“Tears and sweat drown my face as I try to rip off my PPE and exit the room. I didn’t want to leave him, but I couldn’t bear another second in that reality. A whirlwind of emotions crash over me, and my knees weaken. I thought, “If I can …
I am an ICU nurse. We are drowning. [PODCAST]
It’s 2022. COVID-19 is still here, and there is little evidence that it’s going away. Coronaviruses have been here longer than us and will be here after us. For centuries, we have co-existed with viruses, and our God-given immune systems have evolved, perfecting our macrophages which fight the nasty microbes. Cytokines or killer chemicals usually put many viruses at bay during our lifecycle, without us even realizing their magnificent work. …
Management of medications is sometimes handled sub-optimally, at least in the United States. At the extreme, physicians who prescribe multiple medications prescribe some medications that treat the side effects of other medications. This could be considered physician negligence in extreme cases.
An example was given in a class I took at UCSF (the University of California at San Francisco). UCSF physicians jointly provided remote advice for a physician treating a developmentally …
Medication management and how consultant pharmacists can help
The COVID-19 pandemic helped bring out people’s true colors. After two years of the unrelenting pressures of the pandemic, people’s true colors came out, and I will have a frank about this truth. As physicians, we often put our patient’s comfort before ours, but at what point does one have to stop and reflect on this.
As physicians, we are often put on a pedestal and have unrealistic expectations. We want …
Keep healthy boundaries and not define yourself by your profession
I started this commentary when the initial COVID spike involving the mass hospitalization of unvaccinated individuals occurred, and non-COVID patients requiring hospitalization were turned away because no beds, especially in intensive care, were available.
Some patients traveled hours to find vacant beds, and a few even died! I put the draft aside as COVID declined and hospital beds became available.
Then, Omicron joined Delta, and cases climbed once again. Hospital beds refilled …
In a recent survey of nurses (n=5,600), 63% of respondents reported having experienced racism in the workplace. These racist acts were mainly done by peers (66%) or a manager or supervisor (60%). Such widespread racism should send shockwaves throughout a profession known for its caring and compassion. These findings outlined in a report from the National Commission to Address Racism in Nursing are a …
Nurses are in need of racial healing
“The starting point is to do our best to approach discussing COVID and vaccination with the appropriate type of empathy and understanding.
To understand that our patients don’t have access to the same level of data and research that we do, and even if they did, they might not understand …
A milligram of understanding for the vaccine-hesitant [PODCAST]
In recent decades, mounting evidence has suggested the Epstein-Barr virus (EBV), a ubiquitous member of the herpes family that causes infectious mononucleosis (a.k.a. the “kissing disease”), can cause multiple sclerosis (MS). Last month, a study published in the journal Science went even further, citing EBV infection as likely the leading cause of MS. It is a compelling connection that begs many questions. For example, if someone has …
Kissing disease’s link to multiple sclerosis
I was a third-year medical student in 1999 when the landmark report titled “To Err is Human” was released by the Institute of Medicine (IOM), unveiling the uncomfortable truth about the fallibility of physicians and our medical system. I remember it vividly.
The publication’s scandalous revelation that nearly 100,000 preventable deaths occurred in hospitals each year shocked me. I recall feeling simultaneously offended and defensive at the implication …
In “Open Everything” published in The Atlantic on February 9th, 2022, Yascha Mounk discusses his arguments for lifting any remaining COVID-19 restrictions to “shake off the pandemic malaise.” He asserts that we are “in danger of prolonging the status quo more than is justifiable” and that “the time to end pandemic restrictions is now.” The broad strokes that Mounk makes are diametrically opposed to …
Are we opening everything too quickly?
As Pandora’s box of coronavirus opened in 2020, it engulfed our planet into an abysmal nightmare. As darkness fell, those of us in medicine sought refuge under a lamp called “knowledge” that sparked its flame from scientific evidence. But what if medicine and life itself were being written in real-time on a clean slate?
From the get-go, the medical world switched up its protective parental gear.
Moral responsibility got perceived as heroism. …
Viral nomenclature or a sign of our times?
An excerpt from Changing How We Think About Difficult Patients: A Guide for Physicians and Healthcare Professionals.
After I finished my residency in EM and started working as an attending physician, I realized I had a problem. I believe a lot of you have the same problem. Some of our patients are so angry, oppositional, and non-compliant that we get angry …
Changing how we think about difficult patients
“Instead of trading up for a faster horse by drawing in the exam room, it felt like I’d just built a motor car.
I created a new workflow around my digital assets. When patients checked in for a clinic visit, I scanned the chart for their visit diagnosis and fired off …
How to convert medical knowledge into digital assets that work for you [PODCAST]
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I recently had a good (albeit unexpected) cry and figured out that I have been in an unremitting fear cycle for about two-plus years. When the COVID pandemic first shut things down across the United States, my family and I had just started a much-anticipated ski vacation. On the way to the resort, we heard that Vail and other Colorado resorts had just shut down. When we checked into our …
Early into my military career and as an oral and maxillofacial surgery resident, I started to acknowledge the fact that, during periods of sleep deprivation that were initially inherent to my military training hours and then surgery call requirements, I found myself thinking dark thoughts that I had never experienced before. I scheduled an appointment with a Psychiatrist and was diagnosed with depression. Scratch that. I was diagnosed with “high …
I risked my career to save my life
The 3-hour concert was over. On the way back to the car, the excitement of it all kept us singing the lyrical masterpiece. I turned on the ignition and typed in our address.
“You have 1 hour and 35 minutes to go,” the GPS alerted me. I glanced at the fuel gauge. The gas floater barely survived the red indicator.
Taking no risks, I drove us to the nearest gas station to …
How inflation fueled health care costs
“When my patients asked me about losing weight, I would say, ‘Eat less and exercise more.’ I know that it is more complicated than that. There are psychological and socioeconomic factors. There is bariatric surgery and there are medications. But ‘eat less and exercise more’ is common sense, and …
Guns, the Supreme Court, and physicians’ voices [PODCAST]
An excerpt from Modern Healthcare Delivery, Deliverance or Debacle: A Glimpse From the Inside Out.
“The significant problems we face cannot be solved at the same level of thinking we were at when we created them.”
– Albert Einstein
In my book, I outline some of the critical drivers of the high cost of medical care in the U.S. These include waste as …
Better health care for less, version 2.0
It seems that each positive story I read about the benefits of artificial intelligence (AI) is countered by a negative story.
One internal medicine physician writes: “Someday, with enough computing power and artificial intelligence, we may be able to have systems that can do some basic medical advice and education about health care that could end up saving doctors a lot of time and …
Artificial intelligence is worse than the old boss
The details have been changed, but the story is true. A physician I know goes to work each day by 7:30 a.m. He is a confident, competent leader in every way within his clinic. But each night, he goes home to a spouse who is losing steam in every way. Diagnosed with a chronic condition, she is growing increasingly weak and dependent. He asks her how she is, and she …
What happens when you can’t fix it? Tales from the home front.
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