She clutched her chest, gasping for words that would not come in English. The nurse leaned in, trying to decipher. Her son was not there to translate, and the phone interpreter line was not connected yet. I could see her distress worsening. Precious minutes slipped away before we finally realized she was describing classic heart attack symptoms. That patient survived, but the outcome could easily have been different. And in …
Were you the one who always held it together? The responsible one? The one who made sure everyone else was OK, sometimes at the cost of your own well-being?
For most eldest daughters, this role is inevitable. We don’t choose it. We are handed it, early and often, because we are so “capable.” We accept this role and excel at it. That’s what most eldest daughters do with whatever is handed …
Understanding the legal process in America is not easy, and I do not envy the attorneys who try to defend doctors in court. I do envy them for their protections. Lawyers, for the most part, as elected members of Congress, create our laws. Others, also for the most part lawyers, are selected to be U.S. Attorneys, and they enforce those laws. Lawyers called judges control our courtrooms. Almost all of …
“Who would you go on a date with, and why?” That was the question that came up in a recent speech workshop. People shared fun, lighthearted answers. But for me, the answer came straight from my heart. I would go on a date with my dad.
My father passed away nearly fifteen years ago, just before my life was about to begin a whole new chapter. I was newly married, preparing …
He was five, wiry, and fast, so fast his mother looped her purse strap around his wrist in the waiting room. She spoke softly, in Spanish, explaining that he could not sit still, could not sleep, could not stop. As she described his meltdowns, he interrupted with nonsense sentences, unrelated to her words, untethered from context. It was not defiance; it was overflow.
I and my team of CNA Spanish interpreters …
Some battles announce themselves with trumpets; others creep in silently, spreading their fire unseen. His battle was the latter. What began as a hidden spark in his muscles had grown into an inferno consuming his young body from within.
He was barely thirteen, a boy from Bihar, when fate dragged him into this fight. By the time he reached us, fever had bound him for three relentless weeks. His pulse was …
I am a cancer doctor.
It took me many years to become one and while I paid for my medical school tuition, my residency and fellowship training was partially subsidized by government funds for general medical education. Every residency and fellowship is partially funded this way because the government recognizes the need for doctors. I have also had an NIH funded basic research lab where I did research that has contributed …
Physician burnout and physician suicide continue to plague the medical profession. Everyone knows the tragic statistic: one U.S. physician commits suicide each day. While some statistics report a decrease in the problem over time, the accuracy of these reports is questionable. The reality is that it is far too common.
The term burnout, while a necessary label, implies that a single factor causes it. In reality, each burned-out physician is different. …
Every week, I see patients not because they need to, but because their insurance company says they must. A patient came in recently for one reason only: Her insurer required a referral before she could see a specialist. She didn’t want to. I didn’t need her to. But we both had no choice. After a 20-minute visit neither of us needed, I did what the insurer required: document, click, submit. …
The patient was in her forties. She experienced chest pain, but it did not appear to be “classic.” Her ECG was normal. Her labs did not raise alarms. The team leaned toward anxiety. Hours later, she went into cardiac arrest from a heart attack. That silence after the code still stays with me. We anchored on the first test. We closed the case too early. We stopped listening to her …
At the recent ECTRIMS Congress in Barcelona, researchers presented data that should make every specialist pause. In a claims analysis of nearly 70,000 patients with multiple sclerosis (MS), 98 percent of infections were first detected not in neurology clinics, but in primary care and other non-neurology practices. Even “serious” infections requiring hospitalization were almost entirely picked up elsewhere. The message was clear: Specialists, by design, often miss the forest for …
“Do you know what it feels like, to know you could die at any moment?” His words linger in the air, heavy, long after the threat of violence has passed, long after our team has calmed him with words and soft gestures. It is not the first time a patient’s family member has swung at me, nor will it be the last. But it is the first time with a …
There’s a common belief that leadership requires a title after your name, an office on the top floor, and people looking to you for direction. But in medicine, leadership happens at every level.
Take me, for example. I’m an attending physician, whose role on the team is as a hospitalist. In the hierarchy of medicine, it’s easy to dismiss this role as “just a physician.”
Yet there’s nothing “just” about it when …
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The pilgrimage of my dreams included a suitcase full of diapers, extra pants, and a quiet prayer for dignity. Italy has always been a dream destination for me. As a Catholic, I consider Rome the Holy City of my faith, and this year’s Jubilee motivated me to visit the four Holy Doors. I also love art and culture, and Italy is home to many historic sites and great works of …
I just spent a weekend doing absolutely nothing. Well, nothing memorable, anyway. The week before, I’d been on home call during an Epic upgrade. If you’ve lived through one of these updates, you know the chaos. In addition to the usual phone calls about echo results, arranging studies, and communicating with referring physicians, I was getting a constant stream of secure chat notifications updating me on the system’s progress. These …
When I first stepped onto a college campus, I was the first in my entire family to do so. Coming from a humble immigrant background, community college was my gateway. Like many community college students, I was nontraditional, new to the country, starting from scratch. This was my first exposure to the American educational system, and I was just trying to figure it out while working multiple jobs.
Eventually, I served …
To be honest, I never imagined myself treating A-list celebrities and professional athletes in Manhattan. As a young physician in Juárez, Mexico, I spent my earliest years working in community clinics and even pharmacies on the city’s impoverished peripheries. Back then, the idea of practicing at one of the most prestigious hospitals in the United States (let alone as a pain management specialist) was unthinkable. And yet, only a few …
Suicide is the elephant in the room in medicine. We rarely speak about it openly, yet it remains a silent epidemic, among our patients, and tragically, among physicians themselves.
I first encountered this reality as a medical student in Tennessee in 2022. One of my earliest patients was not much younger than I was. Because we were close in age, I felt we …
On my first week of onboarding as an attending, before I had seen a single patient, I met the boulder in a training room.
It arrived as a screenshot. The EHR instructor clicked into a demo chart and a cascade opened: quality gaps, refill requests, preventive care nudges, “smart” routing rules that promised efficiency and smelled faintly of delegation without authority. I had imagined the threshold to attendinghood as a clean …
Two emergency physicians with similar training work at the same hospital. Both have twelve years of experience. Both are contracted to work 2,000 hours per year, see roughly twenty patients per shift, and supervise staff. One is a man, the other is a woman. The same work, the same training, the same conditions. Not the same salary: The woman earns about $21,000 less each year.
That is not a hypothetical. That …
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