My interns started the term with mixed career aspirations. One wanted to do interventional radiology, the other, “not sure.” Now, in their last few weeks of our term, they’re thinking about a surgical career. Which I think is great. I’ve been lucky enough to have had some great advice over the years, and I’ve nutted a few things out myself along the …
So you want to be a surgeon? Here are 10 tips to help you.
Angel was then, and is even now, one of the most beautiful babies I have ever seen and I have seen many in my thirty years as a child abuse pediatrician. Yet, to look at her today, asleep against her foster mother’s shoulder, one could never guess at the devastation wrought upon her.
I first met Angel, then only a few months old, in the pediatric intensive care unit just before …
In the midst of child abuse, the face of an angel
Mr. U* came to the hospital overnight with severe heart failure. His breathing was supported by a ventilator and he was sedated. Thus, our primary means of communication was via his daughter. His daughter, distraught, stayed awake through most of the night. She appeared suspicious about her father’s care, immediately asking my credentials when I entered the room and demanding that we discuss treatment decisions with her alone. The next …
How doctors and families can work together in patient care
Medicine is filled with intricacies and subtleties about the human condition. Within these nuances, and embalmed with the science of the profession, lies the true art of medicine, a concept not hastily understood, nor easily defined. Although the practice of medicine continually changes in response to new biological understandings, novel technologies, and evolving cultural contexts, the ethical foundations of the clinical relationship between patients and physicians paradoxically remain constant. …
Can I add you to my list of medications?
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
Clearly, physicians are the leaders of the health care team. We were educated and trained for that role.
But on the business and political sides of health care, maybe not so much.
One reason is that the word “leadership” has a lot of different meanings. A leader in one …
What does it mean to be a health care leader?
I recently sat down with a well-known physician within the orthopedic community as well as among the medical socialites of social media. When I walked into his office, the first words out of his mouth were about my attire. As I was concerned about first impressions, I broke out the fancy suit, custom tailored, of course, a matching shoe and belt …
Does the attire determine professionalism?
I was asked by one of my readers recently to write a post on how I maintain work-life balance during the all-consuming intern year of medical training. I love this idea because keeping myself sane while spending 80 percent of my time in the hospital has proven to be a constantly challenging task, and I’ve come up with a few ways …
5 tips to maintain work-life balance as a medical intern
“Safety first” is a mantra of today’s hovering parents. It’s the default explanation that a parent invokes when an edict has been issued that cannot be challenged or reversed.
“Mommy, can I please have a water pistol?”
“I’m sorry, honey. You know how Daddy and I feel about guns. This is a safety issue. Now go and practice your violin and afterwards help yourself to some kale chips.”
The safety concept has crept …
Feeding tubes and the culture of patient safety
I remember being more confident that most of my peers. The look of dread on my fellow interns face pre-call, and the fatigue post-call always seemed unnatural to me. Maybe it was on account of my lifelong pursuit of medicine. I felt nothing but elation at the newly branded “M” and “D” that came after my name on the hospital badge. I was no longer a volunteer, no longer a …
A couple of weeks ago I was on-call and had to go down to the emergency room to see a patient. Before I entered the room, I was told that the patient was accompanied by her long-time physician who was a bit “crazy and old school.”
“Hmm … that’s strange … why would her physician be in the room with her?” I …
The old school physician is who we should aspire to be
“Doctor, I have trouble breathing when I walk up stairs, and I cannot lie flat in bed, so I have to sleep sitting in a chair. I feel much worse than before I got pregnant.” I recognized the diagnosis at that point, but I continued the appointment to confirm my suspicions and to revel in the art of medicine.
I listened to the young woman’s lungs, full of crackles from fluid backup, …
A global perspective can change how you diagnose patients
I’m walking very slowly with my dad down the produce aisle at the local supermarket, past the colorful waxed apples, Mexican mangoes and Rainier cherries, and imagining my life’s blood trickling onto the floor from an invisible wound.
As I pass by the misting system spraying the bins of green, red, yellow and orange peppers, past the lady reaching for carrots, past the stock guy balancing the heirloom tomatoes into a …
I inwardly watch my life’s blood flow away. And no one notices.
I’ve just finished sitting through a wonderfully aptly named lecture: Probability and Statistics, in which, among other things, we learned (again) that the utility of various clinical tests depends at least as much and generally more on the patient and condition involved than on the specific test itself. From stress tests to mammograms to PSAs, the relationships of true and false positive and negatives, positive and negative predictive values all …
No unnecessary screening tests. Even at the cost of my online reputation.
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I have always been one of Angelina Jolie’s biggest fans. The Academy of Motion Picture Arts and Sciences saw fit to reward her 1999 performance in Girl Interrupted with an Oscar, but I wasn’t well and truly smitten until the second Lara Croft Tomb Raider movie was released in 2003. In that film, Jolie, who performs her own stunts, is seen …
Angelina Jolie’s story is one of true courage and grit
While working at small rural hospital I was once again faced with the emergency physician’s dilemma. Admitting a patient and being told to write holding orders. In the midst of a very busy department, I sat with a nurse who guided me through the ridiculously complex and counterintuitive electronic orders system. All this so that the admitting doctor wouldn’t have to log onto the computer, from home mind you, and trouble …
From an ER physician: Write your own admitting orders
By now, everyone in health care is accustomed to the idea of patient satisfaction data and the multi-million dollar industry ($61 million in annual revenue for Press Ganey alone) which exists thanks to the health care leaders and policy makers who embrace it. Most physicians believe it is absurd to use it as a marker of quality care, but have accepted …
Shift the focus from patient satisfaction to employee satisfaction
Dear Bill Maher,
I respect your First Amendment right to exercise free speech. In regards to your recent comments on doctors, however, your words don’t matter. Here’s why.
There is a concept known as the beauty of medicine; I attempt to capture it in the following paragraphs.
If you present to the emergency department with acute chest pain, we will work you up for …
Bill Maher: You don’t matter to doctors
The sad thing is, I hardly remember the patient. Everything about her is just an overhead pediatric trauma alert followed by the flurry of cutting clothes off, throwing IV lines, and calling out our primary and secondary survey — “blown right pupil,” “unequal breath sounds,” “gross deformity to left ankle,” and then, “no pulses” — followed by the age-old barbaric resuscitation efforts that are now muscle memory to us, as …
Medicine: A profession that saves lives but often silences death
Lifetime has an unscripted series, Born in the Wild, which documents couples’ decisions to forgo birth in a hospital and instead give birth in nature on their own terms without assistance:
In this new series, families take one step beyond home birth and make the powerful choice to experience childbirth in the great outdoors. No inductions, no epidurals … just expectant mothers facing …
Should home births be turned into reality TV?
The story of Chesley “Sully” Sullenberger — the “Miracle on the Hudson” pilot — is a modern American legend. I’ve gotten to know Captain Sullenberger over the past several years, and he is a warm, caring, and thoughtful person who saw, in the aftermath of his feat, an opportunity to promote safety in many industries, including health care.
In my continuing …
Captain Sullenberger and his lessons for health care
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