These days we are talking more about advanced directives and living wills in health care. This is progress, but as a member of the sandwich generation, I am focused on the aging process. I don’t have kids, but I have parents and have the honor of watching patients struggle with aging and helping loved ones grow old — walking the long, winding and thorny road.
Patients have asked me, “Where are …
Stepping into a hospital for the first time as a clinical medical student is a strange dichotomy. There is still so much you have to learn before you will become a physician, but you are quickly thrust into life-and-death situations. One of my early rotations was in the emergency room. As a student, you have no actual authority and must be closely monitored at all times. Many times you will …
I had just witnessed my first patient die
As a first-generation college graduate with the honor of earning my MD and PhD at a federally funded medical scientist training program (MSTP) and nearly no debt upon embarking on the journey of residency, I have a lot to live for and am grateful for all that life has offered me with regard to both mental health and capacity. I am a product of the Baltimore City Public School System. My …
A loss of physician support at a time of need
It seems like natural human tendency to explain ourselves. When we are late to a meeting, we come up with an excuse in case anyone asks. When our kid starts throwing a temper tantrum at the store, people stare at us expecting an apology. In the same way, when we decide that there are things outside of medicine that are more important to us than the job – an explanation …
It’s OK to care more about things outside of medicine
As a woman in medicine, where the odds for pay, promotion, and leadership are stacked against me, I feel obligated to light the path for younger women who come behind me. It has taken me a while to be comfortable with my style of leadership, own my own voice, be able to regroup after rejection, and tolerate feeling on display and yet often invisible.
I wish someone would have told me the following …
5 powerful tips for women in medicine
Two device salesmen recently came unannounced to our small private gastroenterology practice. They were hawking a product that could quickly and non-invasively determine how much scar tissue had formed in a patient’s liver, a useful tool for assessing patients with hepatitis and many other liver conditions.
We are physicians, not entrepreneurs. We do not regard the colonoscope as a capitalist tool. Yet, these two salesmen were barraging us with facts and …
How should salespeople sell to doctors?
I entered residency self-assured, if not in my scholarly achievements, at least in who I am as a person.
I left slightly broken.
Something happens to you in residency, and you don’t realize the transformation as it occurs. It may be the loss of a patient who died on your watch, or the realization that you have not changed the world. It could be the constant fear of failure or punishment by …
A reflection on the last day of residency
Many cooks traditionally use broth derived from simmered bones of fish, fowl, or four-footed critters to flavor soups and sauces. Recently, bone-broth bars have popped up around the country and serve a non-caffeinated, nutritious alternative to tea or coffee. In some of these health-conscious establishments, the owners claim that these drinks also have filling, cleansing, and detoxing capabilities.
I decided to see if a daily cup of bone broth should be …
An orthopedic surgeon’s bone broth journey
This article is sponsored by Careers by KevinMD.com.
After several months of intense discussions, “Dr. Joe Smith” thought he was headed from his successful two-physician practice to a respected practice with many more physicians. It was pretty much a “done deal,” until he was told that the senior partner decided he really didn’t want someone with an …
How physicians can investigate their employers
“For the rest of my life, I’ll never see her again or smell the scent of her unwashed hair. I’ll never hug her soft squishy hips or sigh when she tells me to stop sleeping, get up, and enjoy the day.”
This runs through my head before I start sobbing in my car. Most of the time I feel fine, but when I confront the finality of my grandmother’s existence, tremendous …
How long life doesn’t mean dignity
Medicine is currently struggling with the problem of physician burnout and the specter of diminishing wellness. Despite concerted efforts, burnout continues to expand. In light of this, being vigilant for limitations in the current framing of the issue is prudent.
Words express the conceptualizations of our world and frame ideas. Such framing is meant to be revealing. However, frames and the words that construct them may also be constraining. One approach …
What common words and phrases really say about medicine
As each calendar year closes, organizations compile best/worst lists: TV shows, movies, exceptional people that bring character or immortality to our year as it fades into history.
Medicine has its heroes and scoundrels. I would expect that all physicians can instantly name five teachers who shaped them and five guys they scored as real zeros on their evaluation forms. For the benefactors, we not only gave them higher scores but assimilated …
Being on the lists of the best and worst doctors
In the last decade, specifically in the last five to six years, we have seen the gradual disempowerment of America’s physicians as well as their unfortunate patients.
Starting with health management organizations, managed care, all the way to the insurance exchange, doctoring has been forcefully wrestled away from physicians only to be placed into the hands of large insurers, administrators and the United States government.
The common denominator was never about improving …
The old days of medicine are gone
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We as physicians need a dose of our own medicine as a booster ever so often.
I went in for a simple procedure. A lumbar epidural steroid injection for pain which has recently become more than tolerable at times — nothing disabling. Nothing that stops my everyday life and living. I didn’t think much of the procedure at all because I am at the other end of operating room procedures on …
Only when you are a patient do you experience the frailty of being one
The day is etched in my memory. The knock at the door. Two detectives and one police officer. I knew the news was bad. We sat at our dinner table, and the dreaded words came: “Your daughter is dead.”
“How?” I asked.
“She hung herself during the night.”
My body went numb, and the moment became surreal — like I was watching myself in a movie rather than being part of the conversation. …
A physician who lost his daughter
About halfway through the internal medicine residency, there comes a time when a resident must decide on what he or she plans to do after three years of training. We may come across a second-year resident saying: What should I do next? Should I become a hospitalist or plan for a fellowship? But in what? Cardiology and gastroenterology are fascinating careers, but is my resume ready for a competitive match? …
For residents unsure about their choice of specialty
I recently met an old friend of mine for the evening in New York City. He’s a talented young orthopedic surgeon, who has already, in the short amount of time since finishing residency, experienced so many of the problems our health care system faces.
The topic of conversation quickly turned to the current state of medical practice, the dramatic swing to corporate medicine, and the consequential loss of autonomy suffered by …
A divided house always falls: Why doctors lost control of health care
I recently stopped by our local grocery store after work to pick up a handful of items to bring home. With only four items in hand, I luckily found a short checkout line behind this lovely elderly couple who were almost done and ready to pay. As they smiled and made small talk with the cashier, I imagined a typical geriatric medical story about them.
They appeared in good health which …
The elderly couple who bought vitamins at the grocery store
Physician well-being, burnout, and “work-life balance” are pretty common topics in training. We start at intern orientation, discussing how to work 80 hours a week, eat, sleep, exercise, and still have some semblance of social life. It’s like we’ve forgotten the origins of our job title: “resident” or “house staff” — implying that, until recently (and even now, in places outside of North America), we, the physicians-in-training, lived at the hospital. …
The fallacy of work-life balance in medicine
The news has recently reported the story about the Cleveland Clinic resident, Dr. Lara Kallab, who was fired after making anti-Semitic comments on twitter. Among them, she tweeted that, “I’ll purposely give all the [Jews] the wrong meds.” Not only were people horrified by her comments, but she also lost her job (and possibly career) because of it. However, was her punishment too harsh or not severe enough?
My opinion is …
There is no room for racism in medicine
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