Our children will never be the sole judge of our job as parents of course. We are likely our own closest and most fastidious critic. And really it’s just us (and our partners) that can truthfully reflect and evaluate how it goes as we raise our children — what our hopes were when we started on the journey of raising another and where we find ourselves.
And so, however radiant the …
Reflecting on how we raise our children
What defines a competent psychiatrist? To staunch critics of the field, perhaps nothing. Some believe psychiatry has done far more harm than good, or has never helped anyone, rendering moot the question of competency. What defines a competent buffoon? A skillful brute? An adroit half-wit? Having just finished Robert Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, a reader might easily conclude that psychiatric competency is …
What does it mean to be a competent psychiatrist?
When my husband and I stopped watching television a few months after we were married, we often didn’t notice what had changed until we’d compare notes with friends. “I miss my old hobby,” a neighbor might complain, “but I just don’t have the time.” And yet we’d see his head just above the back of the couch, silhouetted against his big screen TV for hours. Not only did we regain …
How to create more primary care role models
In the past half century or so, medicine has changed the complexity of the human population as it has never been seen in the past. Think about it, there are people walking around today that fifty years ago, wouldn’t even be alive. This evolution in medicine has not only brought about transformation in the human population, but it is also changing the approach of how clinicians need to treat these complex …
Patients have changed. How do we manage them?
If F. A. Hayek were alive today, he would support the revival of labor unions in general and professional labor unions in particular. Towards the end of the Second World War, Hayek wrote a book warning us all that allowing governments to engage in extensive central planning of economic activities is nothing more than a road to serfdom for humanity. F.A. …
Physicians must unionize. Here’s why.
The action steps, in any health emergency, are: ABC. Airway, breathing, circulation. The airway has to be open, the patient has to be making an effort to breathe, and the heart has to pump blood. In any emergency, health care people are trained to address these, one by one, in order. Fix what you can before moving on, and concentrate on what’s going to kill the child first. Then, arrange …
Airway, breathing, call your insurance company?
Stuart Scott revolutionized the sportscasting industry with his unique style and likable demeanor on ESPN. Mr. Scott recently passed away after an 8-year battle with recurrent appendiceal cancer. Mr. Scott was a devoted father and put his relationship with his two daughters above everything else. He was a sensational broadcaster and was passionate about his craft. He inspired many young athletes …
4 things we can learn from Stuart Scott
Perhaps doctors should be more like the president.
After all, we also carry the ultimate responsibility for our constituents, even though we, too, have team members who do part of that work.
The way I understand things to work at the White House, those other team members collect, review and prioritize the information the president needs in order to manage his, and all …
What if the president worked like doctors today?
“Blessed. I’m so blessed.”
She kept repeating this, from her seat on the examining table.
“I’m so blessed.” I unwrapped the bandage holding on the splint that had covered her arm for the three weeks since the bullet went in above her elbow and came out through her forearm, hitting no bone, touching no major artery.
“Blessed.”
Homeless. With diabetes that needed insulin, which needed a refrigerator, that she didn’t have.
Vulnerable. A few years earlier, …
Blessed to be alive after a gunshot wound
Happy 2015! Health care in the United States continues to change faster than any of us can keep pace with and this shows no signs of slowing down. Having written a lot in 2014 on a variety of different topics, I wanted to focus on my own 5 wishes for hospital care this New Year. A lot of you may think that what you’re about to read sounds like wishful …
5 health care wishes for the New Year
As we welcome another year, many of us make resolutions to live a better life, usually one that is healthier than the year before. As I planned my own resolutions for 2015, I was reminded of a talk given by my rabbi, David Ingber of Romemu. His sermon centered on the Torah portion about the importance of “the Shemittah” or the sabbatical year, noting how we as a society should be observing the “five Rs” …
What my rabbi taught me about being a healthier, happier physician
Ever since the first invocation of the dogma “publish or perish” in the 1930s, modern medical practice seems to have followed in the ways of Darwinian evolution: It’s survival of the fittest. This doctrine, concise yet striking, refers to the competitive nature of the academic profession in which we have been raised and continue to grow. Although obtaining a medical degree reflects many years of effort, discipline, and camaraderie, …
Publish or perish: It’s survival of the fittest
In a hushed surgical theater in Boston in 1846, anesthesia changed medicine forever. The first successful public demonstration of ether anesthesia allowed patients to undergo surgery they would otherwise not have been able to tolerate. Previously, patients who had been subjected to biting down on cloth or looking into a blue light could finally undergo surgery …
The American Society of Anesthesiologists: Deep roots in patient safety
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An excerpt from The Communication Panacea: Pediatrics and General Semantics.
If one pays attention to the language used in the context of all of these developments, it is clear we have moved into an entirely new semantic environment. Just as in the civic realm the word “citizen” has almost entirely been …
Semantics and the subversive doctor
Can primary care survive? At a time when the services of a well trained, well-supported primary care physician are needed more than ever before to help patients negotiate through the confusing health care maze, the specialty is under siege.
We are overwhelmed. Those of us in primary care are overwhelmed by the growing weight of medical, legal, financial, and clerical responsibilities placed on our shoulders. The quality of care we can …
Primary care is broken: Here are ways to fix it
The truth is, I know it’s easy to go to the Minute Clinic. I know the enticement of not needing an appointment, of being able to shop while you wait, of having the prescription ready to pick up by the end of your appointment. Who doesn’t like convenience and a friendly smile to add? Who doesn’t like the customer service offered …
Retail clinics sound good. But if you need follow-up care, good luck.
New York Post reporter Susan Edelman revealed the name of the unfortunate anesthesiologist allegedly present on August 28 at Yorkville Endoscopy, during the throat procedure that led to the death of comedian Joan Rivers. She is reported to be Renuka Reddy Bankulla, MD, 47, a board-certified anesthesiologist from New Rochelle, NY.
Having her name made public will be a nightmare for Dr. Bankulla, as …
Joan Rivers: What should the anesthesiologist have done?
“What do you want for dinner?” I asked my wife.
“I don’t know,” she answered. “What do you want?”
“How about hamburgers?”
“No, I don’t want hamburgers.”
“What do you want then?”
“I don’t know … pasta.”
“I’m a little sick of pasta,” I said. “How about pizza?”
“I’m really in the mood for pasta.”
Silence. Then: “OK, pasta.”
I’ve observed, both among my patients and my friends, that the issues which ultimately threaten to dismantle romantic …
The art of compromising is the key to a healthy relationship
One of my patients got admitted this past week. As a new attending, this is still an unpleasant experience. Have I failed? Is there more I could have done to prevent this? I have to say that this particular case wasn’t shocking. The patient hadn’t been doing well lately, and I wasn’t surprised when I got the message that they were on the way to the emergency room.
Due to our …
Primary care is a story of misaligned incentives
The day before I began my second year of medical school, I spent the day at the beach with my daughter, who had just celebrated her third birthday. Most of my classmates had spent their “last summer ever” traveling or doing research, but I had chosen to take the time off to make up for some of the family time I …
A 3-year-old taught me to chase my dreams
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