“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]
When the “opioid crisis” is mentioned, most people think of heroin, prescription pills like oxycodone, or — more recently — the powerful synthetic opioid fentanyl. Fewer people would think of novel opioids like tianeptine, although an increasing number of Americans have taken this substance in the form of over-the-counter supplements like ZaZaRed or Tianna – often without knowing that the substance has opioid properties that can cause dependence and overdose. …
The complications of drug regulation
An excerpt from You What?!: Humorous Stories, Cautionary Tales, and Unexpected Insights About A Career in Medicine.
The relationship between physicians and nurses is a complicated one. We are both there to “Take care of the patient.” Each has their own role. Doctors are undeniably in charge of ‘their patient’s care.” Particularly in an operating room. Somebody has …
Be nice to the nurses. Respect the nurses.
“The hospital systems ignored us by putting us lowest on the totem pole for the COVID vaccine. The pharmaceutical companies overlooked the strains on us and increased our vaccine prices. The medical supply companies took advantage of us by limiting our supplies and increasing prices astronomically. Worst of all, the insurance companies …
Being a private practice pediatrician in a pandemic [PODCAST]
The current COVID-19 vaccines have been developed with unprecedented efficiency and speed. Years of research, development, production, and regulatory approvals have been compressed into months. But accelerating the science is only half the puzzle. If we want to save lives right now, we need to improve the messy, inequitable implementation process of COVID-19 vaccine distribution.
As newly minted (and gratefully vaccinated) physicians who have had the privilege of contributing …
How creative solutions to inequitable COVID-19 vaccine distribution can save lives now
As a family physician, guest lecturer at a local medical school, and creator of a pre-med curriculum for young learners, I’m often asked by parents how to support their child who wants to be a doctor.
The most important point to remember is that you don’t need to have any science background or be a professional of any sort to support your child. We all want to help our children follow …
“We need to shampoo the patients’ hair,” said Kristen, a physician assistant with a two-foot flaxen rope of her own. She’s an authority. Operating room nurse Jess seconded the idea. Between the two of them advocating, it needed to happen.
Somehow for the last 23 years, as a man with short hair, I’d always considered a rinse with water or peroxide to be sufficient to clean a patient’s scalp and hair …
How washing hair taught me to be a better doctor
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