I am hanging up my stethoscope and exiting the ambulance bay doors for the last time. I chose emergency medicine to care for critically ill and injured patients, and I’m leaving because this has become near impossible.
I believe it imperative to share some of the reasons that I, and many like me, are leaving a field we once loved, as their ramifications will sooner or later impact you and those …
Why I’m leaving emergency medicine
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“While the world has spent the last two years laser-focused on the COVID pandemic, another public health threat is still lurking in the shadows: the rise of antibiotic-resistant bacteria. Antimicrobial resistance (AMR) has been recognized since the …
Combating antimicrobial resistance during COVID [PODCAST]
It was 2:21 a.m., and the pager exploded in my ear like I had forgotten to turn the volume down before plugging in my headphones. The nurses told me your heart rate was getting faster, and your oxygen was dipping lower. When I made it to your room, you were laying in urine because you were too weak to stand. Your breathing was rapid and shallow, like you were caught …
The art of medicine is born in the unforeseen
My sister didn’t want to die from breast cancer. In the six years since her diagnosis of stage 4 breast cancer, she fought valiantly to stay healthy and to continue to live. A superb oncologist put her cancer into complete remission, which lasted for some time before it reappeared in distant lymph nodes but not in any viscera.
One weekend she complained of severe stomach pain and sought help at a …
“They may say I can’t sing, but they can never say I didn’t sing.”
– Florence Foster Jenkins.
I was a bachelor over the weekend. My wife Beth was in Columbus at a horse show, just killing it, while I languished at home in The Land with the dogs. Much of what a summer typically includes has been stolen by the traitorous behavior of my “good hip.” Where my left hip only …
When the time comes, be sure there’s something to retire to
Reading many articles on burnout, physicians are understandably frustrated with being asked to be more resilient in the face of the pandemic, staffing shortages, and oppressive systems, to name a few. Often, when wellness is eluded to, physicians are encouraged to take better care of themselves or show “resilience” when truly what’s going on is that we’re asking them to adapt to unhealthy systems and show intense perseverance without signs …
We’re confusing resilience with grit
If “video killed the radio star” and Zoom squelched the commute, it seems certain that virtual reality and three-dimensional imaging will be the death knell for cadavers.
Recently, NBC Nightly News did a story featuring staff members from Case Western Reserve University’s School of Medicine using the metaverse and 3D imaging to map out the details of an upcoming complex brain surgery. No matter that the four participants were in different …
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“Every January, millions of people make New Year’s resolutions. It’s a joyous time full of high hopes.
Ask people what they wish to achieve or hope to accomplish in the following year, and the answer will usually be …
Secrets for managing time, stress, and people [PODCAST]
Hatred doesn’t have to have a motive. Hatred does because hatred can.
Hatred can disguise itself as a man dressed as a woman. Hatred does because hatred can.
Hatred can get guns and weapons and kill innocent people celebrating their freedom on July 4, twenty-five miles outside of Chicago. Hatred does because hatred can.
Hatred can be arrested without incident. Hatred does because hatred can.
Hatred has the privilege of being denied bail and …
The why doesn’t matter: Highland Park
In a crowded primary care clinic in an inner city, Mr. Smith, with pursed lips, was sitting next to his oxygen tank and waiting patiently for his doctor. He gratefully commented on how much the oxygen tank had helped him with his daily activities. However, his recent Covid-19 infection had exacerbated his symptoms. It had been more than two weeks since he started coughing. He couldn’t wait to see his …
Fill mid-level positions with unmatched medical graduates
As the pandemic-stricken health systems recover from the unprecedented challenges that tested them for preparedness, agility, and health equity, the pandemic undoubtedly also nurtured rapid innovation in telehealth, vaccine manufacturing, and point-of-care diagnostics, which have streamlined and accelerated patients’ access to immediate care at the point of need.
These technological medical advances, especially in the realm of point-of-care diagnostics, are transforming our health system in three especially important ways:
Firstly, point-of-care diagnostics …
Immediate, accurate diagnosis is crucial to the future of equitable patient care
We knew the job would be tough but never considered how tough. Demanding jobs should be compensated accordingly, but what is the correlation between job choice, toughness, and salary? Is no job too tough as long as they pay you enough?
After residency, I narrowed my options down to two private practice positions. One was a small group practice with one office location and a higher call burden in the Midwest. …
Toughness is not infinite and is not defined by a dollar amount
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“Nowadays, even scientific fact has been politicized. Even though many of us may wish to stay out of politics and stick to our “nobler” lane of medicine, the reality is even your clinical practice could be considered …
Activism is a part of medicine and we cannot remain neutral [PODCAST]
For years, residents have tried valiantly to extract themselves from the hospital by physically moving out of the premises or reducing duty hours. Now it may be time to return.
Rents are rising, and in the major metropolitan areas where most residencies exist, this is being felt acutely. Salaries are generally static, but rents have risen about 7.4 percent compared to last year. Doctors come into residency with enormous …
It’s time to retake the call room
Did you assume that your life would be magically perfect once you finished training?
I know I did.
I fully believed that once I graduated from my fellowship and became an attending, everything in my life would just fall right into place. Somehow my finances would be simple, my marriage would be great, I would be an amazing mother with well-behaved children, and things would be easy.
Wrong.
So many of us have this …
Want to stop going through the motions and actually have the life you dreamed of? Try this.
Burnout. We define, measure, and talk about it endlessly but do little to fix it. Unchecked, it can lead to medical mistakes, career dissatisfaction, early retirement, provider suicide, and excess costs. With the recent pandemic, the public has become more aware of it, but action to fix it is still lagging.
Feeling underappreciated, feeling one’s work is meaningless, feeling powerless to make changes, and feelings of moral injury are but a …
No wonder doctors feel like hamsters running on an exercise wheel to nowhere
As my patient’s face slowly became visible on the computer screen, I smiled and waved to her. She waved back with vigor.
She was a Cuban housekeeper who arrived in Miami during the Mariel boatlift in 1980. Now in her mid-60s, she had recently been diagnosed with leukemia and endured a two-month hospitalization during which her bone marrow grudgingly entered a remission, following an onslaught of chemotherapy. She was now back …
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“With schools closed, children spent hours upon hours sitting in front of a screen for instruction and homework. Non-academic screen time increased as well, with parents needing to work from home and thus relying more on screens …
Reversing the impact of the pandemic on childhood obesity [PODCAST]
An excerpt from Tornado of Life: A Doctor’s Journey Through Constraints and Creativity in the ER. Reprinted with permission from The MIT Press. Copyright 2022.
The appendix is a body part with an image problem. Derived from the Latin word for “hanging on,” the term can mean a bodily outgrowth or …
The appendix: an ancient organ for the modern age
International medical school graduates (IMGs) play an integral role in the health care system of the United States and constitute approximately one-quarter of the physician workforce. In 2022, fewer IMGs registered for Match than in 2021, with a match rate of 58.1 percent. The transition to USMLE Step 1 pass/fail, elimination of Step 2 Clinical Science, and implementation of secondary application will likely impact IMGs in their 2023 Match. Here …
9 ways international medical graduates can boost their residency match outcomes
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