An excerpt from An Eschatological Isolation.
At 12:11 p.m., the overhead speaker announced: “Code Blue, Three West.” She repeated, “Code Blue, Three West.”
Shit. I started my stopwatch and saved the patient note I was writing in the back office of Three West, the intensive care unit of a community hospital in Tampa Bay. Already wearing a sealed N95 mask, …
A morning code blue for a COVID patient
I had just received a call that I had been accepted to medical school, and I had immediately pulled up a Google search: “best time to have children in medical training?” I was certain that this was not how most people celebrated news of their acceptance to medical school, but this was a priority for me. A quick scan of the results of my Google search was clear, “Don’t do …
So, are you committed to medicine — or your baby?
In any industry, there will always be unhappy customers. Having a formalized method of dealing with complaints is absolutely necessary to protect consumers and patients. What isn’t discussed enough is the severity of these complaints’ psychological repercussions on physicians and other medical providers.
Most providers spend years of their lives in school, sacrificing family plans, social events, and sometimes their own well-being, all on a mission to care for others. Despite …
The psychological repercussions of patient complaints
The health care crisis is a difficult one to face. Health care budgets have skyrocketed, and rates of chronic illnesses have increased much faster than before. As physician leaders, what if we each took personal responsibility for the crisis? Perhaps it all boils down to how many people trained in health care know what is necessary for living healthy lifestyles. Yet, that knowledge often doesn’t materialize in excellent health outcomes. …
A holistic approach to health and wellness requires openness and vulnerability
Own it.
People sometimes say, “Own it.” Own your mistake. We use it less frequently to say own reactions or actions instead of blaming others and external forces for our actions. Life coaches call it being in a state of “emotional childhood.” It means that instead of saying you are responsible for your thoughts, feelings, and actions, you blame others for these.
“The situation is bad.”
“I am angry because it is not …
Stop blaming others. You need to own your actions.
I am sitting in hot springs deep in the dark and crisp air woods – naked. It has been a day of lectures and workshops at a retreat with my fellow physicians. We are all naked in the effervescent, warm bubbles of the springs. In the dark, I can recognize who people are by the fluorescent necklace each wears. You know, the kind that you crunch and shake to activate …
The profound experience of being naked with other doctors
When plastic surgeon Dr. Robert Pearl published his Los Angeles Times op-ed, “How Doctor Culture Sinks U.S. Healthcare,” a polemic essay critical of primary care physicians like me, he set off a firestorm. While he made some valid points, Dr. Pearl also blamed many of the preventative health failures in the U.S. squarely on the shoulders of primary care physicians without acknowledging that our health care …
The unfair blame on primary care physicians
My phone rings.
“Namaskar! My cough is really bothering me. What should I do?” says a middle-aged man.
“Namaskar! I am Astha Prasai. I am here to help you. Please bear with me while I ask you your problem in detail,” I answer.
Mr. Kafle from Kathmandu is worried about this nagging cough he has, and it has been a month since he has tested positive for COVID- 19. After talking to him …
Telemedicine in Nepal during COVID-19
Even though I completed residency almost 15 years ago, it is easy to remember the dread I experienced before taking hospital call. The sinking feeling in my stomach as the call date loomed near, the hypervigilance and terror every time my beeper went off in the middle of the night, the fear of imagined catastrophes that would by necessity be my fault.
My anticipation of call was usually worse than reality. …
Physicians: Stop dreading call
July 1 is a day that marks the new era when student truly becomes doctor, where hundreds of residency programs start day one of the three-year or longer residency, a life-changing rite of passage. Where the initial hours start the tens of thousands of hours of experiential full immersion training. Looking back, intern year was one of the hardest years of my training and definitely one of the hardest years …
Reflections from a former intern
I’m not an organizational leader, a member of the C-suite, a department chair, or a VP of anything. I’m a coach who guides physicians as they try to provide exceptional care and actually have a life. But I know a lot about setting goals, executing on priorities, and inspiring through vision statements.
Here’s the thing. This is not a successful long-term strategy:
Hello, health care organization leader, are you listening?
I am a first-generation Chinese American. And amidst the complexity of the pieces that form my identity (mom, wife, daughter, woman, doctor), it is the piece I have often prized the least.
In one of my earliest memories, I am riding a crowded bus in Beijing. My aunt and cousin are pointing out the American tourists as we pass, commenting on their high nose bridges and round eyes and how these …
It’s time to rethink the model minority
A guest column by the American College of Physicians, exclusive to KevinMD.
My mother recently died at 94 years of age. This followed the death of my father around 5 years ago at the age of 88 years. Although both of my parents lived long and generally healthy lives, each developed progressive, severe, and prolonged …
Reflections on caring for parents with dementia
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Most physicians have been defendants in lawsuits. Plaintiff experts almost always have a feeding frenzy. In truth, expert witnesses are held to codes of conduct about remaining objective and avoiding partisanship or advocacy. Yet, should the verdict favor defendants, these experts, except for deserving the term “hired guns,” are rarely, if ever, held accountable for their feeding frenzy, which conflicts with their ethical obligations.
I want to share my experience. I independently …
A counterintuitive strategy when you are sued for medical malpractice
What a year of change.
A pandemic. Cancer. Death. Loss. Fighting. Abandonment. Pain.
Becoming an orphan. Becoming a caregiver.
My family was hit with a sledgehammer and crushed into pieces. My joyful plans and decades of hard work wiped away with the insidious evil of a 5 x 7 mm tumor that spread like the pandemic, ravaged my mom — stealing her in months.
My hopes and dreams and decades of hard work to …
The COVID-19 pandemic has been unprecedented as such an event has not happened on such a global scale since 1919, with the Spanish Flu. At the beginning of the pandemic, we sometimes heard muzzled voices of health care providers who experienced sheer horror due to the quickly escalating demand for urgent care, ICU beds, and ventilators.
It is important to note that these incidents were happening on an unprecedented scale due …
Moral injury: What is it, and how is it relevant post-COVID?
Amidst beeping monitors, I sat holding my mother’s frail hand in mine with tears rolling down my face and an eerie silence within my soul. I was trying to make sense of the last 24 hours.
My mother had migrated to Houston after an early retirement at 55 to spend time with her granddaughter and me. But life had other plans, as she was diagnosed with breast cancer a year into …
Culture and end-of-life caretaking
Burnout among doctors is not something new. In fact, way before the pandemic, 69% of physicians reported they were somewhat or incredibly happy in 2020, before the pandemic started.
This number drastically fell to 49% when COVID-19 stepped in. This is a statistic that we need to be aware of.
For many of us, we embarked on our journey in medicine with naïve optimism. We stepped into medical school thinking about the …
The dark truth of physician burnout
“Control leads to compliance; autonomy leads to engagement.”
– Daniel H. Pink
There has been much public discussion relating to guardianship and its tenants. It is tempting to draw conclusions around topics related to current events, while knowing very little about the processes behind the scenes. Guardianship is a very complicated topic; the ethical concepts of paternalism and autonomy are at odds, and in addition, clinical and legal realms are involved to …
The nuanced issues behind guardianship
Harriet broke her hip and needed surgery. Post-operatively, the hospital was swift to push her out the door, while Medicare controlled the financial strings. Instead of going home, she went to a nursing home.
During the pandemic, she never saw her family in person, then contracted COVID-19 and died alone.
For over 30 years, I have visited patients in nursing homes, and during this time saw older adults shepherded by the health …
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