Cleveland took a major economic hit a few years back when United Airlines cut most of its flights from our city. An airport is the heart of a metropolis. Lack of direct flights means that business meetings, leisure travel, conventions and trade shows will likely opt for more convenient locales. This was a business decision for United which I am sure was rational. Nevertheless, their gain was our loss.
As a …
I dreaded Mr. L’s office visits. His mouth half vacant of teeth and his clothes reeking of hand-rolled cigarettes, he regularly demanded medicines he didn’t need. He was pushy and thankless. I frequently declined his requests. He stuck with me anyway.
Over the years he grew in orneriness. Divorced, childless, and unemployed, he declared one day that he was tired of living. He was reasonably healthy. He disavowed depression. Would I …
Might doctors be inclined to facilitate the deaths of patients they don’t like?
In a recent PBS interview, Mayo Clinic CEO Dr. John Noseworthy suggested patients should “change physicians” when faced with non-empathetic doctors suffering from burnout. His cavalier resolution to our occupational struggle feels like a betrayal, to both his esteemed colleagues across the country and our profession. In my opinion, firing your physician is a risky proposition in light of the looming physician shortage.
Burnout is an overwhelming …
Should patients fire their doctors if they suspect burnout?
“Listen, when I was your age, I did the same thing …”
The words came out of my mouth too fast for my frontal cortex to weigh them or to monitor, let alone modulate, the intensity of my delivery.
He was a relatively new patient, 17 years old, scheduled for a well-child exam. A tall, athletic young man, he was alone in the exam room. His right arm was in a sling.
“What …
The medical regrets in my life
“If my father dies, you’re going down with him.”
The words pierced the air, and suddenly there was silence.
I hadn’t noticed Frank’s son at first. He’d been pacing in the back of the family group gathered in our ICU waiting room. Now, up close, I could appreciate how large and intimidating he was. And I’d just had the thankless job of telling him, along with the rest of his family, a …
A doctor keeps a dead man’s secret from his mourning family
Milly* was 82 years old and had been diagnosed with a recurrent ovarian stromal tumor — one that is typically seen in much younger women. Surgery was ruled out, and a colleague from outside of Boston sent Milly to me for an opinion about medical treatment. I reviewed her case before I met her: no significant medical problems, …
A doctor thinks a patient is prepared for death. He’s wrong.
My background in nursing has given me a perspective that many physicians don’t have. From the beginning of my career, I have valued the information that patients have provided me about the context of their lives, family, work, and beliefs. I have never cared for a knee or a prostate, but rather I have cared for a person whose life experiences …
The stories that patients tell me are always a gift
Burnout is a popular topic of discussion among health care professionals, but preventing it often eludes us. While burnout is common in many professions, it is particularly present in health care. It is estimated that about half of all physicians in the United States suffer from burnout with numbers rising rapidly. Burnout is associated with detachment from those around us and feelings of isolation. Burnout can lead physicians to lose …
It is time to build a workforce of resilient physicians
Otis was our first baby. He was covered in a caramel-colored fur, weighed 150 pounds and was the best bullmastiff dog anyone could ask for. He protected me from my husband’s incessant tickle attacks and thought that my lap was the best place for him to try and sit.
Two years ago, I was walking Otis and he suddenly collapsed. After an extensive workup, including an EKG, blood work and an …
We give pets dignified deaths, why not our loved ones?
There are so many insightful stories out there about what happens when physicians experience life as a patient or family member. They always make sobering reading for everyone in health care. Over the years I’ve heard dozens of these stories from fellow physicians, describing experiences when they’ve unfortunately been sick themselves. It’s an inevitable fact of life for everyone that they will be the patient one day, but it’s often …
5 things physicians realize when they’re patients
Man has been dying on a regular basis for millions of years — should we not be end-of-life experts by now? Why do I feel the need to devote pages and hours to this depressing topic? Is there a goal to my project, beyond venting the shared suffering which soaks my soul? What is my purpose?
For humans, denial of death and marginalizing its effect on our lives is a major …
When we stop denying death we empower ourselves
We brought his family into a separate room with plenty of chairs. Sitting to the right of his father and mother, our attending uttered the first words in the room.
“I think you know what I am about to say.”
His mother took in a deep sigh, her eyes already swollen from inconsolable tears.
“I think he is dead.”
The whole room sank. We were all punched in the gut by those words.
“Oh my …
Every day in the hospital, I walk through someone’s personal hell on earth
“Doc, I’m tired.”
This is a refrain that we hear from many of our patients who have been incarcerated in California’s prisons for decades. Now past the midway points of their lives, our patients describe how the absence of autonomy — what they eat, how they dress, how frequently they bathe, how they spend their day, and when they communicate with their families — has taken its toll, making them weary …
The health impact of incarceration
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Not far from the busy pedestrian streets in the center of Vienna, down a quiet narrow street, lies a small cobblestoned city square. Before World War II, this city neighborhood was the bustling, vibrant heart of Vienna’s Jewish Quarter, but today it is has a quiet, almost subdued feeling. Vienna’s current Jewish population is only a small fraction of what it was before the war, and the quiet feel of …
The health of the natural world and humans are intimately intertwined
We were a team of women. A strong, intelligent female attending, a fellow, me as the resident, and the eager intern. Gunners in the ICU. Throwing in lines and throwing out numbers and grilling newly published papers for truth.
Then I got a call from the head of the department. I was asked about another fellow in the program. A male fellow. His behavior was in question. I was asked if …
We must break the circle of sexism
Do you ever have one of those days, when it seems like every patient is coming in for the same thing? And that you’ll never remember the differences, when it comes to doing your dictations at the end of the day?
A few weeks ago, six of my appointments had as their chief concern “ear pain.” But of course, in the end, no two ears were at all alike. I love …
5 cases of ear pain lead to different outcomes
Not long ago, one of my elderly patients (who gave me permission to tell this story) began requiring blood transfusions for a condition known as ischemic colitis. Usually, it occurs because there are blockages present in the arteries that supply blood to the colon and, starved of blood, the inner lining of the colon becomes inflamed. But her arteries, it turns out, are normal. So we term her ischemic colitis …
Is too much care as harmful as too little?
Our two presidential candidates are irksome and infuriating to everyone. We are disgruntled with them. The psychiatrist in me asks the question, why are we so angry and upset with them? The majority of us voted for these two as our nominees. What does all of this say about us? Why have we put up nominees that anger and disgust us?
We had sixteen other Republican candidates to choose from and …
How did we get into this presidential mess?
In the last presidential debate, the conversation quickly turned to a subject that is divisive and controversial for many Americans: abortion. More specifically, the topic of late-term abortions. Considering both candidates got the facts on this very sensitive topic wrong, I thought clarifying a few key points might be helpful.
When discussing this topic, Donald Trump said the following: “In the ninth month you can take the baby and rip the …
When politics makes it necessary to dispel myths about late-term abortions
Physicians are known to be masters of self-sacrifice, and self-control. They undergo years of training and make substantial emotional and financial sacrifices until they complete their training. The reward at the end of the road is a fulfilling job where he or she can treat people who are in need and enjoy the emotional, personal, and financial fruits of their labor.
But is this the reality? At a time when the …
Have physicians finally joined the working class?
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