How writing a letter on Substack might recharge your life in medicine

Physician
September 4, 2022

“The good life is ever-changing, challenging, devoid of regret, intense, creative, and risky.”
-Friedrich Nietzsche

One year ago, bruised and battered like any physician practicing in this pandemic, I decided to double down on weariness and start writing a medical letter on Substack. I’ve been writing about once a week, with subjects ranging from the newest coronavirus variant of concern, to a reflection on the hidden strengths in frailty, to the pleasure …

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Grief on the front line

Physician
September 4, 2022

Several years ago, I wrote a piece about my experience of personal grief while working as an emergency physician in Australia. The grief I experienced was due to the untimely death of my older brother Martin — a high-achieving lawyer and sportsman — who slowly withered away as he lost his battle with a rare and aggressive lymphoma. It is fair to say that his death broke me, but …

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Skinny fat and normal weight obesity [PODCAST]

Podcast
September 3, 2022
YouTube video

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“Obesity is genetically common in our family. I was being gaslighted and judged by a bunch of obese people, most of whom were doing nothing to improve their health and obesity issues. Yet they fully believe to …

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My patient left against medical advice

Physician
September 3, 2022

“Mr. Stenson left AMA …”

“Why?” I said out loud to my attending.

“He left with his IVs in …” said his nurse in disbelief.

An hour earlier, before rounds, I sat down with Mr. S to talk about his anxiety attack.

Ten years ago, he was shot ten times in the chest, which left him with PTSD and depression. Not long after, he started having unprovoked panic attacks. What started as once or …

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If a program doesn’t care for fellows, could a union?

Physician
September 3, 2022

In my self-righteous youth, I bristled at the thought of physicians unionizing. Certain our collective altruism and professionalism would prevail. Unions were for oppressed laborers, not well-regarded, well-paid professionals. Reading the recent paper in JAMA and 30-plus years in the field have caused me to think again. That, and recently having provided support to a young physician couple with a newborn.

There is nothing quite as messy, all-consuming, and awe-inspiring as …

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Talk about death in plain, simple, easy-to-understand terms

Conditions
September 3, 2022

“You’re dying.”

I can often visualize the impact of my words as soon as they leave my mouth, the heavy weight sinking into the mind and body of my patient as they sit in the stark white hospital bed.

It usually isn’t the first time they’ve heard the sentiment. After all, we tell them countless times in different phrases we use as physicians, expecting them to understand, but none quite as precise …

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Coping mechanisms for medical professionals

Physician
September 3, 2022

I am a pulmonary-critical care medicine physician. I had a medical issue in 2020 and was on limited call responsibilities. When I came back, it was in the throes of the first wave of COVID.

It goes without saying that the last three years or so have been very difficult for everyone in the medical profession. We lost a truly horrific number of patients to COVID — in the early days, …

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If it’s not clinically pertinent, then stay out of my uterus [PODCAST]

Podcast
September 2, 2022
YouTube video

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“No matter how far we’ve come, women are still judged by fertility status but shouldn’t be.

If it’s clinically pertinent to ask about reproductive health, then yes, absolutely ask … in a respectful way. That doesn’t mean judging …

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Video visits as clinical touchpoints to improve older adult mental health

Tech
September 2, 2022

The COVID-19 pandemic has taken a profound toll on older adults, isolating them physically and emotionally from their communities and families. Mental health has suffered across generations and, as a practicing geriatric psychiatrist, I have had a front-row seat to the unique conditions older adult populations are facing. Despite rising rates of depression and anxiety, infection control measures have accelerated the adoption of digital health, including telehealth, opening myriad new …

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Drawing the line on unnecessary medical tests

Physician
September 2, 2022

How much medical uncertainty can you tolerate? Most patients have not given much thought to this consequential issue, but it hovers over them in their doctors’ offices. This is also an issue for medical professionals. Indeed, how both sides in the doctor-patient relationship navigate this will be instrumental in choosing the path forward.

Medicine is not mathematics. It’s a murky discipline with incomplete data and moving targets. Many of your symptoms …

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A room once full of vitality lies empty

Physician
September 2, 2022

More than two months after he died, his name still adorned the whiteboard of the hospital room he inhabited. As I stood there and gazed, recalling the memories he left me with, the nurse who tended to him entered the room and started to cry. Her love for Eric, she told me, did not enable her to erase his name.

He was disheveled, non-compliant, and plagued with multiple morbidities when first …

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Why this doctor prefers perfectionist physicians

Physician
September 2, 2022

Your plane is about to take off. Like most folks, you are just a little anxious about flying. It is very rare, but you know a lot of bad things can happen to the machine that carries you at 30,000 feet above sea level. Consider this: Would you rather the mechanic who inspects your aircraft be absolutely conscientious to every minute detail, be exquisitely perfectionistic in his examination of the …

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How technology can streamline tedious health care processes [PODCAST]

Podcast
September 1, 2022
YouTube video

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“Companies that embrace digital processes will reap the rewards, as shown by the Forrester survey taken in 2020 after the pandemic began. The survey found that digital document processes were helping organizations maintain their business resilience and …

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Smaller practices should participate in clinical research. Here’s how they can.

Physician
September 1, 2022

The COVID-19 pandemic and the resulting shutdown accelerated the adoption of decentralized clinical trials (DCTs). The number of trials with virtual and/or decentralized elements exceeded 1,000 in 2021 for the first time, according to GlobalData. That’s a 50 percent increase from 2020. GlobalData expects the number of site-less and/or virtual clinical trials to jump another 28 percent this year, potentially topping 1,400.

This presents a perfect opportunity for smaller and …

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Monkeypox: Should the hospitality and transportation industries worry?

Conditions
September 1, 2022

The monkeypox outbreak continues to accelerate worldwide; by some counts, the U.S. now harbors the most significant number of currently known cases. Pathways for the initial spread beyond endemic areas for this current worldwide outbreak are thus far unclear but may be at least in part related to international infected passenger travel. Now, with elevating case counts, there remains an increased risk of infected persons spreading disease …

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Medical training and the systematic creation of mental health sufferers

Education
September 1, 2022

The COVID-19 pandemic has uprooted our lives, tilting them into imbalance and oftentimes severing our individual sense of inner peace. The newfound public initiative to combat these paralyzing challenges is welcome, especially to me. I’ve coped with major depression for as long as I can remember.

The grinding pursuit of my own inner peace led me to medical school. Medical training, I expected, would make a healer out of me, able …

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How in silico drug development can improve patient outcomes [PODCAST]

Podcast
August 31, 2022
YouTube video

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“In silico technologies also enable drug developers to perform, in theory, an unlimited number of tests using a wide range of variables that include age, sex, and the health status of each member of the virtual patient …

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Narrative medicine develops empathy among physicians

Physician
August 31, 2022

A hallmark of modern medicine involves providing compassionate care through an empathetic doctor-patient relationship. This post describes one powerful technique for developing empathy among medical providers: narrative medicine writing.

What is empathy?

A basic definition of empathy involves your ability to understand someone else’s perspective by putting yourself in their (metaphorical) shoes. Empathy can involve cognitive aspects (i.e., understanding why a person is feeling sad or happy) or emotional aspects (i.e., sharing …

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It’s time to address pain despite the opioid crisis

Conditions
August 31, 2022

Have you ever felt as if your doctor wasn’t really listening to you or was just rushing through your appointment? Have you ever felt as if your doctor didn’t understand the pain you were in or didn’t take it seriously?

Most health care providers are evaluated based on the experience their patients had, and their payment is often based on those patient experience scores. A major component of patient …

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