On a fine afternoon, my nurse came in and gave me a heads-up. “Doctor, the next one’s a bit of a handful. Made a fuss scheduling, complained about her old doctor endlessly at reception … doesn’t seem like a picnic.” I smiled reassuringly, reminding her (and myself) that non-judgmental care is the cornerstone of medicine. However, my mind let out a little sigh, knowing that the next half hour was …
An excerpt from Safeguarding Physician Wellbeing.
There are numerous books written by physicians of various specialties, primary care, and subspecialists, on the topic of physician burnout. Most physician authors, like me, have been inspired to write a book due to personal experience with a high degree of burnout, and/or have had academic interests and research on the topic. Writing such books can be cathartic, intended as a warning for our …
I am a former associate director in a state physician health program (PHP). I also hold faculty appointments at Baylor College of Medicine and Harvard Medical School in medical ethics and psychiatry.
There is a little-known nether realm inhabited by a subset of doctors who have or are suspected of having substance use disorders. These physicians often are referred to state PHPs which, because they’re generally considered voluntary in nature, have …
I just walked about 90 km in six days along the Via Matildica del Volto Santo between Mantua and Lucca through the Appenine mountains in the Emilia Romagna region of northern Italy. This beautiful, lesser-known route, crossing regions once ruled by the formidable Countess Matilda of Canossa, offered a unique blend of physical challenges and the opportunity to connect with history.
As a geriatrician committed to enhancing the health and well-being …
Nearly three decades ago, David Hilfiker, a family medicine physician in rural Minnesota, authored an essay in the New England Journal of Medicine titled “Facing our mistakes.” In the piece, he chronicles three major medical mistakes he made during his long career practicing medicine. Some of the mistakes are horrifying and others simply tragic, but he is brutally honest and forthcoming—displaying a frank self-reflection that is too frequently absent …
An excerpt from Narrative Medicine: The Fifth Vital Sign.
“If you don’t take a temperature, you can’t find a fever.”
— Samuel Shem, The House of God
I enrolled in a creative writing course at a local university to better understand the parameters of narrative medicine. I learned about the pillars of the narrative, such as poetry and creative nonfiction, and our class …
America expends much time, effort, and resources when people become seriously ill, bringing many face-to-face with their own mortality. For patients and their families, it is an emotional and difficult time under the best of circumstances. As a cardiologist, I participate in the decision-making that comes at this time, and it has provided me with the honor of delivering care that has allowed patients to rebound from acute illness and …
As an anesthesiologist, I recall countless occasions when colleagues from the other side of the drape addressed me, like, “Anesthesia, did the patient receive antibiotics?” or “Anesthesia, I need more muscle relaxation here!”
Especially in my first years as a young physician full of insecurities, it intimidated me, so I never complained and only spoke up when vital.
Nowadays, I grasp the unspoken rules of the OR and can navigate the daily …
In our hyperpolarized and political society, it seems everything has a political angle, including health care. I think that some of this conflict is unnecessarily but intentionally introduced by special interest groups to force a point, a change in policy, or the acceptance of societal positions that are controversial for many and not universally accepted. Examples include LGBT issues, gender changing or affirming care, abortion access, birth control, health …
As I wait for the next patient to be brought in, I start reviewing their chart. Past medical records have been received and scanned in per protocol, I see. This won’t be the first time I’ve seen his chart as he had to submit medical records and be approved before he could get an appointment to see me.
A forty-something African American male has been complaining of chronic back pain for …
If only I had managed Mrs. Smith’s blood pressure better, she wouldn’t have had that car accident.
If I had made the case for a statin better, Mr. Wu would not have had the diverticulitis episode.
These types of thoughts have been with me for all of my decades of practicing medicine. Somehow, I’m supposed to blame myself for things that are less than ideal about my patients’ situations and about which …
Fifteen years later and I can still see it.
I wasn’t able to go to the scene that night, but several of my colleagues did. As morning broke, a new shift of my colleagues went to the scene. And on the next morning, I did. We were there to provide medical support to the hundreds of investigators, evidence collectors, workers, and firemen who were helping with the scene. We were working …
It is somewhat cliché these days to talk about physician workforce shortages, but recent data highlights that the problem is getting worse. Two research publications this past year were particularly alarming.
First, in a recent analysis of internal medicine resident career plans from 2019 to 2021, only 9.4% of internal medicine residents indicated they planned to pursue a career …
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Nope, nada, no gracias, non, rara—they may sound different, but they all mean the same thing: no. In our world of instant messaging, the immediate gratification society seems to have lost the ability to unplug, unwind, and say no to unnecessary demands, which inevitably causes us more inner distress than any good.
The journey into my medical career was anything but easy. It was grueling and made me question myself – …
In the quaint New England town of Scituate, Rhode Island, with a population of 10,000, a health care revolution was brewing. Dr. Michael Fine, a passionate family physician, had moved to Scituate with his family in 1992 to serve a quiet, rural community with significant health care challenges. By 1999, though, Scituate’s residents had become very worried about the cost of health care. Two insurers packed up and left …
Kim Downey:
I recently had an enlightening conversation with Dr. Sarah Wittry. We enjoyed learning about all that we share in common!
As a physical therapist, I was delighted to hear that Dr. Wittry’s medical career began in physiatry/PM&R.
Having friends and relatives who have benefited from hospice care, I have tremendous respect for her current work in palliative medicine and hospice.
We spoke of how it has felt to each of us to …
The first book I ever read was The Last Angry Man. I could never have imagined then how it would influence me now.
It is about a fictional character, Dr. Samuel Abelman. He is a general practitioner practicing in New York City during the 1950s. He is in the twilight of a career that spans fifty years of commitment to the Hippocratic Oath.
In the 1950s, the emerging professional trend is specialization. …
“Medicine is a form of art.” Those are the words my grandfather told me as I embarked on my journey through medical school. Medicine resembles literature; we, physicians, enter into people’s lives, and we become part of their life tales. The way we do our work influences how these stories are told. Some tales speak of loss and sorrow, while others resonate with healing and joy. It’s akin to sculpture, …
Humans are naturally attuned to various biological rhythms, such as daily (circadian), weekly (circaseptan), monthly (circatrigintan), and yearly (circannual) cycles. These rhythms not only govern our sleep, eating habits, and energy levels but might also influence the design and functioning of systems we create, like technology and organizational processes.
For instance, it’s commonly advised to restart computer systems weekly to maintain optimal performance. This practice mirrors the circaseptan rhythm, suggesting that …
I remember when I first decided to step away from medicine. While I wasn’t burned out like some of my colleagues whom I would later coach, I did have what I now understand to be compassion fatigue. It was a familiar feeling I had felt before, and I knew that if I continued down the path, it would take me right back to the night I almost ended my life.
Called …
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