So I am on the road again — sort of. What I do is work away from home, which isn’t quite the same thing. Where I work as a radiologist is not within commuting distance, so I stay at a nearby hotel. In general, that has worked out fairly well.
Not long ago, however, when I went to start the car after breakfast, I became immediately aware of a roaring sound.
The …
The world according to Steinbeck
This article is satire.
Good morning and thank you for flying SkyAnesthesia. I am your flight attendant, Dr. Jablonski, and my co-pilot this morning will be Attending Dr. To-Be-Named. This Boston-based flight crew is honored to serve you.
While our Team SkyAnesthesia, or TSA for short, does not utilize metal detectors, please remove all jewelry and body piercings prior to boarding. Please be sure to securely stow your belongings in the provided …
Good morning and thank you for flying SkyAnesthesia
Along came COVID, and no one was prepared. We had minimal PPE. We were told to put our N95 mask in a paper bag, use it on every patient, and use it for one full week. Normally the N95 mask would be disposed of after each patient room exit.
Health care staff was dying at the hands of COVID and lack of PPE. Over 115,000 health care workers died from COVID. …
The displacement of the health care family
“Stress is just part of the alcohol con trick. And the truth is that every benefit we have ever imagined alcohol giving us it doesn’t. It is a drug, and it works the same way as all other drugs.
Many of my clients are doctors and nurses, and some are …
Stress: Is it time to expose the alcohol con? [PODCAST]
When I was married to a physician, dinner was often delayed. When he finally came home, I was hungry if I hadn’t already eaten with the kids. Our dog would greet him with her whole body of yearning and relief, tail wagging furiously, whining, smiling, crying. She was the embodiment of what I felt but could not express. So I watched with jealousy as our dog received from my husband …
The difficulty in coming home: What doctors and soldiers have in common
Mental health has blazed its way to the forefront of the national conversation over the last decade. Increased awareness and decreased stigmatization around mental health issues have undoubtedly allowed many to have access to necessary resources, and the world is better off because of it. Influencers no longer shy away from discussing these topics, and employers are taking steps to create cultural change in …
Mental health advocacy applies to physicians, too
I spent the past year and a half of this pandemic getting a degree in quality, safety, and leadership. Though there were days, nights, and weeks where I simply did not know how I could finish the work or go on, I never realized how much I needed the work to help me process what is happening around us. To help me navigate my rage at the state of our …
We have been forced into a mass casualty scenario
“Crowdfunding models of paying for health care maximize the probability that all members’ eligible bills will be paid in full each month. These models come without the burdens of skyrocketing premiums and deductibles. Unlike traditional models, members aren’t chained to yearly contracts and have more flexibility and autonomy with …
Crowdfunding to pay health bills [PODCAST]
Stories of overworked and burned out, front line health care workers have been in the news since early in the pandemic. Job vacancies in health care and social assistance are at a record high, according to Statistics Canada data published in March of 2021.
At the same time, COVID has highlighted the persistent health disparities between white and Black, Indigenous and People of Color (BIPOC) …
I’m a burned out family doctor and racism is part of the problem
Despite protests from the medical community contained in multiple amicus curiae briefs, the Pennsylvania Superior Court recently ruled that the term “cause of death” on death certificates is ambiguous and should include any physician errors that contributed to the death — they were correct.
What they failed to consider was that, without an autopsy, the listed cause of death is often wrong, so using it to determine precipitating …
Do we really know why they died? The inaccuracy on death certificates.
March 2020. Administrators informed us that primary care physicians would be deployed to the “front lines” – either the emergency department or the COVID-19 wards. When I shared my news with my 21-year-old daughter, she cried and hugged me and said, “I don’t want you to die.”
Fate intervened, and I didn’t get deployed. By the time I was up, the numbers improved, and it was time to return to my …
What this primary care physician learned from her COVID-19 infection
My patient balanced precariously in the bustling hallway as she carefully removed her boots and slipped into lightweight sandals. My medical assistant offered to hold her purse and jacket as my patient held her breath and stepped onto the scale. Squinting at the numbers, my patient sagged in frustration. “Same as last year. Nothing I do ever works.”
By the time I met her in the exam room, the patient had …
Why you should not use BMI for your New Year’s resolution
There is value in reflecting on the most difficult experiences, as it affords an opportunity to examine how we act, react and change in response to the forces around us. The most difficult experiences in medicine are often not discussed, as there is typically not a space in which to begin such stories. So, without further preamble or justification, here is my worst experience in medicine, one which I’ve never …
“Virtually everyone understands the importance of major medical insurance as it relates to unexpected high-dollar care for severe injuries and significant medical conditions, but the value equation for health insurance is quite different when applied to coverage for primary care services.
The full potential cost for primary care services is neither …
Is direct primary care the answer to insurance-based problems? [PODCAST]
This article is sponsored by Masterworks, the art investment platform.
Jeff Bezos has been doing a lot of buying and selling lately.
In fact, he recently sold billions in Amazon stock to buy $70 million worth of this asset. And he isn’t the only billionaire accessing this $1.7 trillion …
I failed my Step 1 medical school board exam by 1 point. This was very hard for me to process, and I consistently wondered if I would have passed if I had just waited an additional week. This new challenge led me to reach out to a new resource: the disability office.
Never before had I considered my medical diagnosis of endometriosis and anxiety as a “disability.” I had obviously done …
Requesting disability accommodations in medical school
As I write this, a rapidly spreading COVID-19 variant called Omicron is the uninvited guest this holiday season. I’d hoped that the vaccine would have had more widespread acceptance, and we wouldn’t be in this situation, but this is our unfortunate reality now. In addition, COVID-19 has metastasized the already inherent bureaucratic cruelty of the U.S. medical system into death by a thousand slashes of red tape. I will explain why …
The bureaucratic cruelty that is modern medicine
“The data are remarkable and promising, though beyond the numbers is a bigger picture. Each data point represents a life – a mother, uncle, grandparent, loved one, friend. Technological advances in image guidance and therapeutic delivery are allowing us to extend life – and quality of life – for …
How MRI-guided radiation therapy is changing the paradigm in pancreatic cancer [PODCAST]
One of my favorite passages from sacred writings is the story of Moses, still tending his father-in-law’s sheep, an ordinary day in an ordinary place, suddenly encountering God, the ground he stood on now consecrated into holy ground, admonished to “Take off your sandals, for the place you are standing is holy ground.” All of the world’s religions speak of holy ground. For Muslims, even the simplest prayer rug in …
You are standing on holy ground
Nurse: “I need help with the computer; patient transfer needs to be completed.”
Me: “Ma’am, the patient’s medications are on ‘MAR HOLD,’ which means Medication Administration Record Hold. Therefore, we cannot administer medication unless an attending physician releases this hold. Can we get the physician on the phone for him to reconcile the meds?”
Nurse: Reluctant to call the physician, insists on completing the transfer at the unit manager screen. Finally, she …
Physician informatics demystified
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