I found you standing on a platform. It was a foggy, damp morning, and your vision was obscured. People came and went, some with urgency, others not so much. Some people you knew, others were strangers. Your husband was usually nearby, often holding your hand, other times out of sight.
At times you could hear his voice, but couldn’t find him with your reach. There were noises that would startle you, …
I’m sorry you are sick. I’m sorry you had to wait a long time in the waiting room. I’m sorry you haven’t gotten your pain medications. I’m sorry I don’t have an answer. I’m sorry the department is busy. I’m sorry it’s loud. I’m sorry I don’t know why it smells in here. I’m sorry your neighbor is screaming. I’m sorry you are in pain. I’m sorry you are uncomfortable. …
I’m sorry: Why I lost my love for medicine
When we began exploring the concept of moral injury to explain the deep distress that U.S. health care professionals feel today, it was something of a thought experiment aimed at erasing the preconceived notions of what was driving the disillusionment of so many of our colleagues in a field they had worked so hard to join.
As physicians, …
Moral injury in health care: What have we learned?
When I was an intern, one of my attendings told me that I was “too nice.” He said it to mean that I needed to toughen up to “make it” as an emergency medicine (EM) physician, and that the alternative might be fatal. To give some context, this attending was of the direct, overly sarcastic, wry sense of humor variety. In the end, I left that shift alarmed, with a …
4 tips to become a “nice” doctor
Your first is always special.
It is a mixture of youthful inexperience, awkwardness, anticipation, and giddiness that creates a cacophony of emotions and physical changes that is hard to describe unless you have experienced it yourself.
Your repertoire of techniques/maneuvers is quite sparse — to say the least.
You might fumble around and accidentally put the wrong thing in the wrong orifice.
Not knowing what body part should go where, if you are doing …
A reflection of a physician’s firsts
It is no secret that health care providers shoulder a lot of responsibility. As a whole, they take this on with both competence and kindness. Sacrificially, they go above and beyond in order to provide patients with the highest of quality care. They juggle a multitude of professional and personal responsibilities in creative and admirable ways. Meanwhile, each health care provider learns to adopt a unique combination of coping mechanisms …
How physicians become medical narcissists
The line, “If you want something done right, do it yourself,” is complete bull. To run a successful business of any kind — but especially to run a thriving medical practice — you have to make sure you’re using your time wisely and properly delegating responsibilities.
In 2019, health care is complicated. Your practice is more than just seeing patients, treating them, and sending them on their way. There’s insurance requirements, …
If you want something done right, have other people do it
You’re a clinician. You had a patient die under your care, and now your hospital is being sued. You are not named in the lawsuit, but you are being asked to give a deposition. How much of your time is this going to take? If some lawyer sends you thousands of pages to review before scheduling multiple phone calls …
What to do when physicians get subpoenaed as witnesses
Yesterday, I got just about the strangest version of “MD aware” I have ever had.
We all know what this is, the person who is relaying some critical clinical information (positive blood cultures, Mr. Smith in Room 402 is having chest pain, etc.), and then they ask for your name so they can write it down somewhere in the chart.
In this case, …
Physicians are overwhelmed by alarms and alerts
What was the first question that popped into your head last time you had an adverse outcome with a patient? If you’re anything like me, it was: “What did I miss?”
As physicians, we tend to be very hard on ourselves. It starts as undergrads (we must get perfect grades, scores, activities, and clinical experience), and it escalates from there. Whenever we fail to be perfect, we inundate ourselves with, “What …
4 easy ways to combat toxic perfectionism
The radio crackled to life: “7-month-old boy found unresponsive. We started CPR, and he has an IO and ET tube. We’re 5 minutes out.”
It was 8 a.m., and the emergency department team descended on the resuscitation room to prepare. I scurried around trying to finish some quick tasks to get my existing patients’ medical plans moving forward during the time I would surely be fully engrossed taking care of this …
When a doctor struggles with empathy
Our job as health care professionals is not just to diagnose our patients by applying our scientific knowledge and clinical skills, but also to be the “communicator-in-chief,” “listener-in-chief,” and “reassurer-in-chief.”
Any doctor who doesn’t fully grasp this, is not doing the best job they can or being the best doctor they can be. I truly believe that over 90 percent of our everyday job as a physician involves being a good …
5 powerful words you can say to patients
Peg began internal medicine residency with altruistic goals. She didn’t want to become a specialist or seek personal financial wealth. She just wanted to help people. With a prior career related to her degrees in art history and sculpture, she had a unique way of truly embracing medicine as an art. Rarely spotted without a smile on her face despite long training hours in the hospital, she eagerly embraced taking …
Medicine claims the life of a physician heroine
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Since childhood, I have suffered from severe stabbing headaches. Then in my first year of medical school in anatomy, as we peeled back the scalp of our cadaver, I saw a nerve poking out of a muscle on the back of the skull. With a flash, I knew that I was seeing the source of my pain. But despite identifying it, it would be another five years before I …
The re-education of a physician into the school of pain
For the last three decades, the numeric pain score has been the go-to assessment for acute pain in the hospital setting. Since this methodology was developed for research purposes to see if drug “A” had an effect on patient “A,” its clinical utility is not just worthless but dangerous.
Let’s look at a simple example of a pain order set that is commonly used across the country. If a patient says …
When the standard of care is bad medicine
Though the news at first stayed local in Philadelphia and the northeast, it’s gaining traction nationwide. ZDoggMD is on it. Bernie Sanders held a rally.
What happened? The venerable Hahnemann University Hospital, the main teaching hospital for Drexel University College of Medicine in Philadelphia, is bankrupt and will soon close its doors after more than 170 years as a safety-net hospital serving inner-city patients.
Why should we care? After all, there …
The disaster at Hahnemann University Hospital
Hitting a roadblock in your life and career? Don’t get frustrated. Use the resources that are readily available to you.
Not sure what they are? Think about it. You have had access to them all the time.
The moment you decided to become a doctor, you became unstoppable. You may have followed the traditional path and went from college into medical school and then residency. Maybe your path took a few turns before medical …
The experiences in medicine shape your future
As he stuck his ungloved finger on the parched tongue bearing the color of pale salmon, he called out for the visiting medical student. It was my first official medical rounds in a university hospital in Khartoum as a Sudanese-American medical student, visiting my “native” country, an experience afforded through a global health project spawned in Farmington, Connecticut. The sea of wide-eyed Sudanese students parted, and I found myself floating …
A physician’s call to action from Sudan
The recent Boeing 737 airline crashes have left a scar on the American (and worldwide) psyche regarding air travel. Boeing, an iconic brand, prestigious in history and talent, neglected to update and formally educate pilots regarding an essential software update which ultimately contributed to two fatal crashes, killing 346 people in total.
Recent audio between an American Airlines pilot and Boeing’s leadership offers some insight — and lessons — into this …
What health care can learn from the Boeing 737 Max tragedies
I am a physician who was born and raised in Puerto Rico. I confess that since I was a child, I have always wanted to visit Roberto Clemente’s statue in Pittsburgh, Pennsylvania. Recently, my dream came true when a meeting I attended in the city allowed me to see it for the first time. I was overjoyed to personally witness how Pittsburgh had honored Roberto’s memory. There I was, standing …
A physician’s reflection on Roberto Clemente and his leadership legacy
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