The shootings at Sandy Hook Elementary School in Newtown, Connecticut have been traumatizing for the entire nation. While we have unfortunately become used to hearing about school shootings and other public mass shootings in the U.S., the brutal murder of 20 innocent elementary school children (all ages 6 and 7) is just too much to bear.
In fact, the moment …
How a psychologist explained Sandy Hook to his children
I’m certain that if I hadn’t been just finishing a midnight appendectomy, Daphne would have died. Not fully balancing all the bad luck in her life, she fortuitously chose to exsanguinate when a surgeon and OR staff were immediately available. Nevertheless, vomiting all that blood, she damn near died before she got to the hospital.
Niceties like passing a scope to find …
Operating on the hypercritically ill
I will say this up front: Newtown, Connecticut will not be the last time tragedy strikes. For good or bad, in this age of social media including twitter, it is easier to track the coverage of this story and people’s opinions about it. I have been thinking about this constantly today, and talking with my friends and neighbors about what happened this morning.
Outlining the problems setting up this tragedy …
Newtown, CT will not be the last time tragedy strikes
As I was driving to work this morning, I was thinking about how I wish I had time to exercise more. It’s my 7th week as an intern, and I have only gone on a run once in that time (a 2.5 mile run last week in 25:30 — pitiful considering that two months ago I was running 8-10 miles at least once a week). I got to thinking about …
Take back some of the richness that life can offer
For the families who lost children, their world as they knew it has effectively ended. Yet somehow the sun rises again and the next day is here. For the rest of us grieving along with these families, the only way to move forward is to take what President Obama called “meaningful action.” I interpret this to be action that is radical and significant enough that it will somehow give meaning …
How can we as a society honor the dead children?
For the majority of physicians in the U.S., taking their skills abroad and providing care via medical missions in undeveloped countries is usually not an option. For me, that was always an option. I am an OB-GYN who works as a locum tenens, a traveling physician who temporarily fulfills the duties of another. This has provided me the flexibility to have …
Locum tenens prepared me to volunteer in undeveloped countries
“As flies to wanton boys, are we to the gods. They kill us for their sport.”
-King Lear, Act IV
There are certain days that everyone will always remember. People of my generation uniformly remember where they were and what they were doing the day that John F. Kennedy was shot. My children’s generation will never forget 9-11. For my parent’s generation, images of Pearl Harbor, D-Day, Hiroshima and Nagasaki were burned …
It is almost midnight: Can this day be over soon?
You may have noticed that stores everywhere, and restaurants, too, are getting mobile — as in mobile technology. In a store like Nordstrom, where thousands of items in many departments must be inventoried and managed, it saves a lot of time, personnel, and therefore money, at least for the store. From last season’s belts to the spring’s platform shoes, it is in the system, on the iPod and available for …
Shopping for items in the operating room
It used to be that radiologists mainly helped out your doctor so that they could figure out what was ailing you. Such is no longer the case.
Nowadays, with the easy access to almost any doctor of any specialty, you can visit your radiologist, obtain a needed study (or procedure, in the case of an interventional radiologist), and never even see your …
Don’t be afraid to ask your radiologist for help
Chains do not hold a marriage together. It is threads, hundreds of tiny threads which sew people together through the years.
– Simone Signoret
Allen’s cancer has continued to grow quickly. He raises his chin so I can see. I check my notes from a month ago and pull out my ruler and make new measurements. I jot down my findings and turn to look him in the eye. We both know this …
Tiny threads hold a marriage together
Be obscure clearly.
-E. B. White
As a family doctor, I work at clarifying obscurity about the human condition daily, dependent on my patients to communicate the information I need to make a sound diagnosis and treatment recommendation. To begin with, there is much that is still unknown and difficult to understand about psychology, physiology and anatomy. Then throw in a disease process …
I work at clarifying obscurity about the human condition daily
Physicians are being attacked in many ways and in many places. It is no longer about how able, available, and affable you are. It is about how well you toe the line when it comes to going along to get along while being watched by an ever increasing line up of watchdogs. Many of whom have sharp teeth.
Here are a few questions that might indicate you are headed for trouble:
Do …
How do you know if you’re a disruptive physician?
It is the holiday season, and all through the hospital, patients are being made “NPO.” This is the medical term for “no eating or drinking allowed.”
Mr. T, silver-haired and newly unemployed, is NPO on account of his pancreatitis. “We don’t want to upset your pancreas,” the team tells him when we pass through on morning rounds. It is nearly breakfast time. We hover around his bed in a half circle …
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Recently, millions of people around the world witnessed a remarkable feat. Daredevil Felix Baumgartner rose to remarkable heights in a capsule tethered to a helium filled balloon. At approximately 128,100 ft (24 miles) and a speed in excess of mach one (faster than sound), he leapt from his capsule and endured a free fall of 119,846 feet. At one point in the dive, he began to spin dangerously …
Heroics in medicine involve both a team and an empowered patient
Mothers who deliver prematurely face serious health risks that are often neglected when we talk about prematurity. Today, in honor of Savita Halappanavar’s death from sepsis that was a direct result of her previable premature delivery, I would like to let the world in on the physical perils faced by mothers who deliver prematurely.
Many of us have infections. We rupture our membranes prematurely, and for 40% of …
Mothers who deliver prematurely face serious health risks
Consider the following two clinical scenarios:
1. William, a 62 year-old accountant, has been feeling “depressed” since his divorce 5 years ago. His practice, he says, is “falling apart,” as he has lost several high-profile clients and he believes it’s “too late” for his business to recover. His adult son and daughter admire him greatly, but his ex-wife denigrates him and does everything she can to keep their children from seeing …
Delivering mental health care in a more rational fashion
By now you’ve probably heard of the concept of “concierge medicine.”
To me, it’s an idea that’s Win-Win-Lose:
Win: Doctors. Those in concierge practices have chosen to forgo the traditional business model in favor of charging annual fees that range from $1500 to $15,000 per patient. How much you pay depends on the market, exclusivity factors, and amenities, like comprehensive annual physicals with add-ons like a dermatology appraisal and nutrition consultation. Concierge …
Concierge medicine: Winners and losers
It is not an easy time to be a physician in the United States. Attempt to order an expensive test for a patient and an insurance company is likely to second guess your decision. Try upholding the bottom line for your medical practice and the government will probably start questioning whether you are overcharging for your services. To make matters worse, …
Don’t overwhelm patients with unnecessary detail
I recently saw a 90-year old patient in my cardiology office practice. She was demented, but cooperative with the exam. A devoted daughter, with whom she lives, accompanied her to the appointment. Her dementia was severe enough to make a cogent history from the patient impossible. However, the daughter had something on her mind, and it had nothing to do with her mother’s heart condition.
“My mother’s primary care doctor wants …
The unintended consequences of boilerplate guidelines
What is your impression of an airlines when you sit down and open the tray on the back of the seat in front of you and find food and coffee stains on the tray? You may just worry if the same attention that was given to tray tables carries over to the maintenance of the engines. Or what is your opinion …
Why doctors should have clean and organized desks
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