She began telling me the same “sob story,” but this time, I looked at her and coldly said, “Mrs. _____, you are going home. I don’t care what you have to say; you are leaving today. I need the bed for someone else.” She began crying. I walked out without saying another word and wrote the discharge order. The Intern with me said the words that I will always remember, …
As I write this, I’m struggling with the fact that I haven’t “finished my work for the day.” My inbox has unread emails. My task list is bursting. I have unfinished laundry/ chores/ dishes. I told myself, “I don’t have time to sit and write an article!”
And yet – the seed had been planted. I could no longer ignore the whisper that said, “You have a story to tell. And …
A guest column by the American College of Physicians, exclusive to KevinMD.
By any measure, the past year has been difficult for everyone.
The ongoing pandemic with its widespread personal, social, and economic disruptions, as well as civil and political unrest throughout the country has clearly stretched the fabric of our society and had remarkably negative …
Ballet dancers and doctors are essentially the same people. Long before I entered medicine, ballet taught me the skills that made me successful in my clinical practice. I was a life-long learner. I improved my skills with daily practice. I was creative with limited resources. I strived for excellence and was rewarded for these efforts. The skills I learned as a professional ballet dancer prepared me well for medicine.
There was …
Physicians have gone toe-to-toe with death since the earliest days of the profession, even knowing that our efforts would often be futile. Over the past century, dramatic technological advances have nearly doubled the average American lifespan, and modern practitioners have a level of control over mortality previous generations could scarcely have imagined. But medicine has by no means conquered death. This puts health care providers in …
Before COVID-19, I left the practice of medicine for what would turn out to become an entire year. While away, I found a new way of seeing our hearts and bodies as humans in the medical profession, allowing me to return.
Here are five lessons I learned in the hope they might help others.
1. Perfectionism doesn’t make you perfect
If perfectionism isn’t an unwritten rule in our profession, it’s, at minimum, a …
“Why do they book your well-child checks for 15 minutes?” my medical student asked me yesterday. I laughed. I couldn’t help it. Gut reaction – like when you laugh instead of cry. I explained that all of our appointments are 15 minutes – well-checks (regardless of age), to colds, to suicidality or chest pain. I work for a large hospital system, and that is how patients are booked. I the …
A recent conversation with a nurse evoked a metaphor for the COVID-19 pandemic. The floor on which she worked had just had several patients die from COVID-19 in rapid succession. One particularly sad case involved a man saying his final goodbye to his mother, both infected with COVID-19, through a video call because they couldn’t be in the same room as the mother passed away. The nurse said that she …
I was at my gym last night (yes, it’s finally open). Billy Joel’s ballad about trust was the metronome to my squats. Though vaccinated, I was wearing my mask. Knowing the latest evidence about vaccines, my mask was only for the optics of those mostly maskless around me. I overheard the couple next to me say, “OMG. Fauci says we should double-mask. What a BSer!”
Trust is fundamental to the delivery …
As I finished the endless clicking, the clinic day came to a close.
Clicking to begin and end phone visits.
Clicking to get on and off Zoom visits.
The endless video game clicking that is life as a physician documenting electronic health records. Too bad I have never been a gamer; maybe some who are can imagine amidst all of this they are in a scene from a Nintendo or Playstation classic.
Clicking boxes …
Every physician has had the experience. The moment you ask yourself, “Why am I doing this?”
It could be when you look into the waiting room where there are more patients to be seen and know if you take a break, it will set you back even further.
It could be on the final stretch of the 24-hour shift that redefined the meaning of the word “nonstop.”
It could be the third time …
Deeply entrenched racism, rooted in the foundation of white supremacy, has had a stronghold in medicine for hundreds of years. Its legacy of harm against Black, Indigenous, and people of color (BIPOC) communities, particularly its atrocities against Black Americans, is undeniable. Yet significant change eludes us. For decades, these communities have borne the disproportionate burden of public health short-comings from police brutality, gun violence, infant and maternal mortality, and …
Long ago, in the BC (before COVID) era, I would chat up a local in a foreign country. Their usual response upon learning I was from the U.S. would be to seek clarification on aspects of American culture found most peculiar. There were your usual suspects — the Electoral College, imperial versus metric systems, and why we’re obsessed with the Kardashians — but the most common question was about our …
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Changing direction once established is not easy, but it can be rewarding. I recently read the essay on KevinMD (“How this physician escaped the system“) from a physician who shifted gears to her own business after some discouraging experiences in “the system.” During her residency, her attending physician asked her what her purpose was in becoming a physician. To her credit, she said that her goals …
Before getting dressed for work this morning, I stood in my kitchen, marveling at the ice crystals, or “tree diamonds,” as my mother calls them, from the window above the sink. As I waited for the coffee to brew, I scrolled through the text messages sent to my phone overnight until I saw my friend’s forwarded news link: “Doctors suspect COVID delayed immune response in young surgeon’s death.” I clicked …
When I think about boundaries, I am struck by how individual, varied, and unique each of our own personal definitions of boundaries can be. For one person, it is the physical boundary between the external world and our property. For another, the emotional and relational boundary between physician and patient. For many, the physical, emotional, and energy boundary between work and home. And often the most difficult, the boundary between …
As doctors, we are taught the art of assessing our patients through the doctor-patient relationship. We learn a series of open-ended questions to gain insight into our patients’ values and thoughts regarding their personal health. We learn how to evaluate lab values and make diagnoses. Through all of this, we strive to make optimal decisions for our patients to avoid the legal ramifications of medical errors and because physicians thrive …
A moment in medical school that left a huge impression on me was when we had chairman’s rounds with the department of medicine’s chair. He was a renowned breast oncologist and researcher and described a bit of his process when interacting with a patient. The process he had developed over his years of experience was so fine-tuned that there was not a single movement, action, word, or breath that was …
The recent controversy and backlash surrounding Kamala Harris’s Vogue cover shows that it is still fashionable to diminish powerful women. It also is the latest example of the sad fact that no matter how far we have come, women are still held to a different standard—by both men and women.
As a female vascular surgeon, I have spent my career pushing back on ideas about what …
The COVID-19 pandemic has exacerbated and highlighted many health issues, particularly those suffering from chronic pain.
An estimated 50 million people in the U.S. live with chronic pain, of which approximately 19.6 million experience high-impact chronic pain that interferes with life, social, and occupational activities. Regardless of the pathology of pain, chronic pain may involve Read more…
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