“All the faceless young men who are brought to his operating table, prepped and draped, broken and bleeding, are finding their experience of war bears little resemblance to their reveries of war. They should have known better. At corner taverns in Chicago, Albuquerque, and Murphysboro, there were tired veterans with …
Lessons in caring too much from a fictional physician [PODCAST]
An excerpt from Rheum for Improvement: The Evolution of a Health-Care Advocate.
Their expert witness, “Dr. Z,” was simply a hired gun willing to do their bidding for a price. He had completed only one year of a rotating internship in family practice in the 1960s. He had not done a residency and had no rheumatology training. He had not seen …
Publicity and sharing our experiences are our best tools against legal injustice
At the beginning of August 2021, during the early stages of opening my practice, I decided to take an opportunity that I would be forever grateful for. The organization International SOS was looking for physicians and other health care providers to join a massive once-in-a-lifetime operation at Fort Lee military base.
At the time, the country was attempting to end the war in Afghanistan quietly. We were told that there would …
What it’s like to work with International SOS
Anyone can win at poker when dealt a royal flush. But what can you do when the cards you are dealt don’t appear winning at all? My answer: Make the best of what you have.
Recently I learned of a colleague who sustained a broken back in an accident. He continues to work, wearing a brace and not taking pain medication. I know from watching his videos that he routinely handles …
Playing the hand you are dealt
A 37-year-old man was diagnosed with Lyme carditis after presenting to the emergency department (ED) with fever, weakness, history of tick bite, and prolonged PR interval of 394 ms (a type of heart block) and positive Lyme testing. In the ED, second-degree AV block was noted intermittently on the monitor but not documented. Both infectious disease and cardiology were consulted, and the recommendation was to continue IV ceftriaxone for 28 …
Why I’m furious over observation status
Once hailed as “The Paris of the Caribbean” the city of San Pedro de Macoris (SPM) was established in 1822 and became one of the major producers of sugar, molasses, bovine cattle, rum, and Major League Baseball players.
In the mid-1800s Cuban immigrants threatened by a slave revolt and their own war of independence, settled in SPM and established the country’s first “ingenious” or sugar mills or bateyes. They brought their …
San Pedro de Macoris: a physician’s photojournal
“No matter what, your healing work matters. No one should tell you otherwise, and nothing can change that, not even a shortcoming. You provide healing in a way no one else can. Care for yourself, and you can be the healer you truly wish to be.”
J. C. Sue is a …
A physician’s self-care song [PODCAST]
As we anticipated the release of new CDC data on overdose deaths, those of us who specialize in substance use disorders braced for grim statistics, but this milestone was still shocking: over 100,000 lives lost to overdoses in one year, the great majority from opioids. Overdose deaths began outpacing traffic fatalities in the United States in 2013, but 2.5 times as many people died from an …
The status quo is failing people with opioid use disorder
It became a prison to me — impending doom.
I knew I had only three months left before I could retire. Three months isn’t long, but it is a lifetime away.
That long drive to work in that heavy highway traffic where there was always a collision. The anxiety of the drive knowing all along there was even more anxiety to come.
The patients that were involuntarily committed — forever schizophrenics and bipolar, …
From the prison of my job to freedom
In late November, the state of the COVID-19 pandemic shifted once more when South African scientists reported the discovery of a new SARS-CoV-2 variant named Omicron. When panic surrounding Omicron’s emergence set in, numerous countries instituted travel bans on South Africa and neighboring nations.
As a medical student, I have begun to examine COVID-19 epidemiology and policy decisions more closely. Given that Omicron is already circulating globally and …
Why travel bans in response to Omicron are harmful
I understand what it feels like to be in the depths of depression and hopelessness. I have had a lifelong battle with stuttering, obsessive-compulsive tendencies, depression, and suicide.
I continually fight these battles and have learned to heal and recover through family, friends, and ultra-running. Since attempting to take my life on September 12, 2009, I have developed wellness tactics to help me journey through life to achieve optimum performance and …
Coming back from the brink of burnout
Thank you, Dr. Kara Pepper, for your recent article “Why you should not use BMI for your New Year’s resolution.”
Our weight-obsessed, BMI-focused culture has been a thorn in my side for much of my life. And since eating disorders thrive in secrecy, let’s get talking. In sharing my story, I hope to encourage revision of the way we speak to patients and utilize (or do not utilize) …
Eating disorders thrive in secrecy, so let’s talk about it. Starting with BMI.
Welcome to a special episode of The Podcast by KevinMD.
In this 60-minute episode, I partner with DrFirst, a pioneer in health IT for over 20 years. We bring together physicians with different backgrounds to explore information overload and physician burnout.
Dr. Sameer Badlani is chief digital officer, …
Information overload and physician burnout: a KevinMD panel discussion [PODCAST]
Remember in Jurassic Park when Ian Malcolm describes Chaos Theory to Ellie Satler, watching a drop of water roll down her hand? It might roll to one side or the other based on any number of differences in the hair on her hand, subcutaneous blood flow, imperfections in her skin, all tiny variations in a complex system, affecting the outcome. The scene came to mind last week when in 24 …
Please don’t stop fighting for what brought you to medicine: a tale of 2 physicians
I’m angry. The sound cut out again, for the fifth time in the last hour. “Why can’t I get through one telemedicine visit without some technical problem?” I ask myself. I can feel the chest discomfort, my shoulders tense, I start to flush, tell-tale signs of frustration and anger bubbling up. I did not go to medical school to become tech support. After 12 patients, it’s finally time for lunch. …
Telemedicine exhaustion is real
“There is nothing like staying at home for real comfort,” says James Austen. So, instead of traveling and waiting for hours by standing in a queue, what if health care is provided to you at home? That’s why home hospital care (HHC) is a viable solution for physicians and patients. HHC is an innovative, technologically advanced, and effective care model in which certain patients receive hospital-level care at their homes …
Is home hospital care the way forward?
Pediatric cardiac anesthesiologist, woman, mother, wife, friend, mentor. I can’t remember a time when I wasn’t trying to “work smarter, not harder” to get it all done and feel good about myself, only to begin climbing the mountain with a fresh list the next day. My goals were simple: peace of mind and a sense that I was in control of my life and doing a good job for all …
The new rules of time management
“For me, my own personal stories of opioid patients come to mind, including one who keyed my car when I stopped prescribing his opioid after an acute injury. I think of some local opioid overdose deaths in my community. I would love to hear what other doctors and clinicians have …
Coal mining culture and the opioid crisis [PODCAST]
Every primary care provider has been there. A patient comes in requesting a pre-operative evaluation or places a phone call or EMR message expressing the need for “clearance” before having a surgical procedure. Sometimes, we even get a request from the surgeon’s office with paperwork for “clearance.” Time is always, seemingly, of the essence regarding these evaluations, and either the patient or the operating surgeon requests this be done expediently …
I’m sorry, but I can’t “clear” your patient
Medical school is like a tennis match—a series of short sprints and challenges that, when put together, tell a larger story. Unlike tennis, however, everyone can win. Being “successful” in med school has multiple meanings—from caring for your rural hometown, working with your institution to implement a racism in medicine curriculum, and matching into orthopedic surgery. No matter how you define “success,” there will be bumps and potholes along the …
6 tips for success in medical school
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