Religion and spirituality play a role in both patient’s and provider’s lives. Despite this, medical school is usually an atheistic experience. I went to a state-run medical school. No consideration of religion happened throughout my entire medical school or residency curriculum. It was a long apprenticeship to the god(s) of science. A survey in 2015 found that although a majority of people felt doctors asking …
From time to time, I am asked by someone about participating in a medical research study. These situations are usually when an individual, or someone close to them, has unmet medical needs. Understandably, a patient with a condition who is not improving on standard treatment, would be amenable to participating in a clinical trial to receive experimental treatment.
I find that most folks misunderstand and exaggerate the benefits they may receive …
The clinic intake form we used had a space for an asylum number. The number assigned when people first presented to the border requesting asylum. It’s not a tattoo, yet.
Refugee Health Alliance (where I worked for much of July 2019) provides care for asylees, refugees, and deportees just across the border from San Diego in Tijuana. On Saturdays, RHA volunteers roll bulging suitcases filled with supplies to migrant’s shelters to …
Burnout has taken center stage in health care. It impacts every aspect of care and our careers, as we realized we were not living out the ideals and values we thought we had signed up for. As we “merrily” worked along, it was the little grains of sand that grew into pebbles and now into boulders that we carry on our backs. Our gait has …
I lay on my side while my father probed the space between my buttocks, looking for an opening in the incision. I was in bed in the guest room of my house, which had been converted into my room for the last two weeks while I recovered. My father, a surgeon himself, had assumed his professional role and examined the wound with the gentle but firm movements of someone who …
The United States is a nation of laws, not of men’s dictates. The rule of law is what keeps (most) drivers from routinely running red lights, police officers from demanding bribes, and our civil servants and elected officials largely honest. There, of course, will be violators of this code, as there are in any society, but nonetheless compared to many other nations in the US most citizens and state officials …
I sat in the back seat of a police patrol car handcuffed with a mind imprisoned by addiction. My day had finally arrived after months of a manhunt by state detectives for operating a fraudulent prescription enterprise to support my obsession and compulsion with cocaine. No more unmarked police cars staked outside the crack houses that I frequented or my mother’s home or in pharmacy parking lots waiting to capture …
Physician wellness and work-life balance are hot topics in today’s medical arena. It is on the minds of medical students, residents, and physicians in practice. While the concepts and methods to achieve it are enticing, the question remains: how does the individual physician achieve it? Some believe that system-wide changes in medicine will get doctors closer to these goals. Then there are the supporters of strategies that physicians can implement …
Despair has been trying to find me again. That fickle nightmare is breathing down my neck once more. I know her all too well — she has nipped at my heels most of my career and has kept me running for the past 20 years. Running from friendships, running from family, running from loss, running from debt, running from jobs, running from guilt — running as hard as I can, …
What is life? It’s the cumulation of the daily processes all wrapped up into one, filling the void of each day. These processes coalesce hour by hour, filled with demands, expectations, current crisis, and bills to pay. Life is a full-contact sport, each hour brimming with all-encompassing activities, expectations, and trivial pursuits. We live every second to its fullest, squeezing every ounce of information and productivity only to repeat it …
I’m being sarcastic, of course, but that’s often how it seems some days. Those are days when I’ve been busy at patients’ bedsides all day and then struggle to get my documentation done later, typically many hours later. I jot notes to myself as I go along, but it can be hard to recall at 5 p.m. just what I did and why at 8 a.m.
The answer to physician burnout is purported to be resilience training. That’s like glorifying the natural ability of frogs to tolerate gradually heating and boiling water.
Unfortunately, health care today has some toxic ingredients, and physician burnout is directly related to them. Some forms of resilience training I have been exposed to are no more than mental escapes away from medicine, such as art, music, and personal relationships.
It seems that all day, every day, I care for patients who simply won’t take care of themselves. And I sometimes think that we in emergency medicine have caused more harm than we expected.
Now let me first say, I also take care of those who can’t care for themselves. There are those who, through age, infirmity, or poverty, simply have no means. The patient with a chronic condition who can’t …
The water continued to rise as the rain pounded Marsh Harbor, a town on Abaco, one of the 700 islands of the Bahamas archipelago. Hurricane Dorian plodded along, nearly slowing to a stop directly over their meager homes. The rain and wind continued to lash their wood and aluminum dwellings, but the real threat came from the sea. Changes in climate mean the ocean started higher than it did only …
I was in a discussion with a group of patients about how difficult it is for patients to get access to their own medical records. It was initiated after one of my patients was refused copies of her recent hospitalization. There is much confusion out there about who actually owns the record and how it is allowed to be accessed. Most people are aware of HIPAA, the regulation set into …
“The value of experience is not in seeing much, but in seeing wisely.”
– Osler, “Aequanimitas”
Recently, my family and I were leaving a restaurant, and in so doing, we crossed a large parking lot filled with a seemingly endless number of pebbles. My youngest daughter, whose hand I was holding, suddenly pulled away from me. I stopped short, about to reinforce with her the importance of holding hands in the parking …
In the early evenings after work, I thoroughly enjoy taking brisk walks. Walks are a great opportunity to exercise, of course, but I also cherish making time for myself to process the many thoughts that can occupy the mind of a busy physician. My walks are typically the only time of the day when I can quietly meditate, ruminate, prioritize concerns, or simply restore my soul.
I was driving to work one morning, and as part of my new routine, I listen to The Moth podcast. If you do not know it, it’s a wonderful community of storytellers — compelling stories, told by people from every walk of life. I often find myself drawn into the program (like a moth …
About once or twice a day, everyone on our hospital’s computer network gets an emergency message that scrolls across the bottom of our screens, highlighted in the colors of danger and warning.
They include things like a notification that a particular data system is down and that a backup on paper will have to be used for documentation, or the hospital …
In his article, “Medical education needs to stop burning out students — now,” Augustine Choi suggests the culture of medical education is responsible for increasing numbers of depression and burnout among medical students, and suggests that more programs are needed to address self-care and wellness in order to build resilience.
While I agree that mental health treatment should be readily available and easily accessible to those in …
