As a boy growing up in a small town in Pennsylvania, I never gave much thought to the concept of a kiss. My family gave and received kisses without hesitation. I continue to give and receive kisses from my wife and kids in the same nonchalant manner.
Until one night — on shift.
I work in the ER of a medium-sized town in southern Oregon. It was late into my shift. The …
A kiss changed this doctor’s life
This was a momentous week for me. After 14 years of carrying a hospital-grade old-school text pager to receive messages at work, I finally traded it in for a cell phone app. It should have been easy to get rid of my beeper. But instead, I felt waves of nostalgia when I turned it off for the last time. Those 240-character, pre-Twitter, low-resolution LCD messages follow the arc of my …
Farewell pager, I’ll always cherish the memories
I am a physician in recovery and just celebrated my fifth-year anniversary on October 11, 2017.
While in active addiction, my drugs of choice were benzodiazepines and opioids that I washed down with top-shelf alcohol. Near the end of my usage, I was diverting scheduled drugs in order to feed my addiction. After an unsuccessful suicide attempt, I finally admitted myself for treatment.
As part of the treatment process, I enrolled with …
What’s the cost of being a doctor in recovery?
A study from the National Bureau of Economic Research reports on the results of a large randomized controlled trial of a large employer with over 12,000 employees. Program eligibility and financial incentives were randomized at the individual level. Over 56 percent of eligible treatment group employees participated. The study found that in the first year, the employees who signed up were healthier and had lower medical costs, but, and …
Why workplace wellness programs don’t work
They came from all corners of the globe to bid him farewell. He looked cachectic, his frail form interrupted by swelling in his abdomen and legs, a result of end-stage pancreatic cancer. It was Dr. Yeat’s last week in the hospital before being transferred to a nearby hospice. He was now on morphine, and despite severe fatigue and difficulty breathing, he always managed a smile.
Some of his visitors were former …
What’s love got to do with it: lessons from a dying physician
I’ve been single for nearly a decade. A career-driven professional, juggling parenting, PTA, and post-graduate studies, my time is precious.
But there’s something about this season — the heart-shaped Valentines and assorted chocolates — that has a way of evoking a longing for love. So this year, bowing to the goading of friends and against my better judgment, I decided to do something I never — never — thought I’d try.
I …
I work as a pediatrician in a bustling metropolis, in an outpatient setting of a world-renowned academic center. One of those non-profit hospitals you see in television ads. For the last three years, our outpatient encounters have plummeted, and the mothership has put all efforts into recuperating financial losses. Meanwhile, our office phones are ringing off the hook, and we cannot seem to hire enough nursing staff to deal with …
Dear Mom and Dad: Are you calling your pediatrician’s office too often?
As a physician, I am totally disgusted by what President Donald Trump eats — and you should be too. His standing order on Trump Force One is reminiscent of a fast-food bacchanalia, comprised of “two Big Macs, two Filet-O-Fish, and a chocolate malted” according to the recently released book by his former campaign manager Corey Lewandowski and top aide David Bossie.
But it doesn’t stop there: Trump …
The fire and fury of Trump’s diet
The public’s apparently insatiable appetite for medical drama continues unabated as yet another prime-time TV show set in a hospital has hit our screens. FOX’s The Resident has generated discussion like no other. This may simply be due to the fact it’s the first major launch in the era of widespread social media, but it seems to have enraged a vast swathe of our ranks. Has The Resident crossed a …
In defense of FOX’s The Resident
2017 has been open season on the psyche of the 45th president of the United States. Psychiatrists and psychologists have gone public to express their concerns about his perceived state of mind despite the established Goldwater rule that it is unethical for them to diagnose mental illness in a living public figure they haven’t examined and whose consent they have not obtained. The consensus seems to be the Donald J. …
The psychology of Trumpism: scientific assessment versus relentless antagonism
My shift had finally ended. As a second-year resident, I was driving home after 30 hours awake straight. The busy call included delivering several babies, two Cesarean sections, circumcisions, rounding, triaging new patients, and teaching medical students. Never during that 30 hours was a 5-minute nap possible; clinical load would not permit this.
I couldn’t wait to get home at the end of the shift as I was completely exhausted. So, …
A system to identify doctors who’ve been working too many hours
It was Saturday. My first day off in the last 14, which included three 26-hour calls. My wife was left home alone for these stretches to care for our 2-week-old son. I’m sitting on the couch, reading a book to my little man, enjoying a much-needed breather, and making up for lost time in seeing him grow into a person.
And the phone rings. Concurrent emergent cardiac surgeries: the only way that …
Is residency an exercise in futility?
Patients and their family members are impressed when doctors show up for memorial services. They tell me about it. “The doctor liked my mother so much that he came to her wake,” a patient recently confided in me as I examined her. She had been a sole caregiver for her aging parents for years, and her mother had passed a few months earlier. The physician’s presence at her mother’s service …
This doctor doesn’t go to patients’ memorial services
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In 2011, my first novel was published. It is a medical novel, and, unsurprisingly, since I practiced as a nephrologist for many years, it takes place in a dialysis unit. I learned a lot from writing this book, seeing it published and living with the consequences. Since its publication, many professionals have confided to me that they harbor a secret desire to write a book. I want to share my …
To aspiring physician-writers: It’s time to write that book!
Lines are slowly being taken out of the small infant, his bruised and discolored arms continuing to ooze. Machines and circuits, one by one, are being shut up and turned off. Leads and wires are carefully taken off of the lifeless chest of the once critically ill, but alive infant. Just hours ago, physicians, nurses, and other providers were rushing in and out of the room, desperately doing everything they …
The huge impact a dying infant had on this physician
We physicians stand witness to countless tragedies in our careers.
At some point, as we stand by the bedside of a dying patient, comfort a heartbroken relative or officially call a death. We learn that love and loss, sorrow and joy are intertwined. They depend upon each other. They are two sides of the same coin. Dealing with loss after loss, we learn to look for the beauty in all of …
The subject of physician burnout has become a major point of contention in our community. Institutions try to help by implementing “mindfulness programs” or bringing in “burnout experts” for a one-time lecture. Physicians complain that the system is flawed and mindfulness is just another way for them to “blame the victim” for being burned out. Meanwhile, there are doctors who are simply trying to survive through each day; they walk …
Who’s really to blame for physician burnout?
Steve was special — even as an intern and first-year resident.
Out of more than two hundred letters of recommendation for our physician trainees I’ve written over the last fifteen years, I have only written this statement a few times: “Steve has the clinical acumen, integrity, work ethics and wonderful bedside manner that would give me full confidence in having him care for my family member.”
Steve eventually finished seven long years …
Racists drove a doctor from the U.S.
When we think of a brand, we usually think of companies such as Apple or Coca-Cola with their recognizable logos and colors. We may also think about celebrities, such as Beyoncé and the Kardashians, who have large-scale exposure and garner massive attention.
But, what is a brand? A brand is a particular identity or image that’s regarded as useful or valuable. And, a brand’s identity is how a business wants to …
7 tips for branding: What doctors need to know
In his soulful book, How We Die: Reflections on Life’s Final Chapter, the late surgeon and author Sherwin Nuland describes one of his patient encounters as a medical student. The patient, a 50-year-old man, presented to the hospital after a heart attack.
A few hours later, the patient suddenly collapsed pulseless and unconscious.
Training in an era when there was no defibrillator or CPR, the author notes:
For reasons I cannot explain to …
Is “doing everything we can” at the end of life doing too much?
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