Sometimes, when a parent tells me about something that happened with their child, I think (and say, as nicely as I can): Why didn’t they call right away?
And sometimes, when I’m talking to a parent or seeing their child in the office, I think (but don’t say): Why did they call about this?
It can be really hard to know when to call the doctor.
It’s hard because sometimes you plain old …
How to know when to call the doctor
A divorced friend of mine who recently started dating was shocked to find that the complete absence of female pubic hair seemed to be an expectation among her potential partners. I’m not surprised, when I was in the dating pool a couple of years back there were men who actually listed full clamscaping required among the personal attributes they were seeking in a girlfriend (and here I was looking for …
So your partner wants to remove your pubic hair
I want to wake up feeling restless and uncomfortable. It’ll be neat to drag myself out of bed to open that first bottle of wine. I’ll drink all of it within an hour. Then I’ll go to the liquor store. The guy behind the counter will know that, everyday, I will buy a pint of vodka from him. He will look at …
When I grow up, I want to be a drunk
When I attended the Association of Health Care Journalists (AHCJ) conference in Boston recently, discussion swirled on the topics of unsustainable costs of care, doctors’ incentives under traditional payment models to order more tests and treatments, and the struggles of patients’ family members to avoid unwanted care at the end of life. That Sunday night, I was back at my day job (so to speak) in …
End of life discussions require all hands on deck
Today the road all runners come,
Shoulder high we bring you home
And set you at your threshold down
Townsman of a stiller town.
-A.E Housman
As the afternoon’s events unfolded, I sat glued to my computer screen between patients. My life has really been a tale of three cities—Houston, Boston and San Diego. Boston was where I did my residency training, met my husband, had my three children and my first “real” jobs. I …
What happened in the wake of 9/11 saved lives in Boston
A few years ago my best friend ran the Boston Marathon. She came back glowing, proud that she’d qualified, amazed by the crowds and energized by the feeling of community. Never once did she think that she could have died from a bomb exploding at the finish line.
America seems to be facing tragedy after tragedy. From the Aurora shootings, to Sandy Hook Elementary, to the Boston Marathon bombings, each time …
After the Boston Marathon, we are just like the rest of the world
There was an article in the New York Times recently about the importance of cultivating a family narrative to instill a sense of identity, control, and resilience in children. The more children know about their family story, the better equipped they are to handle stresses that would shake their foundation. Is it possible that, in the realm of personal health and well being, the cultivation of an …
We should tell our medical histories to our children
I can remember making rounds with a seasoned surgical attending in medical school. In typical fashion, surgical rounds were a lot like the military. The “General” (attending physician) at the front, always commanding respect (and often fear) followed by the chief resident, junior residents, interns and finally medical students. Cases were presented, statuses were updated and plans were formulated. Then came the barrage of medical fact questions–mostly directed at the …
The fallout of chance medical findings
First a disclaimer: People often receive compassionate, considerate and effective care at hospitals. They have countless interactions which impart the miracle of human caring and enrich their lives. It is also institutionally prevalent to have haphazard care with poor communication, near misses and avoidable misery.
I have been working at a university hospital emergency room as part of a mini-fellowship in bedside ultrasound. It is the first time I have spent …
Hospitals are still awful: The movement toward patient centered care
On the morning that I began this post, I read in our local newspaper that Tennessee is soon expected to have a law that would permit public school teachers to offer views on climate change and evolution that are counter to orthodox doctrine on these subjects.
No, I don’t think that creationism is science and it should not be disguised as such. Global warming, or climate change, however, is more nuanced. …
Medicine and climate change have common elements
Has anyone else noticed the growing presence of ultimatums in medicine today?
The New England Journal of Medicine published a discussion of the ethics of not hiring smokers. My hospital adopted this policy six months ago, and they are not alone. There is a tobacco blood test that new employees have to pass. If they fail, they can look for a job elsewhere. I do not know the exact details, but …
The rise of ultimatums in medicine: Do they work?
I was watching a macho shoot-em-up movie the other day; the type where everyone shoots everyone and in the final scene, the dirty blood-stained hero rides homeward on a helicopter or maybe a horse, into a red sunrise or sunset. He stares blankly, focused on nothing, focused on everything, his look reflecting the turmoil of what he has seen, done and lost. The hero’s grease-smeared face shows the understanding that …
No one asks oncologists how they feel
Every one of us feels a high level of anxiety when we are made to wait. In grocery stores, we jockey back and forth to the line we perceive is moving the fastest and easily get frustrated when we choose the “wrong” line. When driving, we will swerve across multiple lanes of traffic to avoid a line at a toll booth or …
8 surprising thoughts about patient wait times
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During morning rounds on my sub-internship, we always spoke softly about TG. There was never any good news. The 56-year-old writer’s lifelong battle with substance abuse was coming to an end – her heart, liver, and kidney were slowly failing. But TG’s devoted husband was in denial. And behind the scenes, we were struggling, too. The patient needed pain control, symptom management, and psychiatric support among other things. At this …
A more sustainable model of palliative care
The dictionary defines humanism as “a system of thought that centers on humans and their values, capacities, and worth.” No sector of the economy comprehends this definition better than a small business. In a sea of competition, the small business whose primary focus strays from its customer’s best interests will surely sink. Those with business experience will undoubtedly attest that, whether in a hair salon or restaurant, a happy customer …
The largest barrier to achieving humanistic nirvana in medical care
Being a clinical student is not a walk in the park. When we get together for “Reflections on Clerkship” days every two months in our small groups, students let the floodgates open about the hardships they have been facing on rotations. I am no exception. Transitioning to a strict schedule in the hierarchical world of academic medicine has been no small feat. In fact I was planning earlier this morning …
The patient experience can be dehumanizing
With all due respect to the many caring, compassionate, and skilled male OB/GYN physicians out there, we’d be amiss in ignoring the research showing a near majority of younger women preferring a female gynecologist. Some call this reverse discrimination in gynecology. I’d more simply call it patient preference. The bigger question is, “Where does this leave the male gynecologist?”, especially in a current marketing climate promoting the “female only” OB/GYN …
The male gynecologist: Tips to connect with female patients
We are fortunate in our country to have the best medical technology in the world. Unfortunately, delivery of this technology, reflected in a worldwide healthcare ranking of 37th, is a disservice to the American people and must be rectified especially when Cuba is ranked 39th.
As provisions of the Affordable Care Act are put in place, a daunting factor is the shortage of doctors who will be needed to provide this …
Increasing the role of nurse practitioners in the inpatient setting
Next in a continuing series.
Traction and counter-traction: along with maintaining excellent exposure, that is one of the fundamental principles of operating. It’s Newtonian: equal and opposite. In nearly all forms of surgical dissection, there’s a need for some pull in the opposing direction: tissues that are a little stretched-out, that are under some tension, fall open more easily when dissected. Plus, it’s a form of stabilization, another obligatory …
Beauty in surgery: Traction and counter-traction
“I want everything done. Please, Dr. Rousseau, do everything. We have two children–they can’t be without their father. Do you understand? Do what it takes to keep him alive!”
Angie, a petite woman with long blonde hair, fixes me with piercing blue eyes. Her husband, Joe, fifty-two, has scleroderma, an autoimmune disease. In its most devastating form, it hardens the skin and destroys the kidneys, heart and lungs.
Joe is dying of …
Sharing my loss helped a patient’s loss
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