She was 94-years old with advanced Alzheimer’s. She thought it was 1954 and asked if I wanted tea. Not a bad memory for someone in a hospital bed with a broken left hip.
She’d fallen at her assisted living facility. It was the second time in as many months. She’d broken her collarbone on the previous occasion.
Over the past year, she’d lost 30 pounds. This is natural in the progression of …
Responding to our justifiably increasing preoccupation with widespread obesity, the Coca-Cola Company has released a masterful television ad on the subject. They characterize their own efforts, and invite us all to “come together” to combat this scourge. The whole “come together” concept receives great emphasis, with evocative images from the (presumably) good old days of: “I’d like to buy the world a …
It wasn’t until I became a nurse that I realized how long a hospital hall could be! And, whether we are walking, rolling, or running down those halls, our steps can seem endless.
Oh sure. Current hospital halls may be relatively short, compared to the immense and cavernous wards of days gone by. But hospital halls have an open and hollow resonance of …
It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity.
The woman lying on the gurney was motionless. Her chest moved up and down with a timid but halting regularity. The calmness of her face was in sharp contrast to the panicked despair of the …
A sample agenda as the consulting psychiatrist with a homeless outreach team:
8:17am. Arrive at the office, which is in a tall building that is a short walk from the New York Stock Exchange. Speak with the case managers and social workers about who should be seen that day.
8:55am. Walk with a case manager to the ferry terminal meet Paul (note: all patients described here are composites of people I have …
Juan Gonzales, (not his real name), is a somewhat demented elderly Hispanic male, who I met last week in an intensive care unit. He spoke little English, and I spoke limited Spanish. His devoted family was at the bedside, and fortunately his daughter was able to provide some history. He was admitted with palpitations and dizziness and atrial fibrillation with a rapid response.
I’m told every doctor has their list of unsolved patient mysteries. Those patients where something terribly awful or something miraculous happens for which you lay awake at night trying to understand. The nature of doctors is to want solve problems and figure out medical mysteries in sleuth-like Sherlock Holmes fashion. It’s these unsolved mysteries that you remember as they perplex you for days, weeks, possibly years after.
By the time I met her, Ms. Jacob had been in the hospital for 202 days, 15 hours, and 38 minutes. 39 minutes. 40 minutes.
Starting work on a floor that prided itself on delivering comprehensive, efficient care, I studied the computer monitor describing patient lengths of stay, wondering why this woman had been here 25 times longer than the average patient – …
When I first decided to pursue a career as a physician scientist by enrolling in the medical scientist training program, my goals seemed very clear; to bring what I learned at the bench to the bedside. Today, as a junior faculty member in a department of pediatrics who spends most of my time in the lab, this now clichéd phrase continues to echo in my mind. Yet, I am concerned …
There are surprising misconceptions about what family physicians actually do in practice.
Americans maintain a fond respect for the classic image of the family physician, making house calls with black handbag in tow. They admire the Marcus Welbys of the world. While this classic image is endearing, it should not be confused with the 21st century family doctor. The modern family physician is trained to engage in the adaptable world of health …
Health and health care are hot topics lately, and not just for journalists and bloggers debating Obamacare. Suddenly – or so it seems; in fact the trend has been building for years – people from all walks of life want to read about medicine.
Within medicine, a majority of journals now have essay, viewpoint, or perspectives sections. Not only are such sections frequently …
As trauma surgeons we often have to disassociate ourselves from the stories that surround our patients so that we can focus on their life-threatening injuries. It’s also how I personally cope with the devastating injuries to the patient and the aftermath left for the family. Sometimes, though, I am caught off guard and my defenses aren’t strong enough.
A middle-aged man was brought in one evening after being hit while riding …
Ok, I’ll admit it: I had no idea. I thought that the whining and griping by other doctors about EMR was just petulance by a group of people who like to be in charge and who resist change. I thought that they were struggling because of their lack of insight into the real benefits of digital records, instead focusing on their insignificant …
When I first lay eyes on Marilyn, I don’t think she will survive another week. Eighty-nine years old with short, curly gray hair, she sits in a wheelchair in the examination room. According to the nursing sheet, she weighs one-hundred and nine pounds. She wears a bulky white sweater over a gray dress that seems too big for her tiny body. Her …
I’m not old enough, in emergency medicine years, to identify with the struggle of those calling for the end of the term “ER.” The argument was about the “R” vs. the “D”: “It’s not a room!” It’s a department!” was the war cry. Then perceptions changed, battles were won, and along came the very popular TV show, “ER.” The war hawks quieted …
As I have written many times in my previous blogs, it is essential that patients and physicians partner in the management of disease. Outcomes are improved when patients are actively engaged in their own healthcare. Part of engagement involves forming a relationship with a physician through regular follow up visits. Relationships with doctors, just as with friends and spouses, evolve over time. …
That was Virginia’s second visit to the hospital in the ten days of the new year. It also ended up being the last.
Virginia was a patient we all knew. She came to the hospital frequently. The aphorism of our intern year was, if you had not taken care of Virginia once, you were not going to graduate out of internship. And that was hardly an exaggeration- almost no one in …
My first night shift in a stretch of 7 was almost over. It was 6:15am and I had to keep moving otherwise the minute I would stop, my eyelids would drop like two ton shades and I’d fall asleep. That never makes for a good drive home after a night shift.
“Got time to see one more?” asked Jenny the nurse.
Some people think that women who work part-time are ruining medicine and contributing to the physician shortage. So I want to present my very reasonable list of reasons why I work part-time in a flexible job:
1. I am sick constantly. Constantly. My kids are petri dishes. And it always lasts forever. Even as I’m writing this, I’m coughing, and …
But I’m not talking about clinical ability or medical knowledge. I’m talking about expectations. I’m talking about basic behaviors that dictate a predictable response.
Nurses don’t feel valued. Much of this is warranted, but I argue that some of it is self-inflicted. I said this once to a colleague and she responded, “But that places the blame on the nurse.”
