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From Uber driver to Harvard Medical School

Oscar A. Leyva, MD

Education

December 2, 2022

“What happens to a dream deferred?
Does it dry up
like a raisin in the sun?

Or fester like a sore—
And then run?
Does it stink like rotten meat?

Or crust and sugar over—
like a syrupy sweet?

Maybe it just sags
like a heavy load.

Or does it explode?”
– “Harlem” by Langston Hughes

“$23.46,” the Walmart cashier distractedly mentioned to me as I got ready for my first ride. I had signed up and passed the background check. My …

Much more than simple white coat syndrome

Murray Keith Wadsworth

Conditions

December 2, 2022

Ongoing consultations with a new-to-me internist have raised attention to my in-office blood pressure measurements. In preparation for my next appointment, I regularly record my BP, sometimes several times a day. In other office visits, for cancer talks and such, I simply explain I regularly home and grocery store measure my BP, which always seems to be in the established normal range. I am confident that these in-office rises are …

Time constraints in physical therapy [PODCAST]

The Podcast by KevinMD

Podcast

December 1, 2022

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“Picture this. A patient in a hospital or rehab facility has just finished exercising with therapy. He is thirsty, and he thinks he might as well ask for a snack now because he will be hungry in 30 minutes. …

We get what we incentivize

Kristin Puhl, MD

Physician

December 1, 2022

We get what we incentivize.

This is a basic rule. I’d love to say it’s a basic rule of humanity, but unfortunately, I have a background in psychology, so I know it goes a lot deeper than that—it’s a basic rule of every living creature. Humans are, in many ways, just very big pigeons. We reliably prioritize certain rewards. We prefer smaller sooner rewards to larger later rewards; we push the …

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We get what we incentivize

The immediate impact of the transition to a pass/fail Step 1 exam

Megan R. Moore, Sarah E. Toates, and Prasun Sharma

Education

December 1, 2022

Historically, students’ three-digit scores on the United States Medical Licensing Exam (USMLE) Step 1 were a main factor in determining competitiveness for residency programs. In February 2020, the world of medical education shifted drastically when it was announced that the USMLE Step 1 would transition to a pass/fail scoring system. One of the main factors driving this change was that medical students and residency programs were attributing too much …

Why even doctors need regular doctor visits

Zahid Awan, MD

Physician

December 1, 2022

After a great game of doubles tennis, a good friend brought up a recent visit with his primary care physician while sitting with friends, trying to cool down. He expressed appreciation for his position but complained about the need to see his doctor every three or six months, all the while acknowledging various medical problems being addressed.

This led to general comments by several non-physician friends about how they feel that …

Effective doctors need to be challenged [PODCAST]

The Podcast by KevinMD

Podcast

November 30, 2022

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“Empathy, intelligence, and commitment are crucial traits every doctor must have to succeed. However, there is one trait that stands above the rest. One of the most important aspects of an effective doctor is the desire to …

Prudence and promise in psychedelic-assisted therapy

Charles Saylor and Jacob M. Appel, MD, JD, MPH

Meds

November 30, 2022

Psychedelic-assisted therapy (PAT) represents one of the most promising developments in psychiatry in decades. The treatment typically involves the infusion of a compound such as LSD, psilocybin, or MDMA during an extended therapy session with licensed professionals.

Although it lacks widespread regulatory approval or clinical use, significant advances have been made in the study of PAT in the past decade, with a pronounced increase in recent years. Recently, a Read more…

Prudence and promise in psychedelic-assisted therapy

A doctor’s grief

Humeira Badsha, MD

Physician

November 30, 2022

Last evening I crumbled in the arms of my patient and wept. This was unknown territory to me, an unexpected role reversal. For three weeks after my Mom’s death, I maintained a stoic distance as patients offered their condolences, as they asked about my mother, and empathized. We doctors have been trained to do this, to face death, to keep our emotions at arm’s length. But this patient, who has …

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A doctor’s grief

When your letter to the editor is rejected or ignored

Sami El-Dalati, MD

Physician

November 30, 2022

Dear Dr. El-Dalati,

I am sorry that we will not be able to publish your recent letter to the editor regarding the Chowdhury article of 16-Sep-2021. The space available for correspondence is very limited, and we must use our judgment to present a representative selection of the material received. Many worthwhile communications must be declined for lack of space.

The response from The New England Journal of Medicine (NEJM) seemed simple and …

Let doctors in recovery be able to recover their careers [PODCAST]

The Podcast by KevinMD

Podcast

November 29, 2022

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“During addiction, the brain becomes ‘hijacked,’ which then ‘exaggerates the need for the drug and minimizes the dangers associated with the use of the drug.’ This is so affirming because the chemicals in my brain told me …

What is cognitive load? How can we help clinicians manage it?

Kenneth Harper & Microsoft & Nuance Communications

5 tips for treating seasonal depression during the holidays

Stephanie Straeter, PhD

Conditions

November 29, 2022

Although the holidays are typically associated with feelings of joy and thankfulness, it is imperative that people should not automatically assume these emotions are commonly shared. Three percent of all individuals are impacted by seasonal affective disorder (SAD) during the holidays – a statistic many people are unaware of. The media promotes an unrealistic expectation that everybody should be happy during this time, but this is not the case …

The most valuable health care companies of tomorrow will be technology companies

Christopher H. Loo, MD, PhD

Tech

November 29, 2022

I’ve always been curious about the top 0.1 percent.

Their mindsets, backgrounds, upbringing, perceptions, skills, and behavioral traits that got them there.

After living through the Dot-com bubble, 9/11, Enron-WorldCom, the 2008 financial crisis, the meteoric rise of technology (search, e-commerce, social media, sharing economy), and the rise of a new class of billionaires, I intuitively sensed that there was a disconnect between what was going on in the real world, and …

A physician’s remedy for stress, anxiety, depression, and burnout [PODCAST]

The Podcast by KevinMD

Podcast

November 28, 2022

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“My own burnout episode forced me into some heavy-duty soul-searching and serious reflection. I got lost in the world of seeing as many patients as possible, battling for more operating room time, and keeping up procedure volumes, …

The transformative power of EMDR

Michael Baldwin

Conditions

November 28, 2022

I became a self-involved status and achievement “junkie” in order to tune out unbearable inner voices that repeated, “You are worthless … you’re a fraud … you’re a failure.” I was obsessed with grandiosity: I owned a penthouse apartment with a landscaped terrace, a closet full of Brooks Brothers suits, a family crest ring, engraved stationery from Tiffany & Co., monogrammed dress shirts from Charvet in Paris, and towels from …

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The transformative power of EMDR

Stop calling it the good cancer

Tresia Rouse, RN

Conditions

November 28, 2022

“You have the good cancer.”

These are the most common words that spill out of providers’ mouths to patients just being diagnosed with papillary thyroid cancer. However, this statement does not make this diagnosis any easier to comprehend and digest the life-altering news that has been received by the patient. The survivability rate for this cancer is a high percentage; that is good news, but not good cancer. An issue at …

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Stop calling it the good cancer

For me, COVID has a face

Anonymous

Conditions

November 28, 2022

I’ve moved recently, and in the process of moving, invariably, one discovers old items. This had gotten shelved in the fracas of those years, work changed overnight, changing employers, moving. However, in a discussion with a close friend today, this resurfaced as she’s grappling with patients and family who are not seeing what she’s seeing.

Summer 2020

It’s another Sunday night family dinner. Conversation centers around catching up on the latest family …

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For me, COVID has a face

What anticipatory grief feels like [PODCAST]

The Podcast by KevinMD

Podcast

November 27, 2022

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“I experienced many deaths when I was a nurse, from babies, kids, young adults, the elderly, and my own family. It was always heartbreaking, but I found that staying with the dying and the family and supporting …

Has medicine lost its why?

Bevan Choate, MD

Physician

November 27, 2022

From the halls of ancient Greece to the heights of television screens, the myth that the physician is more god than mortal has stood the test of time. As such, we are held to moral and superhuman standards no matter how tough things get. And thanks to our friend Hippocrates, we are oath-bound in our virtues to help anyone in need; while putting OUR personal needs aside, of course. Many …

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Has medicine lost its why?

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