The first occurred when the ethics committee gathered to discuss one of the residents on the nursing wing. She was in the late stages of dementia and unable to speak. She had developed an ulcer on her foot, and the doctor recommended antibiotics and whirlpool treatments. These might prevent having her foot amputated.
Her health care agent with medical power of attorney was her daughter. She said that her mother had …
We’ve all heard the tired cliché about July being the most dangerous time of the year to go to a hospital. All new interns — freshly minted doctors straight out of medical school — are on the loose. And you better watch out, the tale goes. That’s demonstrably false, and July is as safe as any month for medical care.
But there is still a big reason to worry — not …
What no one tells you about being a new doctor
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“If I knew back in training and practice what I know now, I would have looked for the support and mentoring that would have helped me to forge a path in clinical medicine. But I saw help as an admission of weakness. I …
We are humans first and gifted healers second [PODCAST]
It’s 4 a.m. when a 17-year-old awakens at home with severe left shoulder pain that his worried parents call 911. By the time he reaches the emergency room (ER), he has pain all the way to his wrist.
“Any recent injuries?” asks the doctor.
“Yeah, about three days ago, I was lifting about 200 pounds at the gym and noticed that my shoulder was really sore.”
When questioned further, he admits that he’d …
Teen dies when blood culture protocol botched: What can we learn from this tragedy?
The headache wasn’t that bad. The fatigue was worse. I had slept about six hours total in the past three days. I was fortunate to have dutiful help from my husband and both grandmas, but I was still exhausted. Between breastfeeding, diaper changes, snuggling, trying to eat and maybe shower, adjusting to being thrust into the most important role in my life, feeling the joy and anxiety as only someone …
My blood pressure spike on postpartum day 3
Are you a perfectionist?
Did you know that perfectionists are actually some of the biggest procrastinators? Yes, really.
In theory, perfectionism sounds like a good thing. Who doesn’t want to do and be their best? It can even seem like a harmless way to motivate yourself.
But the reality is, nothing is perfect.
What does “perfect” even mean? What does it look like? Who has the instruction manual?
It’s different for everyone. What’s “perfect” in …
Perfectionism is a myth: Are you ready to hear the truths about perfectionism?
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“I acknowledge that as a physician, I am overall financially secure. However, after jumping over multiple extra hurdles to prove myself throughout my medical career, I couldn’t help but feel I have been handicapped financially compared to my non-immigrant colleagues. While others are …
Stop financially handicapping non-citizen physicians [PODCAST]
Ergonomics is the study of how humans and machines interact. More specifically, it addresses the interplay between humans and machines through an examination of optimal positioning of equipment and personnel to allow for the most efficient work play and use of time and space. With its study and importance growing in scope following the invention of the assembly line by Henry Ford in 1913, ergonomics has now found itself as …
Ergonomics: How to live pain-free and have a long surgical career
It has always been difficult for medical professionals to balance the time needed for personal care, both physical and emotional, against the overwhelming demands of their time. This is particularly true today, given the extraordinary pressures created by health challenges generated through external factors, such as the pandemic and those caused by genetics or lifestyle choices. However, focusing on this balance is critical for the welfare of both the doctors …
The importance of non-judgmental empathy
Medical training has historically been known for its intensity, during which work-life balance is traded in for intensive study sessions and early morning rounds. In recent years, medical schools have become increasingly interested in programs to improve student wellbeing. Many of these programs teach students the importance of wellness, touting the value of exercise, hobbies, and spending time with friends and family without providing the time …
To fight medical student burnout, focus less on the clinic and more on life
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“Nineteen children were killed in a mass shooting in Texas. I have barely escaped the pandemonium of the pediatric emergency department to scarf down a bowl of pasta when I hear the announcement on the breakroom TV. My stomach drops. Again? How is …
Guns and public health advocacy [PODCAST]
Today, I propose a new kind of metric in medicine.
I know. I know. (I hear the uncomfortable clearing of your throats.)
On one side of the room: Of course we are human, are we not?
On the other: Here we go again, Doctor Touchy-Feely. Let’s get on with it. I’ve got work to do.
But what if …
We rewarded a “chief complaint,” written as a patient concern or a family observation, features fleshed …
A new kind of metric in medicine
If guilt were an Olympic sport, mothers would win every medal. We worry we should have prevented our children’s problems or might have even caused them. Mothers tiptoe through a minefield of complex personal, family, and societal expectations that no one escapes unscathed.
As an OB/GYN resident, I sought extra training to care for mothers experiencing miscarriage and stillbirth. Miscarriage occurs in 1 in 4 pregnancies due to early genetic Read more…
Post-Roe, miscarriage is more dangerous
In an exciting recent study, researchers found that for adults with obesity, weight loss through bariatric surgery lowered their risk of cancer by 35% and reduced their risk of cancer-related death by 43%. This was true of both gastric bypass and gastric sleeve surgeries, and the results were observed ten years after patients’ procedures.
This is great news for people who have seen weight-loss success through bariatric surgery. The study …
A gastric bypass might help some people bypass cancer
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“Communication is both the sending and receiving of information. Data is as difficult to receive and act upon as the ingredients of a meal because much work is left to be done. Information is palatable, actionable, and leads to measurable results in the …
Patient platforms should be intuitive in design and execution [PODCAST]
Not a week goes by that I don’t have a conversation with an amazingly successful women physician who states: “I’m thinking of quitting.” They are succeeding in all their goals: leadership, family, practice improvement, the highest level of patient care, contributing meaningful research and/or teaching, and even getting some homemade muffins or a bottle of cherry wine from patients on occasion.
Why would someone in this situation feel so dissatisfied to …
Why are women leaving medicine? Gaslighting.
Eric Topol wrote an excellent op-ed in the New Yorker titled “Why Doctors Should Organize.” I’m going to spell out exactly how they should organize.
Doctors should form a nationwide class-action lawsuit against the major EHR companies for cognitive repetitive-strain injury. They can easily prove lost wages and mental strain from technical debt in the software interfaces they are being forced to use.
They should demand …
It’s not a good feeling when you cannot do too much for your patient as a doctor. That’s how I felt when I walked into the room to see Valerie for the first time.
She was in her 60’s. She was flanked by her two adult granddaughters, who were very close to their grandma. You could tell that at some point in her life when she was younger, she may have …
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“How would you like to see your career slip away from you as you gradually become less and less able to sleep, to rest, to feel awake, to feel like your memory is failing you, to be taking pills every night on call …
Fibromyalgia is not a trash can diagnosis [PODCAST]
It always makes my heart sink when the CPR guidelines change.
In 1980 I became a provider of advanced cardiovascular life support (ACLS) as certified by the American Heart Association. This was a great move. Through my internship and the many years that followed, it proved comforting to know that I would act decisively and with confidence in the setting of a cardiorespiratory arrest. The ACLS course dictated dogmatic protocols – …
Nothing is sacred: Changing CPR algorithms can be a rude awakening
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