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The value of moving through grief to healing and growth

Physician

February 16, 2016

(The following story was told to me by a friend; details have been changed to protect privacy.)

An early winter snowstorm left Janet with an unexpected whole day alone with her 17-year-old daughter Ally. As was typical for the pair, they spent the morning in comfortable separateness. Janet took advantage of the opportunity to catch up on paperwork, while Ally stayed in her room working on college applications. In Janet’s view …

This is what I’m wearing instead of a white coat

Kristin Prentiss Ott, MD

Physician

February 16, 2016

Hospitals are places of long-standing hierarchies where some people are made to feel important and others … not so much. A long time ago, I was told nurses used to stand when a white coat walked into a room. (Imagine that now. Laugh. Snort. Choke. Cough.) In those days, in the patient care setting, white coats were synonymous with importance.

These days, non-clinical hospital administrators, various technicians, and Clinique make-up counter …

Dr. Mona Hanna-Attisha is a hero. Here’s why.

John Schumann, MD

Physician

February 16, 2016

I have a new hero. Her name is Mona Hanna-Attisha, MD, MPH.

Dr. Hanna-Attisha is a pediatrician in Flint, Michigan. She grew up in a suburb of Detroit. She graduated from the University of Michigan before attending medical school at Michigan State University. During her clinical years (the 3rd and 4th years of medical school), she spent many months at Hurley Medical Center in Flint, which serves as a clinical training site …

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Do physicians who go on long vacations lose their skills?

Michael Kirsch, MD

Physician

February 16, 2016

Years ago, I was having dinner with two members of the Cleveland Orchestra, one of the finest orchestras in the world. I asked them, with my kids present, how much time they devoted to their craft. As many parents know, getting kids to commit to practicing a musical instrument is about as easy as splitting the atom. The musicians told us how much time they practiced, which was mind boggling, …

Medicine is often more complicated than the first positive finding

Hans Duvefelt, MD

Conditions and Diseases

February 15, 2016

77-year-old Edward Tripp had been to the emergency room with chest pain last Friday night. It was relentless, aching, and involved the upper part of his left chest.

He had no cough, fever or shortness of breath. He was not sweaty or nauseous, and his blood work, EKG and chest x-ray were normal. He was distinctly tender over the part of his rib cage where bone and cartilage join each other …

The racial slurs didn’t hurt. Other things have hurt much more.

Maria Yang, MD

Physician

February 15, 2016

You could feel the air rushing out of her lungs and into your face if she was screaming at you.

“STOP CALLING ME A WHORE! I AM NOT A WHORE, YOU DIRTY N-GGER!”

No one, in fact, was calling her a whore.

“DON’T LIE TO ME, MOTHERF-CKER! I HEAR ALL OF YOU CALLING ME A WHORE! I HEARD IT, JUST NOW!”

Her best defense was a loud offense that included liberal use of racial …

We want access to safe and effective Avastin. Here’s a solution.

Robert Wong, MD

Conditions and Diseases

February 15, 2016

Recently, two states in India halted all use of Avastin for the treatment of eye disease following the report of 15 patients who underwent emergency surgery for potentially blinding infections at the C.H. Nagri Municipal Eye Hospital in Ahmedabad. Though further investigations are ongoing, there is worry that the cluster of infections centered around a tainted lot of compounded Avastin. This most recent event serves as a reminder …

Maybe God made teenagers difficult so we can let them go

Claire McCarthy, MD

Physician

February 15, 2016

It happens each time one of my children enters the teenage years (sometimes a little bit before). I go from having a lovely child and feeling like a reasonably pleasant parent to having a moody houseguest and becoming a shrew.

You’d think, having gone through this now four times, that I’d figure out how to avoid it. Or that I’d expect it. Or not let it bother me so much. Nope. …

The games drug companies play can dramatically raise costs for patients

Rob Lamberts, MD

Physician

February 14, 2016

I had a patient last week who was a real pain in the ass. Wait. No. He was actually a really nice guy. He wasn’t a pain in the ass; he had a real pain in the ass. Literally.

I was initially concerned about a pilonidal cyst, given the unfortunate fact that he was previously afflicted with this condition (which I consider to be incontrovertible proof of Satan). But, fortunately to …

When it comes to positive change, physicians are their own worst enemy

Suneel Dhand, MD

Physician

February 14, 2016

Physicians are an interesting and eclectic bunch of people who have sacrificed a lot to get to where they are. Just getting into medical school alone is an academic achievement to be proud of. And that’s just the start of the journey. What follows is one of the most rigorous courses of study in existence. Test after test, exam after exam. And when you’re finally done with medical school and …

A psychiatrist shares her 5 secrets to love

Vanita Braver, MD

Conditions and Diseases

February 14, 2016

As a mother of three daughters, I frequently find myself singing along to the catchy tunes of Taylor Swift. Singer, songwriter, and overall superstar Taylor Swift is famous for penning undeniably captivating love songs. She is popular not only because she has the voice of an angel, a cutting edge look, and a fierce attitude, but also because she is honest and real. Taylor has an uncanny ability to put …

I left medical school for a startup. Here’s why I went back.

Gina Siddiqui

Medical Education

February 13, 2016

Last May, I reflected on my path from medical school to starting a health tech company in San Francisco. In an environment which fetishizes the “dropout founder,” I always met perplexment when I said I planned on returning to medical school. Now that graduation day is around the corner, I thought I’d shed light on my choice for clinical practice and what I learned on the other side.

Medical …

How my cardiology practice changed with a click

Ami B. Bhatt, MD

Physician

February 13, 2016

I was a bit nervous as I had never done this before. I wasn’t even sure what I was going to do once I saw him. The only certainty in my mind at that time was that this was not the Norman Rockwell image of the physician-patient encounter that I proudly displayed in my office. He was my age, 40 years old, living on Nantucket with his wife and two …

MKSAP: 61-year-old man with generalized weakness

mksap

Conditions and Diseases

February 13, 2016

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 61-year-old man is evaluated for a 10-month history of generalized weakness. He reports no pain or myalgia. History is significant for hypercholesterolemia treated with a stable dose of simvastatin for the past 3 years.

On physical examination, temperature is normal, blood pressure is 138/74 mm Hg, pulse rate is 70/min, and respiration rate is 16/min. …

Can we truly heal another if we can’t heal ourselves?

Dr. Eunice J. Minford

Physician

February 12, 2016

“Liver Transplant Surgeon Addicted to Alcohol” — reads like a headline from a tabloid paper selling sensationalism.

How could it be?

How could a liver transplant surgeon, someone who sees up close and personal the devastating effects of alcohol on the body, be addicted to alcohol? Surely the diseased, fibrosed, hard, shrunken cirrhotic livers with dilated and engorged veins that can rupture and bleed catastrophically; the yellow eyes and skin of the …

Is there any hope for physician-only anesthesia groups?

Karen S. Sibert, MD

Physician

February 12, 2016

Today is a remarkable day for me. I’m officially leaving private practice after almost 18 years, to return to academic medicine with a faculty position in a highly regarded California department of anesthesiology.

Why would I do that?

There are many positive reasons. I believe in the teaching mission of academic medicine: to train the anesthesiologists of the future, and the scientists who will advance medical care. I enjoy teaching. The years …

In defense of variation: A neurosurgeon takes on Atul Gawande

Ahilan Sivaganesan, MD

Physician

February 12, 2016

In 2012, celebrated surgeon-cum-writer Atul Gawande penned an incisive essay for the New Yorker entitled “Big Med.” Deliberately provocative, yet disarmingly reasoned, it suggests that American health care should borrow management practices from the Cheesecake Factory.

To set the stage, Gawande paints an unflattering picture of the status quo: medical costs are too high, quality is not reliable, service is often poor, and physicians differ widely in their approaches and outcomes …

How a neurogenic bladder affects sexual intimacy

JoAnne Lake

Patient

February 12, 2016

An excerpt from Beyond Embarrassment, reclaiming your life with neurogenic bladder and bowel.

Conceivably one of the areas of life most affected by neurogenic bladder is sexual intimacy. When I was first diagnosed, I was afraid to have sex. Because I was new to using a catheter, I was sore in that area anyway. The last thing I wanted was any more activity that would irritate already inflamed …

Is a punitive culture contributing to physician burnout?

Jamie Coleman, MD

Physician

February 11, 2016

Burnout, burnout, burnout. It seems like that is all anyone wants to talk about these days. And I admit, some days, I can get burnt out on burnout. But, all the attention on the subject got me thinking. Did burnout not exist 30 years ago? Why is this such a hot topic now?

And that is what brings me to this post; I came to the realization that burnout very much existed …

Strategies for coping with the side effects of medications

Toni Bernhard, JD

Patient

February 11, 2016

Many of us who suffer from chronic pain and illness are on medications that carry side effects that, in some cases, can be as difficult to cope with as our initial health problems. I’ve recently started a medication that I’m scheduled to be on for five years. I’m taking it because it significantly reduces the risk of a recurrence of my recent bout with breast cancer.

And so, yes, I’m taking …

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