Wednesday, August 10, 2016. You called to check-in. You knew I was struggling.
Months before, I shared with you that I developed suicidal ideation and was not sure I should continue residency. The forced sleeplessness and self-doubt were getting to me.
Did I deserve to be a surgical resident? I felt worthless.
I was so damn tired.
You knew I was afraid to leave the surgery and what that would mean for my military …
“We can keep your loved one alive. but we won’t. Even though you think their life is worth living, we do not.”
The first time I helped a hospital convey this type of offensive message to a patient’s family, it deeply humbled me. My service on a hospital medical appropriateness review committee forged charitable respect for alternative viewpoints that now pervades my work to protect patient rights.
Hospital review committees adjudicate medical …
Withdrawing life-sustaining treatment over family objections
Most people with scoliosis will never require surgery. But who does need surgery, and how do you know?
Often diagnosed in childhood, scoliosis is characterized by an abnormal curve in the spine that can range from as small as 10 degrees to more than 100 degrees. In pediatric patients, this can result in pulmonary problems if the curve is severe.
However, pediatric patients’ complaints are mostly centered around their appearance due to …
When should you consider surgery for scoliosis?
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“Military physicians should also realize that not all employers are equal or treat their physicians equally.
Military physicians entering the civilian job market are in a ‘seller’s market.’ They should get a reasonable employment agreement. It is important …
Contract advice for physicians leaving the military [PODCAST]
In 1998, Drs. Tervalon and Murray-Garcia created the concept of “cultural humility” as a way to transcend the prevailing but limiting concept of cultural competence in teaching medical students and trainees how to respectfully deliver health care to the increasingly diverse populations of the U.S. The cultural competence paradigm leads health care professionals to assign patient group traits or labels. On the other hand, cultural humility incorporates a lifelong commitment …
Advancing health equity conversations through cultural humility
As an audiologist, treating hearing loss is a part of my everyday life. Even still, I’m sometimes amazed at the difference hearing aids can make in patients’ lives. For example, recently, when an older patient with longstanding hearing loss was fitted with a pair of hearing aids, he was suddenly able to participate in conversation with his son again. The smile across his face said everything.
Hearing well can slow cognitive …
How hearing is connected to well-being
Medical care in the United States is broken. The pandemic contributed, but we were well along this misdirected journey. There is a pathological push/pull between financial pressures applied by payors and health care systems to decrease costs, thereby generating profits versus the desire of providers to deliver outstanding care to patients. This is ingrained into our system as it is designed. The dynamic is further muddled by our unique medicolegal …
Management of acute postoperative pain reveals systemic flaws in health care policy
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“While the technological boom in the health care field is not a circumstance of the pandemic, the accelerated roll-out and adoption of digital features certainly are. And rapid innovation in the health care technology field is not …
Melting the iron triangle: health equity in innovative health care landscapes [PODCAST]
As public and private schools around the country gear up for opening their doors to in-person learning later this month, it is important to acknowledge and accommodate the millions of children who deal with sensory processing disorders.
An estimated 5 to 16 percent of school-aged children have difficulties processing the senses either by overreacting or underreacting to sensory information. This includes not only the five senses of touch, …
Let’s address the needs of millions of students with sensory processing disorders
I’ve just passed the 15-year milestone of practicing family medicine in a small farm town in the Midwest. Knowing my patients and their multi-generational families deeply and enjoying their trust is a major part of my job satisfaction.
Unfortunately, the last two years have put a serious dent in both the trust and the satisfaction.
No one ever takes all the advice their physician gives them, at least in my experience. Until …
Patients who are openly skeptical of a physician’s science-backed advice
Violence against health care workers has escalated to unprecedented levels in the last decade. The pandemic seems to have accelerated outbursts against health care providers online, in print, and in person.
A man from Tulsa, Oklahoma, recently angry over back pain, killed his surgeon and other health care workers before ending his own life.
Many health care workers report they are used to working in environments that are …
Keep us safe: Stop the violence against health care workers
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“I think we all have an inclination—at least from time to time—to judge others. No matter how experienced, compassionate, and professional we are as physicians, we’re still human. I can admit that I have indeed struggled with …
Non-judgmental empathy in the exam room [PODCAST]
Sexual infidelity is the headline grabber when most people think about betrayals in love relationships. But, everyday breaches of trust slide under the radar and can erode even the strongest of relationships.
A small lie about a purchase, a slight exaggeration about a job promotion, a cover-up about a forgotten birthday—each takes a bite out of trust and is a form of cheating. Most of us are disappointed by a love …
Not a cheater? Let’s count the ways.
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]
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