a day etched forever in my mind. A day I remember as if it happened yesterday even though 47 years have passed. A day I thought would never come and then, when it did, would never end. It was the day I entered West Point as a 17-year-old kid with big dreams to “become an Airborne, Ranger, Infantryman and lead men in combat.” That was my …
Change is critical to fulfilling our calling
I was a medical student learning to deliver babies, bringing new life into the world, as my mom’s life was fading away. I saw all the missed calls from Dad. I knew in my heart something terrible happened. She was in the ICU. Dad told me she had a heart attack. I flew to be with her. When I saw …
Why I devoted my life to preventing heart disease in women
The cost of health care in the United States continues to rise, totaling over $3.8 trillion per year. Gastrointestinal diseases contribute significantly to health care costs and were recently estimated to be $135.9 billion annually. Innovation in gastroenterology has traditionally focused on expensive pharmaceuticals, devices, and new procedures. Many of the conditions and …
Innovation in a rural gastroenterology practice using a farm
An excerpt from Doc-Related: A Physician’s Guide to Fixing Our Ailing Health Care System.
Early in my career as a rural physician in Texas, I took care of a couple in their mid-70s named Vernon and Nellie. They drove in from another small town 50 miles away. Nellie usually did all the talking, while her husband, Vernon, sat quietly next to …
Patient surveys: the quest for positive reviews
Like anyone else, the holiday season can be the source of great joy. And it can add to the stress and overwhelm that physicians already experience. The practicing physician may find herself torn between responsibilities in the clinical setting and the preparations needed to make a memorable holiday experience for family and friends.
It starts with rushing from work to make it to the store before closing. It’s planning, decorating, baking, …
Beat the overwhelm this holiday season and set the stage for cheer
It was a hot afternoon, but no dog day humidity yet. I was driving back from a satellite office when our nurse practitioner called. A patient with a condition we’d seen many times before, a brain hemorrhage, her consciousness waning. The CT scan showed blood in the ventricles obstructing the flow of cerebrospinal fluid.
The pressure was building and our patient was dying. She needed an external ventricular drain to relieve …
My patient and I were born on the same day. It took a tragedy to bring us back together.
An excerpt from All Bleeding Stops.
42nd Surgical Hospital
Phu Bai
Republic of Vietnam
December 1967
Private Ira Stein has so many wounds, has lost so much blood, that the corpsmen nearly bring him straight to Graves. Steve Benson can’t get a pressure. He shakes his head. “Matthew, there’s no point taking this kid to the OR. He’s too far gone. He has no chance.”
“Bullshit!” …
War is really not all it’s cracked up to be
In the early evening, I stand in the grocery store checkout line. A young mother in front of me presses a pig-tailed toddler against her hip as she rummages for her credit card, and a man with silvered hair and a monogrammed shirt shifts impatiently behind me. As I watch the toddler, I’m hit with a twinge of nostalgia. I think of how I used to pull my daughter’s hair …
Our patients become an inextricable part of our lives
“I wish I had known how common this is. I would have started sooner.”
It is currently estimated that one in four women physicians has infertility (compared to one in eight in the general population). Why do I care? Because I’m one of them. But truly, we should all care. These women are our partners, colleagues, trainees, and friends. Their experiences shape the landscape of physician wellness for all of us.
To …
The voices of women physicians with infertility
Below are moments from my intern year of general surgery residency. They represent moments that occurred over three years ago, which I took home to my journal to process and work through. Back then, the moments left me speechless. And today, re-visiting them, the moments clearly demonstrate the fragility of the human spirit.
A silently sobbing 7-year-old the day after surgical repair of his broken femur. His face contorted. His pain …
The pain of doctoring and a call for change
When the term white supremacy culture is used, people get uncomfortable — they picture the skinhead as the prototypical racist. And while those people are dangerous, whether by their openly racist views being broadcast or in other subtle ways, they are largely recognizable.
White supremacy culture is inescapable in the United States. We have been saturated in it. Our country was founded on its tenants. The far more dangerous racist is …
Racism in medicine much more than just overt
The recent tragic shooting on the Rust movie set shocked me. A good friend, a prominent cinematographer in Hollywood, texted me his blunt assessment: “Live rounds on a set. Ridiculously unprofessional.”
Humans are naturally shaken when there is a senseless loss of life. Or are they?
As a hospital physician who has personally watched many people die unnecessarily of COVID-19, I found this fatal filming accident to be a powerful metaphor that …
Parallels between Alec Baldwin’s Rust movie set and the unvaccinated
Today’s health care system has become so standardized that if a person in a medical office were instantly and magically transported to a medical office in another city, the person would instantly recognize that they were still in a medical office. Our offices are now antiseptic, cold, and devoid of educational material and humanity, and this office decor can adversely impact a physician’s ability to provide care to their patients.
When …
A physician’s exam room should be educational and inviting
Do you have any idea how beautiful you are? Well, OK; maybe for some it’s were. Before you got a little thick in the middle, smoked, or even just breathed city air for enough years, or drank a little, or did a few drugs, there was a time — and maybe it’s still true — when you were knock-down, take-your-breath-away gorgeous. While operating inside a belly, I’ve often stopped working …
Do you have any idea how beautiful you are on the inside?
My older sister, Joy, will soon die from metastatic breast cancer. She will pass away at age 50. She will leave behind a husband of 21 years and the three children they nurtured to young adulthood. Our elderly parents will lament the unnatural timing of their firstborn’s death. And, I will mourn this loss, wondering whether my support of my sister’s spiritual beliefs makes me, as a physician-scientist, an accomplice in her death.
For the …
A physician and sister, but also an accomplice?
Working in an ER is unlike any other branch of medicine. Your specialty is unpredictable. You have no scheduled patients and no set pace. You could be fighting boredom one hour and running around with your hair on fire the next, or the next 11, for that matter. Your patients are not stratified by age, gender, body part, or severity of injury. Your next patient could have an infected cuticle, …
Reflections after the last ER shift
I will tell you exactly
And only the facts.
You are trapped a little for a time
And unhappy
Then your face hollows and it has a death mask
As the soul withdraws from the body
And you look at me and tell me who you see
It is always someone,
Sitting there like me,
But on the other side of things
Waiting for you.
And suddenly you become a column of white light
And leave the body all at once
Going upward,
I …
I imagine you’re excited to receive this letter, but please listen to me for a moment. I’ll need you to suspend your disbelief here. I am writing to you from the future, and you are me from the past. I needed to reach out to you about the choice you’ve made.
I realize — again, because I am you — that you are super excited about the hare-brained idea to go …
Get free updates delivered free to your inbox.
