It was past midnight in the ED, and she was writhing on the bed, palms clutched over her abdomen. I pulled up a stool, notebook, and pen in hand. I was ready to listen to Mrs. Walker’s story. But I also felt a sense of dread rising: From a quick chart review, I knew that Mrs. Walker had 23 negative CT scans for abdominal pain within the last 18 months. …
“Difficult” patients: Is it them or is it us?
“COVID-19 disproportionately impacts those with pre-existing conditions, and our health care system leaves one in five Americans with a pre-existing condition uninsured. Further, with multiple COVID-19 vaccines already in early but slow distribution, attaining universal coverage is critical, particularly in light of uninsurance having an inverse relationship with vaccination rates.
President Biden …
President Biden’s quest for a public option [PODCAST]
It is not a secret that being a physician can be exhausting and time-consuming, but do most nonphysicians really know what it’s like to be one? The answer is a resounding no. Television glamorizes the role of the physician and hides the tedious everyday realities. Spouses and partners of physicians know too well the frustration of having a partner that seems to be “always working and not shutting work off.”
Being …
The soul-sucking, energy-draining life of a physician
When I sat down to write this article, my thoughts immediately went to the tragic loss of one of my best clients, a physician who recently passed away after battling COVID-19. I remember him not only as an excellent physician but even more so as a great person.
Unlike many physicians I speak to in the course of my work, this client had the foresight to do some careful estate planning. …
8 estate planning mistakes for physicians to avoid
“The patient knocking on your door is not your enemy. They’re sick. They’re scared. They’re in pain. They don’t know why, and they’re hoping for an answer. If you can’t find the source of a problem quickly, it doesn’t mean it’s not there.”
Denise Reich is a patient advocate.
She shares her story and …
Patients don’t need quick diagnoses. They need accurate ones. [PODCAST]
Before you jump on the diet bandwagon with your brother-in-law (who’s crowing about shedding all that weight with so little effort), think about the potential downside.
The problem with an ill-thought-out diet:
Fad diets are designed to take off weight as quickly as possible. They often ignore the long-term effects that might occur regarding both the brain and spine. Someone embarking on a radical weight loss …
Think about your brain and spine before you start that new fad diet
Many who know me might be shocked by this: I shot my first pistol when I was 8 or 9, taught by my father, a physician, aiming at targets in our basement. At summer camp, I loved riflery the way some kids loved art. Staring through the sight, down the barrel, I proved an excellent shot, gathering ever more advanced medals from the National Rifle Association. As a reward, for …
I was a teenage rifle owner, then an ER doctor
Four months into the largest U.S. vaccine rollout in decades, it’s become clear that the messaging surrounding COVID-19 vaccination efforts is as important as the science behind them.
That was true when the first COVID vaccines were introduced in December at hospitals and nursing homes and even more so after the federal government on Tuesday paused the Johnson & Johnson vaccine after reports of extremely rare but very serious — in …
The J&J COVID vaccine pause: What the experts are saying
“I can tell you what I don’t want to do. I don’t want to mill through 50 patients a day, mindlessly clicking through EMR checkboxes so an insurance auditor five states away will deem that I’ve done my job and deserve reimbursement. That’s a high volume, high overhead game, and I …
Meet the orthopedic surgeon who stopped taking insurance and does house calls [PODCAST]
What is this potential side effect of the J&J vaccine for COVID-19?
The potential side effect is a blood clot in the veins that drain blood from the brain. This is called central venous sinus thrombosis. In the vaccine-associated cases of this, platelets in blood, which are important for making clots, have been lower than normal. While …
Johnson & Johnson vaccine suspension: What this means for you
“Humanities can be seen as part of the fabric, society, and culture of human experience. In many ways, they might be seen as the disciplines that make us human and make life meaningful. They broadly encompass ancient and modern languages, literature, philosophy, religion, visual and performing arts, such as music and theater. …
Harness the power of the humanities to counteract burnout [PODCAST]
I sat in a crowded auditorium listening to an attending at a renowned medical institution give a lecture. I didn’t know the answers, and shrouded in imposter syndrome, I avoided eye contact. The visiting medical student from Mexico answered the question, and the attending moved on. Another question came. Again, the medical student from Mexico answered. The attending chuckled and said, “OK, Cinco de Mayo,” an exaggerated emphasis on the …
The daily micro- and macroaggressions of being an underrepresented minority in medicine
Providing primary care to patients with mental illness is a challenging task that requires highly skilled and experienced practitioners comfortable with the full array of biopsychosocial problems with which these patients present. For example, understanding the side-effect profiles of psychiatric medications and their impact on problems such as diabetes and other complex endocrinopathies requires highly evolved clinical skills.
Optimally, the successful care of these patients is best provided in close collaboration …
Avoiding the pitfalls of integrating primary care into community-based mental health centers
“Most residents are young, often in their mid to late 20s, having spent years ensconced in libraries, research labs, and classrooms learning pathophysiology and pharmacology. Upon graduation from medical school, they are now drafted to the front lines of a generational pandemic, working long hours, often in cities where they are …
In gratitude to our nation’s residents [PODCAST]
For many years, I have treated individuals with substance use disorders. I have found this work to be both gratifying and frustrating. Part of the frustration stems from interactions with governmental agencies and families.
The families are, of course, fearful and frustrated. They are watching their loved ones “die” before their eyes and want someone to fix it. It is difficult to understand that their loved one’s brain has changed, that …
Don’t yell at me. I’m trying to help.
VIPIT is the medical term given to the phenomenon of developing clots in various parts of the body after certain (not all) COVID-19 vaccines. VIPIT stands for vaccine-induced prothrombotic immune thrombocytopenia, a complicated term explained simply as clotting of the thrombocytes or platelet cells in the blood vessels after receiving the COVID vaccine.
Clearly, understanding this newly evolving condition is very limited, but what we know so far is extremely concerning. …
COVID-vaccine induced thrombosis as explained by a hematologist
Recently, I was talking on the phone to a physician client of mine about the COVID-19 vaccine and how thrilled I was that everyone over the age of 30 is now eligible in New York, which meant I could now schedule my own appointment.
We discussed the current market, and just when I was about to end the call by wishing him a happy National Doctor’s Day, his younger son, who …
12 tax deductions physicians overlook
“Keep it Simple is a bumper sticker slogan. Life during a pandemic has been anything but simple, and the holiday season presents (not the gift kind) its own special challenges. So does living alone and trying to stay humanized. In his book Together: The Healing Power of Human Connection in a …
How to find sparks of joy [PODCAST]
Indian parents are perfectionists. This is what I had come to understand and believe, even before I had the vocabulary to define it. Perfection was the expectation. Not excellent, not superb, but perfection, and only perfection. After years of reflection, I don’t take issue with the expectation of perfection, but, rather, how I perceived it to be defined for me — a well-behaved, beautiful and academically successful girl who does …
How to be a “good girl”: confessions of an (im)perfectionist
Recently, a former NFL football player, Phillip Adams, murdered Dr. Robert Lesslie, his wife, his two grandchildren ages 5 and 9, an air conditioning appliance man, and critically injured a second man. The NFL player had gunned down these innocent people. And then, he left and went to his parent’s house (who lived on the same road), and after hours of the SWAT team begging this man to surrender, he …
Tears from heaven: a nurse’s tribute to Dr. Robert Lesslie
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