“Currently working in a COVID ICU in a tertiary center in Kathmandu, I have experienced how difficult it is for the health system to manage the patient load. A month ago, ICU beds were fully occupied, ventilator alarms would set off time and again, indicating low flow as the hospitals …
Telemedicine in Nepal during COVID-19 [PODCAST]
In 2009, I came across the white paper written by Satoshi Nakamoto describing a digital currency based on a peer-to-peer network, completely independent of central banks, autonomous, decentralized, digital, and would give access to finance and banking to the masses.
This “magical internet money,” as it was described at the time, would come to be known as Bitcoin.
The reason that this paper was so revolutionary was that it was prescient of …
Should physicians invest in cryptocurrency?
U.S. COVID deaths have surpassed U.S. war deaths from World War II, Vietnam, and Korea. The unvaccinated are a fifth column that has ushered in a wave of nasty COVID variant infections in the United States, with their attendant deaths, costs, and disruptions to society. We need to stop debating the tone in which we address the unvaccinated and label their sabotage for what it is. We need to start …
The fifth column brings a fifth wave
I’m currently reading What Happened to You by Oprah Winfrey and Bruce D. Perry, MD, PhD, and being reminded that I react rather than respond when I am in a trauma activation. When that happens, I don’t have access to higher cortical functions like critical thinking. And as Gabor Mate, MD, would say, I don’t respond to what’s happening; I respond to my perceptions of what’s happening. And actually, I …
How a physician learned to stop reacting to overnight calls
“Until recently, voice changes from menopause and aging have been almost unmentionable. If a woman talked about her challenges, especially if she was a professional singer, it could have meant decreased opportunities and even the end of her career. Most women have stayed silent, coping as best as they can, …
Menopause changes women’s singing voices [PODCAST]
On April 5, 2021, the federal government mandated that health care providers provide free electronic access to patients’ clinical notes, as part of the 21st Century Cures Act. This includes 8 types of notes spanning outpatient and inpatient arenas. If providers/organizations do not comply with this mandate, they will be subject to fines due to “information blocking.”
This was borne from the OpenNotes movement – which declares itself to promote and …
How medical notes will change if patients get to see them
First, you turn off your phone. You can’t have any interruptions. As you walk to your patient’s room where the family is waiting for you, pick up a box of tissues and put it in your back pocket. Don’t hold it in your hand as you meet them. It’ll betray their new reality.
When you enter the room, you introduce yourself to everyone as the doctor. You find a seat to …
How to tell someone their loved one died
“We can’t sit in the stands – we have to get messy and play on the field.”
The casual observer, the season ticket holder, the player, and the coach have very different levels of knowledge, skill, and passion for a professional sport. The casual observer may be confused, not even understanding the fundamentals of the game. The season ticket holder likely has some experience with the sport, possibly playing as a …
Getting messy in the game of health care
“A rough career transition in 2019 followed by the pandemic highlighted how I was still financially tethered to my job — after 10 years of practicing as a subspecialty trained radiologist, saving, maxing out my retirement accounts, and investing in the stock market and in real estate. Looking around, I …
How doctors think about financial independence is dead wrong [PODCAST]
Woodworking / Illustration
The problem with the act of taking medications is that it’s so mundane that we don’t see any problem with it.
This machine-cut, flat, unemotional, same-size-fits-all object that we defencelessly welcome in our very private body has a role. Medications occupy our existence by interlocking with our cells and taking control of our body, fighting, provoking, sedating, and changing the music …
The ritual of taking medications: the pill wheel
But seriously, who needs scientists? It’s not like we listen to researchers or pay attention to the warnings. The world is burning up with record ground-breaking temperatures. These so-called scientists predicted these warnings decades ago, with great details. Who do they think they are? They got lucky! They are fear mongers and not to be believed. Look at the fake media! Landslides, earthquakes, fires, flooding, drought, and the list goes …
Who needs scientists? It’s not like we listen to them anyway.
“With this single word, mom had now completely altered her willingness to see the deep suffering of her child. This single word watered all of this child’s five years of depression, crippling anxiety, history full of ACEs, and very significant struggle down to a simple, selfish, flippant choice.
Furthermore, mom …
How one word may have harmed my patient [PODCAST]
My husband and I recently had a bit of a wobble in our marriage. In truth, it was more than a wobble, and it had been building for years. I am pleased to say that we have traversed the turbulence. Not only are we once again sailing in smooth waters, but we are sailing in more idyllic waters than ever before.
Why did it happen?
For so many reasons, but I need …
Why this physician and her husband almost divorced
“While we still lack a complete cause and effect model of Alzheimer’s disease, there is no doubt that the etiology is multifaceted and nonlinear. This accounts for the fact that it takes an incredibly long time for Alzheimer’s disease to develop. I mention this because one of the major problems …
Does Aduhelm mark the return of science-based medicine? [PODCAST]
Oh, how the tide has turned. Three months ago, COVID was ravaging my homeland, India. The Delta variant was burning through the country like an uncontrolled wildfire. People carted dying relatives town to town, desperately seeking hospital beds or a whiff of oxygen. A cousin in India said, “COVID is not taking lives, just the beds. Lack of oxygen is taking lives.”
I watched India’s suffering unfold and felt guilty for …
The Delta variant is a monster and our last weapon is the unvaccinated
The COVID-19 pandemic spurred an avalanche of mental health issues that have continued to plague the general public over the last 18 months – with the full impact from lingering quarantines, prolonged social distancing, and now the fear over the unknowns of new variants. In fact, nearly 70 percent of working adults say this has been the most stressful time period of their lives.
Fortunately, along with the unprecedented surge …
Debunking common virtual therapy myths and 4 tips for new patients
“Dehumanizing patients can lead to indifference in physicians. It is a privilege to be trusted to take care of every patient we encounter, yet we can lose sight of this and begin to see our patients as a burden, or as units of work, rather than as individuals. When individual …
A neurosurgeon’s lessons on love, loss, and compassion [PODCAST]
My son is a fourth-year medical student, and we have had some great discussions about credit cards recently, including their benefits. I believe this information would be helpful for all medical students to consider.
As a student my son once preferred to use a debit card or cash to keep his expenses controlled. This financially conservative approach is what he was taught during his young adult days in our home. Avoidance …
4 reasons you need a credit card in medical school
“Toward the end of my clinical career, I didn’t feel like I had control over much at all. The patient safety issues loomed large. We used ridiculous workarounds for broken processes. The constant vigilance to provide excellent care in a suboptimal environment was exhausting. I didn’t see anything I …
Physicians’ sense of powerlessness and being a cog in a wheel [PODCAST]
Four years ago, I was ready to throw in the towel. I practiced for 22 years in a large metropolitan hospital, became very involved in resident education, clinical program directorship, medical staff affairs, in addition to a busy hospital-based surgical practice. I watched as the environment of care for clinicians and the quality of the relationship between the medical staff and system administration steadily deteriorated.
My small, single-specialty surgical group merged …
Ageism and the mid-career physician
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