I was on inpatient service and had already seen most of the patients on my list. I just had to see one more before I could call it a day and rush out just in time to take my daughter to her tennis lesson. I reviewed the patient’s chart to find out that her cancer had spread to her spine, which had incapacitated her to the point that she could …
A nurse is to a patient what a mother is to a child
I am a palliative care physician in a hospital in our nation’s capital region. Like most urban hospitals, ours has been hit particularly hard by the COVID-19 pandemic. My colleagues and I are exhausted and emotionally devastated. We are not alone. Yesterday I learned a friend of mine from medical school, a selfless and compassion-driven emergency medicine physician in Los Angeles, died by suicide. Before the pandemic, between 300 to …
A plea for help from the front lines of the COVID-19 pandemic
One of our most talented residents committed suicide during my psychiatric training. I remember relaxing with him in a VA hospital call room several months before his death, laughing together at some of the idiosyncrasies of our unit attending.
He opened up to me about his doubt in his choice in psychiatry and how he was considering a transfer into internal medicine. Having made the opposite transition just months before, I …
Doctors’ mental health: Don’t wait until it’s too late
“The corporatization of medicine has destroyed primary care as a specialty. The primary care physician is supposed to be your go-to doctor, your advocate, the coordinator of your health care. Now that corporations buy out hospitals and private practices in an almost predatory fashion, the priority is turning a profit for …
Rest in peace, primary care [PODCAST]
An excerpt from Tenacity in Children: Nurturing the Seven Instincts for Lifetime Success.
Did you ever wonder why babies quickly develop a social smile and look you in the eyes? Is it surprising to learn that the muscles in your ears are set within the range of women’s voices at birth or that babies prefer looking at women’s faces …
Tenacity in children and the 7 instincts
I was trained in delivering bad news.
I knew what to expect.
I knew the questions that would come.
I have learned the stages of grief.
More importantly, I had done this before many times in the past 15 years.
This is my job and my responsibility, I told myself.
I got to work earlier than usual, diffused some comforting essential oils, and did my routine 10-minute morning meditation. Then I slowly sipped my tea and …
Physicians should heal themselves first
In a moment of caffeine-depleted delirium, I volunteered to head the creation of a “notes committee” for my 80-member hospitalist group.
I placed myself on a 72-hour hold and quickly established a group consensus: “Bloated notes are a huge problem and a time suck. I’m glad you [rather than me] are working on this. My notes are fine, though. It’s other people’s notes that are bad. Other people’s bad notes are …
Bloated notes are a huge problem and a time suck
“For physicians who lack experience in end-of-life counseling, the process can be daunting at the beginning. However, they can be confident that once they have obtained the proper training, preparation, and experience, these conversations will be among the most fulfilling of their careers. By regarding end-of-life planning as a shared responsibility, …
End-of-life conversations: Embrace the responsibility [PODCAST]
United States health officials have lifted the 10-day pause of the Johnson & Johnson (J&J) COVID vaccine. This pause dealt a devastating blow to the nationwide vaccination effort. The seven-day moving average of vaccinations in the U.S. peaked right before the pause, and has been trending downward. Fear of developing blood clots is adding to vaccine hesitancy. Moving forward, …
Social math is key to J&J vaccine hesitancy
“Nowadays, I go on long walks through the city alone. I make dinner for one. When I go on bike rides, it’s a solo activity. I find comfort in myself, slowing down and making every small occasion a simple, peaceful one. I have a stronger sense of self, and through that, I …
Falling in love during a pandemic: a medical scribe’s story [PODCAST]
During this pandemic, do we blame people for acquiring COVID or do we empathize?
I wonder this as I read a message from my senior, who mentions that people are suffering or in isolation due to COVID because of their own negligence.
My mind reflects back on all the dying doctors who caught the infection while treating the virus. And then, there was the ophthalmologist in Wuhan who diagnosed the virus, the …
I’m a doctor who had COVID. Did I deserve this? Does anyone?
I’ve been limiting my COVID-19 related engagement with social media because this has been a rough year. I like being a resource for my loved ones about COVID-19 stuff, but it feels never-ending.
A friend of mine asked me to weigh in on a letter sent to our local school board. It claimed that masks in school were a direct assault on human rights. This letter listed …
I may be damaging my brain this year, but it’s not from masks
“Every professional I have done the exercise with admitted that their ideal patient was inspired by someone they were close to in their personal life. It was usually a family member, a best friend, or themselves. The ones who carry the most unbearable sufferings-the kind that reminds us of ourselves and …
An acupuncturist’s take on the doctor-patient relationship [PODCAST]
An excerpt from Love Is the Strongest Medicine: Notes from a Cancer Doctor on Connection, Creativity, and Compassion.
For nearly two decades, I’ve been telling my oncology patients, with only a little irony, Welcome to your new normal. There’s no getting around the fact that a cancer diagnosis—for you or someone you love—is life-changing. Sometimes those changes are temporary (even …
Love is the strongest medicine
“The science of complexity lays a conceptual foundation for understanding “complex adaptive systems.” What all complex adaptive systems have in common is that they are all bound by the same set of physical laws. Their “behavior,” i.e., growth, maintenance, and death, can all be described using the same set of mathematical relationships. …
What role does the science of complexity play in medicine? [PODCAST]
I am a psychiatrist who volunteers his time on the clinical faculty of the local medical school. This is a role I have valued over the years that has allowed me to give back and mentor young residents as my senior colleagues did for me during my training.
Recently, I had a chilling experience that has caused concern and pause. I was supervising a first-year resident who was presenting a patient …
When an attending was canceled by a resident
In the face of genetically engineered therapies for many cancers and the incredibly rapid development of effective vaccines for COVID-19, it’s easy to lose sight of the breadth and depth of unsolved puzzles in medical science. Many of these remaining mysteries may be at least partially resolved as we overcome the mind/body dichotomy. A fascinating example of this issue has emerged with recent evidence of the excessive prevalence of Type …
Type 1 diabetes in transgender children and adults
“As health professionals, we have the platform to enact change within our own institutions, as well as local and federal governments. We must elect leaders and officials who spearhead climate action. We must reduce the carbon footprint of healthcare. And we must educate our colleagues and our patients about the impact of …
What medical professionals can do to take climate action [PODCAST]
On Twitter @jpegjoshua recently posted about a staggering health care bill for going to the hospital for a life-threatening condition and then receiving an outrageous statement, which reminded me of a similar story that I had.
I also received a bill for nearly $40,000 but luckily managed to have it cleared through an unmentioned secret. For me, it all started the second …
A secret for my $40,000 health care bills
American medicine is facing an identity crisis. The COVID-19 pandemic brought renewed attention to socioeconomic health disparities and turned up the heat on the question of whether health care is a right or a privilege. The financial strain on hospitals resulting from the temporary postponement of scheduled surgeries exposed a vulnerability caused by an inherently flawed payment system.
The answer to the right versus privilege question has much more significant implications …
Health care as an uncommon good
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