After working a 10-hour Monday, I came home and wanted to collapse on the couch. It was a typical day of dealing with more needs and demands than what was humanly possible to meet. Specifically, I was chewing on what happened at the end of the day regarding a patient’s unrealistic demands juxtaposed up against a medical system that cannot meet the physical and psychological demands of the latest wave …
Managing expectations in the face of COVID-19
“Have you ever been to a new city and realized you’d been pronouncing a street or a town name all wrong? Have you ever been from one of those cities and has it broken your heart to hear someone call Copley Square Cope-ly? Or pronounce the Schuylkill River or Worcester …
A PSA from a neurologist to the medical community [PODCAST]
“Do you plan to cut down on your hours?”
This was what my primary care doctor asked me after she found me complaining about multiple somatic symptoms.
As a psychiatrist, I always took pride in how I prioritized my family’s needs and found a work-life balance. I had decided to work part-time as soon as I graduated from my training. I belong to a dual physician household. Going part-time was the best …
When primary care helps a psychiatrist
In the 21st century, all but one U.S. industry has used information technology (IT) to cut costs, increase access to products and services, and improve quality.
Health care is the lone exception. For decades, medical costs have risen faster than inflation — with spending now above $4 trillion annually. For patients, accessing medical care is both time-consuming and burdensome. Meanwhile, U.S. health …
Break the rules of health care with technology
Them: “I have never heard of this.”
Me: “That’s OK, let me explain what is going on. Your child has a condition called multi-system inflammatory syndrome in children, which we call MIS-C. We see this condition after a COVID infection where the whole body becomes inflamed, causing fevers. You get inflammation in the small blood vessels of your eyes and skin, which is why your son has red eyes and a …
Multi-system inflammatory syndrome in children: a pediatric hospitalist’s conversation
The 911 call came too late. Her daughter was 32 years old and usually quite healthy. But she refused the COVID vaccinations. She said she took her vitamins and was healthy and that “God is my pilot” and “I don’t want toxins in my body.”
Her mother knew she was running a high fever. She knew she was short of breath frequently … until…
Her 10-year-old grandson couldn’t wake his momma up …
The orphans of COVID: Who will care for them now?
You may be feeling hopeless. That wouldn’t be shocking, under the current circumstances. Reading the headlines, one can’t help but remember the beginning of the pandemic, when we were reading about “flattening the curve” and overrun, understaffed hospitals.
Additionally, the dark days of winter can be a difficult time for many, even under the best of circumstances. Losses from the year become highlighted, family dynamics are under strain, and we may …
Finding a pathway to hope: reflections from a psychiatrist
“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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