I asked nurses, technicians and secretaries where it was: the iPad for patients who wanted to speak to their loved ones. COVID didn’t allow visitors. A few days into our peak, it was likely this patient had COVID. They were gasping for air, but could still speak, somewhat. I was hoping to save them an intubation. I told them I may need to put them on a ventilator but assured …
A physician’s COVID role reversal
I was sitting in my kitchen this morning drinking coffee, as is my usual routine on a Saturday. On this particular morning, I was looking at the empty chairs around my dining room table. These antique dark pine Windsor chairs are well-loved and aged with a patina that includes many layers of memories from family gatherings in their previous life.
Acquired in a recent move, this was their first holiday season …
Empty chairs this holiday season
As an anesthesiologist, I fully understand that providers in my specialty, along with emergency room and intensive care providers, must care for patients with COVID-19 at close physical range during aerosol-generating procedures (AGPs) such as tracheal intubation and extubation, without the option of “social distancing.” Consequently, we currently rely on personal protective equipment (PPE), operating room ventilation systems, preoperative COVID testing, and hopefully, in the future, on vaccination and herd …
Surgical smoke evacuators and inertia in the time of COVID
I am a critical care and emergency medicine physician, I have had COVID-19 infection twice, and I’m tired.
My first infection was early on in the pandemic. I had to place a Blakemore tube in a young man who was going to die from his massive bleeding from cirrhosis. I didn’t know then that the patient was positive for COVID, as he didn’t have any “typical” symptoms. I placed the tube …
I am an emergency and critical care physician. I had COVID-19 infection twice and I’m tired.
Breaking down the medical industry
As you inch towards your debut as a physician, it’s wise to assess the medical field’s ever-changing landscape before you establish your place within it. There are many factors to consider when evaluating the medical market and how it impacts you personally. Now more than ever, national trends can directly affect the challenges you face in your career, so understanding them will better equip you to …
Market-driven health care: What you need to know before searching for a position
A year ago, it would have seemed absurd for a medical resident to call out sick with nothing more than a cough and congestion.
It’s different now. The calculus of cold symptoms has changed.
When one of us recently woke with a sniffle, she wondered if she should stay home. She logged into her computer and saw that ten patients expected to see her in clinic that day, including several who had …
The doctor will sneeze you now
After I retired, our regional medical center realized they had accumulated scores of physicians of major capability and stellar professional reputation whose careers had either concluded or entered their closing years. Though I had retired from a different institution, I had been on staff there for twenty years, so they graciously absorbed me into their newly created senior physicians advisory group. Its purpose and activities remain in evolution with periodic …
A physician talks to his retired colleagues
Have you ever walked into a hospital before shift change in the early morning hours? The lights are dimmer, there is scarce staff walking to their floors, and people are counting the minutes until the new staff comes. Most staff exist in this survival mode to get to the arrival of the new nurses. Sometimes you can even smell the burned coffee sitting on the bottom of the coffee maker. …
I recently met a student and aspiring surgeon who asked me if I was happy with anesthesiology and a career in medicine in general. I told him that aspiring to medicine is wonderful and that while I am indeed happy with my career choice, it does come with daily challenges, both professional and personal. This led to a discussion of work-life balance, particularly with regard to family life, in which …
Advice to aspiring medical students on work-life balance
Concern that the scientific growth of medicine has come at the expense of the art of medicine is not new. However, should we consider that not only does this impact the quality and practice of medicine, but might it also contribute to the rampant burnout in physicians? Does a narrow focus on the linear, scientific thinking that characterizes medical education and training mean that physicians are more vulnerable to the …
Medicine for the soul: Harness the power of the humanities to counteract burnout
This question resonates in my mind each day I pass through the prison gatehouse. The gatehouse is a physical barrier and a mental one, separating the outside from the inside, seceding the lives of people who guard and care for inmates from the lives of those within.
Each morning, the gatehouse is abuzz with activity as people file into work. It’s like going through airport security. Every single day. If you …
Over the last decade, as health care solutions have become more specialized and fragmented, primary care physicians (PCPs) have frequently been cut out of the loop, particularly in coding initiatives. Retrospective and in-home risk assessment solutions work around PCPs. This dynamic further complicates PCPs’ ability to thrive in value-based care, which hinges on primary care being underscored.
PCPs can take back control of care and accelerate their own transition to and …
How PCPs can leverage better coding to succeed in value-based care
The practice of anesthesiology is the practice of medicine. People who go to medical school and do a residency in anesthesiology are best equipped to deal with anesthetic delivery because they are qualified physicians before starting four years of specialty training in anesthesia. Many also have a fifth year of subspecialty training before entering their practice. With all this training, why is it that we cannot figure out how to …
Why can’t I cover my operating rooms?
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No matter which presidential candidate you voted for or which political party you belong to, we women should stand together unified and proud in knowing that for the first time, a woman is going to Washington, DC, to serve as the vice president of our great nation.
It is truly a historic moment for all American women and makes the possibility of a woman as president of the United States one …
What Kamala Harris means for women doctors
I had planned to take care of my dad at the end of his life.
In 2009, Dad retired at 75 because of Parkinson’s disease. Over the next couple of years, he lived in his own home. My younger brother Mark, who lived nearby, faced the first difficult milestones brought on by Dad’s declining health. Mark was the one to tell Dad that he could no longer drive. And after Dad …
An excerpt from Patients at Risk: The Rise of the Nurse Practitioner and Physician Assistant in Healthcare.
On a sunny Tuesday in March 2015, the steps of Capitol Hill were draped in white as nurse practitioners from across the United States descended on the nation’s capital. Their …
Proponents of independent non-physician practice make a dangerous assumption
I smiled as I waddled to the recovery room for the sixth time that day. Before maternity leave, my final case was completed; I left with my patients in trustworthy hands, and the loose ends tied up. As I walked to my car, I never imagined the circumstances I would return to 12 weeks later and now six months ago.
I have never subscribed to clichés, but as I sat in …
A physician takes maternity leave during the pandemic
How are two-career households with children — let alone single-parent households — going to manage with daycare centers and schools closed, perhaps for a long time to come? What damage will this do to career progression and earning potential if one parent must cut back on work? Will childcare demands inevitably delay or derail partnership or academic promotion?
When I was a young mother — my two youngest children are only …
Will women in medicine survive COVID-19?
You may be familiar with the words stoicism and have an idea about what it means to be stoic (there’s actually a lot of confusion and misconceptions out there about exactly what they mean). Let’s take a step back for a moment before we dive in any further. Stoicism is an ancient Greco-Roman philosophy founded by a gentleman called Zeno around 400 BC in Athens after he had suffered a …
Could an ancient way of thinking save the U.S.?
If you are a doctor (or med student/health professional) and are human, you’ve probably made a medical mistake. You’ve probably not received emotional support for the mistake. Maybe you’ve never told anyone about a mistake that still haunts you today.
The truth is that almost all physicians have admitted to medical mistakes sometime in their careers. Depending on the patient outcome, many doctors carry the distress of medical errors for months, …
What not to do after a medical mistake
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