“If you don’t let us go home because of the vomiting, his time is running out … I don’t want him to be at a point where there is nothing else to do, and I don’t want him to go home at that point,” said J’s mom.
“Am I crazy to want to see this naturopathic doctor? He promised us he would cure our son of his cancer …”
“It is not …
Palliative care: Most doctors do not know how to talk to their patients
I came across an article a few weeks ago with the heading, “Biden administration denies funding handing out crack pipes to addicts to improve ‘racial equity.'” As similar articles came out across the United States and the United Kingdom, I was immediately bombarded with questions from friends and family members who were in disbelief that the government would do something as ludicrous as giving out crack pipes. …
How stigma and online trolls stopped an intervention that could save lives
At birth, our rudimentary brains have very few developed circuits. Through everyday experiences, we slowly develop simple circuits before the more complex circuits form. Our interactions with caregivers teach us words and shape our concepts, and we ultimately string concepts together into thoughts.
We have tens of thousands of thoughts every day, but many go unnoticed. Our brain utilizes an autopilot mode so that each day isn’t a completely new experience. …
Mitigating perfectionism through self-compassion
He was sick-sick but he had broken his hip, and if you put a broken bone and an orthopedist together, you have an operation. It wasn’t as far afield as the classic ortho-anesthesia video where ortho calls for an OR for a dead patient, but believe me, all kinds of badness can occur that turns sick to dead.
A good sign was that the patient was ornery. He didn’t so much …
The sick-sick patient and the anesthesiologist
I’ve come across several articles recently highlighting the Dr. Lorna Breen Healthcare Provider Protection Act. The primary stated intent of this is “to improve mental health among health care workers. It is named in honor of an emergency physician who died by suicide during the height of the COVID pandemic.
Although my very first thought was, “oh, thank God … they are finally listening,” that was quickly replaced with a sick …
Stop telling physicians to be more resilient
I just received my peer evaluation from work. And I’m gonna admit: I was nervous.
“Yikes.” I cringed when I saw it in my inbox. Would my colleagues call me out for not being as sharp, fast, or adept as them? Would they fault me because I just cannot stomach a dislocation despite working in a pediatric urgent care for several years? (True story: I damn near dropped out while treating …
It’s time to flip the script on peer evaluations
When was the last time you paused for a moment to feel your energy? I mean, really get in touch with the energy you hold inside your being?
Could it be that, as physicians, we have gotten so used to feeling stressed or drained at the end of the day that we’ve forgotten how to feel at ease and be in a state of joy as we take care of our …
Pause for a moment to feel your energy
Her image captured the world: mangled hip, jutting belly, stretcher, war, a woman carried out of a bombed maternity hospital. She’s gray, contrasted against a colorful beach towel, among the smoldering ruins of Mariupol. The outcome was bad; neither she nor the baby survived despite the perimortem Cesarean. News stories reported that she gasped and, with her dying breaths, said that she did not want to live in a world …
The unheard cries: an obstetrician’s nightmare
My mom has Alzheimer’s dementia and lives in memory care. During her February 4th, 2022 health visit, her chart reflected stage FAST 7A (a 7-step staging system for dementia). I am her patient advocate, durable power of attorney for health care (DPOA-HC) that was activated two years ago. I was clear with her care team from the beginning that my mother is a DNAR and, when she became hospice eligible, …
Does your patient advocate have access to stop the medicalized death train?
Many years ago, doctors were relied upon to care for the health needs of their local communities. They were trusted fixtures relied upon to diagnose and treat whatever the ailment. They spent time interacting with patients, not paperwork or screens. There was no bureaucratic red tape or a long list of administrative procedures. It was pure medicine.
I think it would be safe to assume that burnout barely existed. These doctors …
I left medicine. Then I found meaning.
First, this article is not to discredit or compare to anyone. This article is not to take away the celebrations of those whose behavioral changes have made them feel more healthy and fulfilled in their lives — though I will challenge the emphasis on the number on the scale as an outcome measurement to use for such celebrations. This article is to shine a light on a less commonly discussed, …
I gained weight and, with it, I gained life
This year, the National Resident Matching Program provided matching services to more than 42,000 applicants. A medical student’s choice of specialty is one of the most important decisions they will ever make. But deciding which medical specialty to enter can be difficult. The majority of medical students are indecisive about their intended area of practice. Over the course of medical school, only a quarter (26.1 percent) of …
Going mobile: an antidote for career regret
Will Smith’s Oscar smackdown of comedian Chris Rock proves one thing: violence should never be a response to insults – or any other inciting factors – in the heat of the moment. Will Smith knows it, and so do the millions of television viewers who witnessed the assault. Yet, despite Smith’s written apology to Rock, Smith may likely believe his actions were justified. Why do I say this? Because if …
What does Will Smith’s facial expression at the Oscars tell us about our patients?
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“Any questions?” I asked one of my patients, Dona Maria, for the third time.
After her prolonged silence, I asked again, almost in despair, “anything else? Anything that you don’t like about what I have said? Or anything you don’t like about the medications I am recommending?” Dona Maria sees my disappointment and tries to smile at me. Then she shares some stories about her great-grandson, who just turned three.
It is …
How doctors can ensure their Latinx patients receive the best medical care
An excerpt from Boundaries For Women Physicians: Love Your Life And Career In Medicine.
When I openly share my experiences with friends and colleagues, I am amazed by how many other women physicians tell me they have had similar ones. They admit to feeling so low that suicide or …
The key to loving our lives and our careers starts with us
“Peace is your home, integrity is the way to it, and everything you long for will meet you there.”
– Martha Beck
In 2017, the blueprint I had crafted for my life evaporated before my eyes.
Up until that point, I had systematically checked off the steps to becoming an Air Force oral and maxillofacial surgeon. I was in the Air Force, and I was in oral and maxillofacial surgery (OMFS) residency. I …
2 insight-provoking questions when starting over
I don’t think I became a whole person until my mid-30s. When you spend the majority of your life in school, training, and building a practice, everything else goes on hold, or autopilot. There are very few things that I made conscious decisions about. Becoming a doctor was something I decided in childhood, and then it was a mission that I felt I needed to achieve. Every action in my …
A physician was bullied and fired by the bully
It is no surprise that burnout is surging along with this latest pandemic wave. Exhaustion—both physical and moral—is the ashen heart of burnout. Even as the flood of patients recedes in some areas, health care operations are hardly back to normal as many systems struggle with staffing shortages. In the hospital where I work, nurses have carried up to double their normal patient load, while the remaining phlebotomists on staff …
Those with the power to reform our system have little incentive to act
I’ve been as guilty as anyone of leaving my patient out on a limb. As a practicing primary care physician, I’ve had patients with diabetes who observe Ramadan, but I had no idea how to support them during their fast. I’ve had transgender patients yet didn’t have the right language to talk about their health, and nothing in the electronic health record (EHR) seemed designed to support them. I’ve sent …
The center of gravity in health care and the role of primary care
The magical number for one full-time equivalent (1-FTE) professional is 2,080 work hours annually — 40 work hours per week for 52 weeks in a year.
Professionals can work extra hours during non-vacation weeks to make up for opportunities lost during vacation weeks. For example, 1-FTE can work 52 work hours per week for 40 weeks in a year to accrue a 12-week annual vacation, while 0.5-FTE will need to work …
A full-time equivalent is 2,080 work hours annually
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