Some years ago, I had the privilege of serving as chief of staff of my community hospital. One of my responsibilities was to review complaints directed at doctors. Ten to twenty “occurrence reports” came across my desk every week. Most were from nurses who felt doctors had unfairly reproached them.
Hospitals are required by their deeming organizations — ours is The Joint Commission (TJC) — to adjudicate each item with due …
Controlling physician behavior
Have you heard that computer use causes carpal tunnel syndrome? In fact, there is a near-universal belief that technology gadgets can cause all sorts of hand problems. Both the lay public and most healthcare providers believe that entities such as “Blackberry thumb” and “repetitive strain injury” truly exist and that common hand problems such as flexor tendonitis and basal joint arthritis of the thumb are caused by repetitive typing or …
Computers and your hands: Dispelling common myths
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“It might seem odd to write about what high-weight patients would like when they meet with their doctors. Don’t they want what every patient wants? The answer is yes, but the fact is, they often don’t get …
Tips for treating high-weight patients [PODCAST]
The following article is satire.
We’re again approaching that time of year for medical students: ERAS application season. As students whimper and wonder if they’re making the right career choice, as they set their dreams on a specialty but have been told they need a “backup,” while determining their geographical boundaries of where they can possibly think of living for the next three to who-knows-how-many-years. With all this chaos, they must …
Who even reads personal statements?
I worked in rural Kentucky for 20 years, all of it in poverty clinics. I suspect I got to know my patients better than someone working in a specialty clinic in a big city. The challenges and rewards of doctoring are unique to each specialty. But these are the challenges and rewards I experienced in primary care in the backwoods.
I learned that doctoring is hard. People always come in complaining …
Doctoring in the backwoods: challenges and rewards
An excerpt from South Eight.
There is little similarity between the stillness of the archer, or of Arkin’s former self on the rifle range, with the organized chaos of a dozen nurses and respiratory therapists and lab technicians pouring into Room 326 of the PCU. And yet there is something of …
When the cardiac arrest algorithm comes into focus
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“Many health care professionals go into health care to help people, no matter their race, socioeconomic status, or other identities. Even as white health care professionals start to learn about the systemic nature of racism, something that …
How the culture of health care perpetuates racism [PODCAST]
Not too long ago, a circumstance occurred. I have experienced similar circumstances several times in my career. However, this time, my response was different. It was like a switch in my brain flipped. I was ready to leave clinical medicine. It was time for the next chapter.
Wow! It was a moment of surprise, relief, and excitement, quickly followed by a WTF? Where was this thought coming from? There was …
What it means to leave clinical medicine
On July 25, 2022, dozens of medical students at the University of Michigan School of Medicine walked out of the school’s White Coat Ceremony when the keynote speaker, Dr. Kristin Collier, an assistant professor of medicine, approached the podium. Dr. Collier is pro-life and has expressed her anti-abortion views in tweets and interviews. She was chosen as keynote speaker by a vote by the university’s Gold Humanism Honor Society. A …
On the boundaries of medicine, medical education, and political passion
“What does it mean when there are two pink lines?”
Her voice is hesitant, eyes searching to find mine across the counter. She knows what it means. I know what it means. I turn to the test to confirm and slowly put on a mask.
When I was pregnant with my daughter, my brother-in-law took to calling her “Miracle” because, despite none of us having any particular tie to organized religion, that’s …
The story of keeping my daughter safe
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“I was working at an urgent treatment center, where a busy Saturday in January would be overwhelming. At one point, I hired a scribe. She was a bright young woman interested in medicine and some alacrity with …
To scribe or not to scribe? That is the question. [PODCAST]
Within the last two weeks, I’ve read several studies pertaining to provider burnout. Since the beginning of the pandemic, I’ve lost count of the number of articles I’ve come across addressing this issue as well as potential root causes and expert suggested remedies.
One study suggested over 50 percent of us have fallen victim. Another suggested our so-called “creative” administrators and governing bodies, who are supposed to have our backs, actually …
ICU psychosis is a common phenomenon in hospitals. Most of us as clinicians deal with it well.
However, the ordeal changes when your loved one is struck with it. My grandmother, always admired for her storytelling skills, is now admitted with intestinal obstruction, and her worsening Parkinson’s has just escalated the intensity of her psychosis.
Now she tells me a story of a woman carrying knives, seeing blood everywhere, selling half the …
Remembering my grandmother in the ICU
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This episode was during my elective time in India in the late winter of 2017. It was a patient-centered learning opportunity for students around the world who has an interest in medicine. I was excited about this because of my earliest clinical exposure to patient encounters as a medical student. I was excited to meet the patients, talk to them, and help them despite the uncertainty and emptiness in my …
Does patient-centered care really meet human-centered care?
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“What is currently known is that monkeypox is transmitted primarily through close contact with skin lesions, bodily fluids, and respiratory droplets. Men aged between 20 and 50 years, many of whom have sex with other men (MSM), …
What you need to know about monkeypox [PODCAST]
On May 2, 2011, a few minutes past 1 a.m. Pakistan Standard Time, a U.S. Navy SEAL Team Six left the Bagram Air Base in the Parwan Province of Afghanistan and headed for the compound of a high-value target in Abbottabad, Pakistan, located just a few miles away from that nation’s military academy.
It was an operation that lasted 38 minutes, following which U.S. forces returned to Afghanistan with the slain …
Ayman al-Zawahri: the doctor who dispensed death
There have been countless references to the art and science of medicine over the years. I, for one, certainly have embraced both in my long career as a physician in internal medicine. However, I have always had a special connection to the art part.
My late mother was an artist, so I grew up with …
Early one morning in 1996, after a sleepless night on call, I stood with my team in the VA hospital, outside room 102. I was a 28-year-old intern in the general medicine service. We were making rounds on twelve patients that my intern partner, myself, and our supervising resident had admitted overnight. We would walk room to room, and the intern would present the information regarding the patient by gathering …
An experience of shame in training
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“Would you expect the chef at a restaurant to be told that they are not only required to prepare the food in the kitchen but also deliver it to each of the tables and manage the billing? …
Misaligned expectations lead to conflict, burnout, and disillusioned physician leaders [PODCAST]
I was warned about it before we walked into the room.
So when I did walk in, I made sure my eyes stayed focused on his eyes, my gaze high and attentive. I smiled, possibly more than normal, to make sure he felt comfortable. Like a puppeteer holding up his doll, I knew it wasn’t time for me to drop down my eyes yet.
The resident with me began the routine visit …
How privileged a physician’s knowledge is
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