My daughter was born, three months premature, during my third year of residency. Following a harrowing three months in the NICU, we joyfully welcomed her home. After eight blissful but isolating weeks, I was eager to return to the wards. I happily reunited with colleagues and patients, but I also deeply missed being home. During quieter moments, I daydreamed about stroking …
Work-life balance in medicine: Your best is more than enough
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 72-year-old woman is evaluated during a routine examination. She has very severe COPD with multiple exacerbations. She has dyspnea at all times with decreased exercise capacity. She does not have cough or any change in baseline sputum production. She is adherent to …
Test your medicine knowledge: 72-year-old woman with COPD
As a pediatric nutritionist in a clinic that serves children with special needs, I see all kinds of family situations and all kinds of caregivers. Usually, the primary caregiver is a parent. But for a variety of reasons, the primary caregiver may be a relative who cares for the child during much of the day or even has full legal custody of the child.
The latter can happen if both parents …
Nutrition tips for custodial grandparents
Question from a reader: “What are your feelings about when a patient breaks up with you? I love love my doc, but …”
Patients “break up” with me all the time. Well, not all the time, but it’s not uncommon. There are many reasons, some of which are under the patient’s control, and some which are not. Moving across the country is …
So you want to change doctors. Here’s how to do it right.
A version of this speech was delivered May 14, 2015 to the graduating class at the University of Manitoba.
I’m not a doctor. I never will be. I’m a lowly journalist. I tell stories. For almost 30 years, I’ve tried to help Canadians understand their health system and their medical care.
In that time, I’ve seen tremendous advances in medicine and I’ve met, quite literally, thousands of health professionals, from students to …
We have built a sickness care system rather than a health system
I hate to be the bearer of bad news. Sorry to say, breast cancer touches everyone. If there is no one that you love that hasn’t been affected by breast cancer, just wait. It’s coming.
I have had personal experience with friends and family with breast cancer. There’s Tina, who was my roommate in medical school. There’s my mother, now a survivor for 20+ years. I have already flirted with abnormalities …
I’m waiting for the day when breast cancer will become routine
I often wondered what got me here. I am a reader. Give me a book, an apple and a bus ride home and I was lost in the words. Send me to school and make me create 3×5 word cards for hundreds of new words and I was hooked. Then off to high school where science gave me a new vocabulary. …
The dwindling of the medical lexicon. It matters.
I’m a family physician in Eugene, Oregon — a sweet town where folks are pretty darn friendly. I still do house calls. Patients often surprise me with gifts. And nearly every appointment ends in a hug.
Kindness is contagious.
I like to return the favor. So every few weeks I celebrate “patient appreciation day.” I thank patients with balloons and chocolates. Why? For …
Did you forget to thank someone? It’s not too late.
Racism and prejudice are endemic in America. Many of us reflexively answer, No, if we are asked if we are prejudiced. I don’t. I say yes.
While I do my best to give everyone a fair shake, I grew up in a white suburban family in the latter decades of the last century. My friends, my parent’s friends and all those we …
Racism in physicians: It’s not a black or white issue
In case you were wondering — robots won’t replace anesthesiologists any time soon, regardless of what the Washington Post may have to say. There will definitely be a place for feedback and closed-loop technology applications in sedation and in general anesthesia, but for the foreseeable future we will still need humans.
I’ve been practicing anesthesiology for 30 years now, in …
Should I become an anesthesiologist? Read this first before you decide.
It’s a Monday morning, and two patients wait expectantly for the cardiologist. Instead, they get me, a fresh resident. “I don’t know why I’m seeing you,” says the first. I bumble through the chart and find a note indicating he has a large atrium on his most recent echocardiogram.
“So, what surgery do you have coming up?” I offer, to get …
Are preoperative consultations worthless?
In the world of health care, we face a lot of questions and challenges. Hospital administrations across the country are grappling with these and always on the lookout for solutions. As far as raising the standard of health care quality, there’s been great progress over the last several years in the areas of patient safety, adhering to best practices, and trying …
Want to solve health care problems? Ask the right questions.
Many people used to believe that Facebook was an extremely defensible business and that it would be almost impossible for another social network to compete.
It has grown to an enormous scale with massive troves of data and more than 1.5 billion monthly users. The thinking around their defensibility was that because all of your friends and photos and updates are already stored on Facebook, it …
Mobile has put patients in the driver’s seat. Here’s how.
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In the movies, pain is glorious. The runner pushing to the edge. The magic of childbirth. The soldier battles impossible odds to conquer. Pain? “Suck, it up, maggot, pain is nature’s way of telling you that you’re alive.” But, to the cancer patient, in the real world? Pain is nature’s way of saying “you may soon be dead.”
For a patient suffering …
Pain control and abuse prevention: Doctors should take responsibility
This piece will likely draw ire from many, but I do not intend it to be inflammatory. I write it to explain why Bruce Jenner’s recent, and very public, transformation into Caitlyn shouldn’t necessarily make us feel all warm, fuzzy, and optimistic. This is not meant to insult or degrade any individuals who are transgender or merely confused about their own …
Why I’m not celebrating Caitlyn Jenner
Ask any premed student what they fear most and the answer will always be the MCAT, or Medical College Admission Test. After 25 years, the MCAT is being revised, becoming longer (by three hours) and covering a broader range of topics than simply chemistry, physics, and biology. One-quarter of the new test covers “psychology, sociology and the biological foundations of behavior.” …
The danger of politically correct medical schools
There’s a simple way to define value. Ask why we exist.
Imaging exists because clinicians are uncomfortable with uncertainty. Imaging exists because emergency physicians feel that being 98 percent correct about the absence of pulmonary embolism is not good enough. Radiologists exist because imaging is not an assay on a Western blot with a 100 percent accuracy. Radiologists exist because information is …
It’s time for radiologists to stop hedging
Ever since I began residency, I have been encouraging, prodding, and at times, persistently pestering department leadership of my belief that our ophthalmology department should have a dedicated Twitter feed. After months of persistence combined with good timing and supportive leadership, the Twitter feed was launched on June 1, 2015 for the University of Iowa department of ophthalmology and …
Why academic medical centers should be on Twitter. Right now.
A patient undergoing a colonoscopy pressed “record” on his smartphone before being sedated, hoping to capture instructions from his physicians after the procedure. What he heard instead was shocking: “In addition to their vicious commentary, the doctors discussed avoiding the man after the colonoscopy, instructing an assistant to lie to him, and then placed a false diagnosis on his chart.”
The incident cost his …
A patient secretly records his colonoscopy. It cost this doctor her job.
In 2008, at the age of 22, I was diagnosed with hypothyroidism and began my experience with the American health care system and how to care for myself in it. When I was in the process of diagnosing my illness, I went to Oregon Health and Science University in Portland to meet with an endocrinologist and have my ultrasound results interpreted. …
Managing your health is difficult on a student’s budget
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