When I’m working in the hospital, I always find it interesting talking to patients about their medical history and experiences with outpatient physicians. I recently wrote about our broken primary care system. In fact, I’ll be stronger than that: Our primary care system is a tragedy, and it’s reflected in the comments I receive from patients. This is despite the best efforts of an amazingly dedicated number of doctors, …
3 reasons why patients are unhappy
The 2020-2021 residency application cycle was profoundly altered as a result of coronavirus disease 2019 (COVID-19) in the United States which led to a completely virtual season for nearly all specialties. At the time of this publication, pediatrics, obstetrics and gynecology, and ophthalmology have announced virtual interviews for the upcoming 2021-2022 cycle. Using lessons from the inaugural “virtual” cycle, many residency …
#PedsMatch22 and the social media imperative
“As I leaned against the pristine wall, my vision suddenly dimmed. Everything turned gray. I gulped for air. My arms and legs went numb. I felt that drowning sensation I’d had in third grade when a nun pushed my head between my legs to keep me from fainting in church on a …
A panic attack brought on by the stress of medical school [PODCAST]
Summer marks a flood of young new attendings hitting hospitals all over the country. There will also be many doctors whose first contract is coming to an end, and they are moving to a new position. Both of these scenarios create an opportunity to make a first impression at a new job. The effects of that first impression will linger for years to come.
What lingering effects do you want to …
Here’s the secret to establishing a great physician reputation
I began this journey in 2010. It began as a fresh-smelling breeze after a year and a half of anxiety, depression, and uncertainty. I did not think I would be a surgeon. I thought maybe family medicine, psychiatry — at worst, I would like gynecology. I outgrew the fear of the stereotypes and chose surgery for myself, despite what my now-husband warned me. He thought it would change me, depress …
Lessons learned from a general surgery chief resident
Words can be misleading. Medical terms work really well when shared between clinicians. But we can’t assume our patients speak the same language we do. If we “run with” whatever keywords we pick up from our patient’s chief complaint, we can easily get lost chasing the wrong target.
Where I work, along the Canadian border, “Valley French” expressions tripped me up when I first arrived. The flu, or in French, le …
When words mislead in the exam room
“Clinicians want specific things from a pathology consultation. They want a short turnaround time and a clear and coherent report, which can be discussed with the patient and correlates with the clinical findings. Unfortunately, this does not always come to pass, particularly with some smaller or disrupted specimens, resulting from minimally invasive …
Go behind the scenes with a pathologist [PODCAST]
My friends and I spent Thanksgiving 2018 attending surf school in Jacó, Costa Rica. We spent that week fully immersed in twice-daily surf sessions interspersed with conditioning, balance exercises, and of course, downtime to explore the town and rainforests of Jacó. Having been on a surfboard only a handful of times previously, this was a new experience for me. Our surf instructors quickly got us out on the water, and …
Feel the musicality: A surgeon explores how he learns
As the pandemic grew in Southern California, intubating COVID patients became increasingly dangerous. Initially, any patient with signs of respiratory distress was intubated, then sent to the ICU immediately. My physician colleagues and I all thought we were doing the right thing — until we saw all the complications of mechanical ventilation.
Instead of immediate intubation, we tried placing patients on high-flow nasal cannula (HFNC), a special nasal oxygen device that …
My most dangerous COVID intubation
The beer bottle that cracked over Christian Pean’s head unleashed rivulets of blood that ran down his face and seeped into the soil in which Harold and Paloma Pean were growing their three boys. At the time, Christian was a confident high school student, a football player in the suburbs of McAllen, Texas, a border city at the state’s southern tip where teenage boys — Hispanic, Black, white — sung …
A police shooting in a hospital forces a family to rethink American justice
“Yoga therapy differs from contemporary yoga in that the profession has a defined scope of practice based on educational standards and accreditation requirements for training schools and yoga therapists. In dealing with pain conditions, certified yoga therapists possess understanding and knowledge of pain theories and pain physiology and may collaborate with …
What to consider when recommending yoga to patients [PODCAST]
Last summer, Anna Ramsey suffered a flare-up of juvenile dermatomyositis, a rare autoimmune condition, posing a terrifying prospect for the Los Angeles resident: She might have to undergo chemotherapy, further compromising her immune system during a pandemic.
After an agonizing three-day wait, the results of a blood test came back in her online patient portal — but she didn’t understand them. As hours passed, Ramsey bit …
Doctors now must provide patients their health data, online and on demand
With about a year’s worth of experience practicing medicine, I can say with certainty that I’ve got a lot left to learn. I’m a medical student in my final year. In Estonia, we cover all subjects by the 5th year — and in the 6th year, we practice.
I applied for a medical license back home in Finland that allows me to practice medicine with a designated consultant. Having a consultant …
3 lessons I’m learning about practicing medicine
“We eventually got the news that Dr. Rathburn had hung himself from one of those beautiful trees that the wind made dance. How sad. It adds to my own grief. Who had found him? How did he look? Babies born with a nuchal cord have the cord wrapped around their neck. That’s …
A physician hung himself. That could have been me. [PODCAST]
In his 1862 novel, Fathers and Sons, Ivan Turgenev describes (spoiler alert) a death from sepsis in excruciating detail. There is nothing to do but comfort the man in the throes of mortality, his parents, and unrequited love at his bedside.
Today, thankfully, modern technology and processes can deliver a quick diagnosis and treatment, often saving the patient’s life and about two weeks of brutal suffering. Technology is essential, but attention …
When new technology is no match for old-school medical tests
A fellow forensic pathologist cornered me at a conference and told me her story in whispers, afraid to be overheard.
“You wouldn’t believe what happened to me.”
“What?” I said, leaning closer. “Are you OK?”
“I was asked to do a second autopsy by the family of a man who died in police custody. When I got to the neck, I …
Forensic pathology’s dirty secret
“Why else should a person become a doctor?
Because there is always something to learn. Because holding someone’s hand when they’re scared is a profound gift that feels as good to give as it does to receive. Because your job will call on you to be brave, honest, and the best human you …
A family physician shares her inspiration [PODCAST]
When a colleague in health care mentioned hesitation to get the COVID-19 vaccine in two separate instances, I was shocked and dismayed.
If we recommend vaccination to our patients, how can we not take the same precautions for ourselves?
With COVID-19 especially, anyone working in health care is exposed to many people and should be especially motivated to get vaccinated.
As cut-and-dry as this issue seems to me, I do remember similar issues …
4 steps to convincing health care colleagues to get vaccinated
Physicians are leaving the broken medical system at unprecedented rates. We continue through a war with an uncertain liberation day, and we are exhausted. Meanwhile, the only battlefront in which we have control is that of our mind. We have not been taught how to tame this beast. If we hope to thrive in medicine, we need to “capture our thoughts” and redirect how these result in feelings, actions, and …
10 replaceable thoughts (and 15 books) to help you survive burnout
“I firmly believe that if physicians leveraged themselves and their knowledge of medicine, there would be no need to for them to undertake ventures in the fields that they know little about. The old adage goes like this: Physician, heal thyself. I call on my fellow physicians to heal themselves by …
How this physician created a multi-specialty ambulatory surgery clinic from scratch [PODCAST]
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