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
About a year ago, I was referred to a sleep clinic and was diagnosed with “very mild obstructive sleep apnoea” (OSA). A continuous positive airway pressure (CPAP) device was recommended with a litany of disorders that would occur (heart disease, CVA, HTN, decreased mortality, motor vehicle accidents, etc.) if I did not use the apparatus consistently and properly.
I assiduously used it for two test periods. Though the physician reported improvement, …
A medical ethicist asks questions about CPAP
“Instead of focusing on one organ system, I want to know everything. The diagnostic challenge is to discern patterns of insults, symptoms, and lab tests that correlate with specific microbes, specific organ dysfunction, specific diet issues, and environmental exposures. We keep asking questions until we detect patterns in the chronically ill …
Our work as physicians and healers is to see the whole patient [PODCAST]
The 2021 residency match “capstoned” the inaugural virtual interview season. Interviews may likely continue to incorporate some virtual aspects given the realized efficiencies. But these efficiencies come at a cost: limiting the applicant’s ability to get a feel of the programs and adding virtual fatigue to the inevitable stress of interviews.
As two medical students who participated in this most recent interview season, here are a few best practices we encountered …
Best practices in virtual residency interviewing
I once spoke at a leadership forum on opioid abuse. I was asked to speak about the role of hospital systems in addressing this important issue. As I thought about what I would say, I realized there was very little I could add. The crisis is epidemic, and hospitals are ill-prepared to do anything proactive. It is that overwhelming. Leading medical missions, I learned an important lesson that …
A physician’s personal story with opioids
“Suicide is a path, whether fast or slow, that a person chooses to take because of their own reasons. We certainly can never predict suicide or truly understand it. But with that said, every time it happens, it is a tragic loss of life that time can and will never heal.
We must …
Physician suicide: We need safe spaces to talk about it [PODCAST]
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