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My patient with an aortic dissection almost died

Conditions

September 25, 2022

“I just moved here from Portland two weeks ago,” said Ms. Shelly in a weak voice.

When I walked into the room, I immediately noticed her blood pressure was 224/108. The patient was mostly sleeping, but when I started speaking with her, it was apparent to me something was wrong.

“Do you have a history of any heart problems?” I asked Ms. Shelly.

“I had aorta surgery two times…” she murmured before falling …

A 15-minute relationship fix [PODCAST]

The Podcast by KevinMD

Podcast

September 24, 2022

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“Depression involves withdrawal, withdrawal from oneself and others. Feeling safe enough in a relationship to reveal our innermost feelings safely is connective and should be considered a valued part of the anti-depressant lifestyle. Continued relationship satisfaction is …

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A 15-minute relationship fix [PODCAST]

Literacy and patients’ understanding of health education

M. Bennet Broner, PhD

Conditions

September 24, 2022

In my first bioethics class, the components of health education (HE) were just being developed, and despite the passage of time, full understanding remains elusive as HE proved far more complex than originally conceived. We learned, simplistically, by present standards, that the provider (MD, DO, PA, NP) only needed to deliver information at a patient’s level of understanding, and the patient would provide a reasoned response. The constant over the …

A stark contract between American and Canadian health care

David J. Stewart, MD

Policy

September 24, 2022

An excerpt from A Short Primer on Why Cancer Still Sucks.

The United States has the world’s most expensive health care system. It spends about twice as much each year on every American as the Canadian system spends on Canadians. Per capita, the U.S. spends far more than Canada on drugs …

Who are the neurodiverse people in your life?

Krystal Sodaitis, MD

Conditions

September 24, 2022

As physicians, we equate terms like “disorder” and “syndrome” with pathology. If a diagnosis is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV, it’s considered a “problem.” In the case of neurodevelopmental diagnoses, I am becoming increasingly aware that this may not be the case. As a neurodiverse individual with many neurodiverse family members and friends, I believe there is nothing “wrong” with our brains. Different …

KevinMD on PermanenteDocs Chat [PODCAST]

The Podcast by KevinMD

Podcast

September 23, 2022

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In this special episode, KevinMD is on the other side of the microphone as he’s interviewed by Dr. Alex McDonald, originally aired as a PermanenteDocs Chat presented by The Permanente Federation at Kaiser Permanente.

He shares his …

I will not sell my soul to modern medicine: Curing physician moral injury

Tomi Mitchell, MD

Physician

September 23, 2022

Something is wrong. You can feel it, but you cannot put your finger on it. You go through the motions daily, but your joy is gone-its soul-sucking. Your patients sense it too. They used to love coming to see you, but now they see the changes. The light has gone out of your eyes. You used to love your job, but now it feels like a burden. This is not …

Health care’s 3 epic childhood obesity failures

Karla Lester, MD

Conditions

September 23, 2022

I don’t know about you, but I’m tired of spouting the same old worsening childhood obesity statistics, applying the same dilute and sometimes broken strategy, not getting anywhere, judging myself as a doctor, then shifting the blame to my patient and their parents, then feeling powerless and defeated.

Lather. Rinse. Repeat.

It’s a cycle we’re stuck in, and it’s not serving anyone, especially our patients.

I’m not going to go over the impact …

I’m a doctor who just had his first colonoscopy in my 60s — without anesthesia

Mike Neskovic, MD

Conditions

September 23, 2022

Well, I am that family physician and geriatrician who is now almost 70 years old. And I cannot believe it because, in some ways, I am still like 27 years old!

First of all, I’m very healthy, and I’m lucky that nobody in my family had colon cancer or any cancer. Most of my relatives lived into the late 80s, and my grandmother and my grand grandfather lived to the ripe …

We need a mental health infrastructure bill [PODCAST]

The Podcast by KevinMD

Podcast

September 22, 2022

Subscribe to The Podcast by KevinMD. Catch up on old episodes!

“As we slowly emerge from the physical withdrawal required during the pandemic, the emotional toll of this past year will become increasingly apparent. Complicated problems demand organized, financially-supported solutions. We need a mental health infrastructure bill now, …

An awkward conversation with a friend might just save someone’s life

Brian Sayers, MD

Physician

September 22, 2022

There is something special about that childhood friend. It’s a bond that lasts a lifetime, something we can only experience fully in our formative years. My friend was Richard. We were inseparable in school growing up, then roommates in college, growing into manhood together. When it came time for medical school, I went to Dallas, and Richard to Houston, where he would start his career. We drifted apart in those …

The ramparts of the neurosurgeon’s mind were unassailable

Marc Arginteanu, MD

Conditions

September 22, 2022

An excerpt from Azazel’s Public House.

Pete tried to invade Tommy’s brain and force an oops moment. But the ramparts of the neurosurgeon’s mind were unassailable.

Clancy, unaware he was battling on two fronts, tried to spare any brain that had a …

How to change your specialty during residency

Danielle Kelvas, MD

Education

September 22, 2022

There are no clear statistics, polls, or studies to know exactly how many physicians each year, or within their working lifetime, switch specialties. But with physician dissatisfaction scores steadily rising, this is becoming a very common sentiment.

First, I want to normalize and encourage everyone to practice self-compassion during this process.

I personally changed specialties early in my career and have numerous colleagues who also changed. We all profess immense happiness in …

Walk to reduce your loneliness and improve your well-being [PODCAST]

The Podcast by KevinMD

Podcast

September 21, 2022

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“Just before the pandemic, I walked 96 miles (154.5 km) in seven days on the West Highland Way in Scotland, though I was hardly alone in this endeavor. About 250 people start the walk each day, including …

Shame not on us: Diagnoses and treatments need to be transparent

Susan Salenger

Conditions

September 21, 2022

In Australia recently, a woman successfully sued a hospital for $2.4 million for a series of misdiagnoses that left her quadriplegic. A London woman was recently misdiagnosed four times before doctors discovered she had cervical cancer.

A Canadian woman recently filed a $3.5 million lawsuit claiming she was misdiagnosed and ignored when relaying her symptoms to doctors; she could have died. A 26-year-old woman nearly died after a …

Making death conversations fun!

Althea Halchuck, EJD

Conditions

September 21, 2022

“Arriving at an acceptance of one’s mortality is a process, not an epiphany.”
– Atul Gawande

Imagine a group of old (mature) friends gathered for a “girls” weekend in balmy Florida. The friendships started in grammar school and have continued for the better part of 50 years. These women have met at least once a year for more than 25 years and shared life’s ups and downs. On this trip, one of …

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Making death conversations fun!

The nicest patient I’ve ever met

Ton La, Jr., MD, JD

Physician

September 21, 2022

The nicest patient I’ve ever met was Mr. Harris.

I first met him in the ED with his son and daughter by his side, noticing a foley bag filled with bright red blood.

He was an elderly gentleman with ALS and was brought by his children for hematuria and blood clots overnight. Never happened before, and we were all unsure of the cause. Urinalysis soon showed likely UTI, so we started antibiotics. …

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The nicest patient I’ve ever met

Myalgic encephalomyelitis/chronic fatigue syndrome and long COVID [PODCAST]

The Podcast by KevinMD

Podcast

September 20, 2022

Subscribe to The Podcast by KevinMD. Catch up on old episodes!

“ME/CFS is a complex multi-system illness that destroys lives (essentially killing the person yet leaving them alive). It leaves patients with unimaginable fatigue, post-exertional malaise (meaning that minor exertion makes them feel worse), cognitive deficits, cardiovascular dysfunction, …

Is your smartwatch smart about your health?

Rushi Nagalla

Tech

September 20, 2022

Your smartwatch talks a lot but may not say as much as you believe with regard to health. Constant data collection from wearables claims to improve medicine at large. Is the “quantified self” the next evolution or a gimmick for patients?

Imagine your sleep and heart data beamed straight to your medical record. Your care team might notice a red flag and schedule a virtual appointment immediately. Health care wearables, meaning …

Don’t let vindictiveness creep into medicine like it has in politics

Arthur Lazarus, MD, MBA

Policy

September 20, 2022

The callous and inhumane dislocation of migrants recently perpetrated by governors of the states of Florida and Texas reminded me of an equally disdainful and appalling tactic utilized by health care workers since the 1960s: “Greyhound therapy.”

Greyhound therapy refers to attempts by health care workers and administrators to remove undesirable patients from emergency rooms, hospitals, and other types of facilities by providing them one-way tickets on a Greyhound Lines …

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