“The blood test shows a genetic mutation at MLH1. You have Lynch.” The words were spoken by my genetic counselor the minute I sat in my chair should have hit me harder, but I only felt numb. I glanced at my closest friend, the person they had insisted go with me to the appointment, and watched as tears filled her eyes. I glanced back at the genetic counselor and the …
With Lynch Syndrome, knowledge alone isn’t power
“As a young girl, I’d stand on my tiptoes, craning my neck to watch her sweep cerulean eye shadow across lids and smear foundation on sunken cheeks. While my high school friends resorted to secondhand eye shadow instruction from the pages of Teen magazine, I learned by watching my mom transform the …
One physician’s journey from burnout to bliss [PODCAST]
Leanne, a nurse, sits next to me in the ICU. She says into the phone, “Now, Johnny, you be good for Nana.” We’re only halfway through another 12-hour shift, and she won’t be home until after her 5-year-old son is ready for bed.
Such calls to palliate separation have long been part of the fabric of health care families’ lives. But the pandemic has magnified the frequency and pain of these absences.
Much …
Health care workers get the applause, but our families are essential, too
It seems that the midlife “slump,” “crisis,” or “malaise” phenomenon is actually something that has been studied and written about a lot in the last 40+ years. The phrase “midlife crisis” was originally coined in the 1960s, as explains Jonathan Rauch in his 2018 book, The Happiness Curve: Why Life Gets Better After 50. He describes some fascinating research that shows a definite age-related dip (a U-shaped curve) in happiness …
Physicians and the midlife dip
“I just started laughing. It was early on Monday morning during our COVID surge. I couldn’t help myself. Phones were not on yet, but I already had triage COVID calls. “Put on your roller skates” was all I was thinking. I questioned my laughter.
The day and a life of a primary …
This physician loves primary care. A pandemic isn’t going to change that. [PODCAST]
Imagine that you’re a physician in the middle of the global pandemic. The life-saving vaccine has just come out, and your job includes administration of the vaccine. At the end of your day, you have 10 extra vaccine doses in an opened vial that will need to be discarded if not used. You know there are not enough vaccines available yet to vaccinate everyone who needs this vaccine as soon …
A physician faces criminal charges for going above and beyond #WeAreDrGokal
If you’ve been diagnosed with a condition and the recommended treatment is surgery, there are proactive steps you can take to lower the risk of post-surgical complications and improve the likelihood of a good outcome. First, before deciding to undergo surgery, which always carries some risk, seek a second opinion from a physician who has experience treating the specific diagnosed condition. In most non-emergency cases, undergoing surgery immediately after diagnosis …
Choosing an experienced surgeon and high-volume hospital can impact your outcome
“As a professional woman who most identifies as a physician more than any other title, I know that I run the risk of losing myself to this disease. I am not ignorant to the risk. I understand that my identity is supposed to be separate from my achievements and that my babies …
How COVID changed this physician forever [PODCAST]
“Research conducted by the Center for Talent Innovation (CTI), a nonprofit research organization in New York, defines the three pillars of executive presence (EP) as gravitas, communication, and image. Stated differently, EP reflects how you act, how you speak, and how you look. CTI concluded that when people are perceived as …
Executive presence for women leaders [PODCAST]
In the waning days of the Trump administration, a surprising announcement came down from the Department of Health and Human Services (HHS) that the barrier required to write buprenorphine prescriptions for opioid use disorder would be lifted via reform of the so-called “X-waiver.”
The X-waiver is a rare regulation in American medicine that requires an 8-hour training and documented DEA permission before a medical doctor can prescribe Suboxone to …
The confusing policy surrounding the buprenorphine X-waiver
He stood silently. His eyes fixed on us, immaculately dressed in a dark three-piece suit adorned with a gold watch and chain, hair meticulously groomed, a brightly colored bow tie centered perfectly on a freshly starched white shirt, wire collar stays in place, black wing-tip shoes glistening. Gold cuff links and military-like, sharply creased pants, with just a subtle break of the cuff on the shoe tops, completed the picture. …
The world needs more hope-givers. Be that person.
“I am grateful that I work in a small rural hospital that is like a family. I am grateful that my organization has done everything in its power to protect us… but I hope we can do better. I hope medical workers have enough left within them to give their all …
Life in a rural emergency department during COVID [PODCAST]
Every week, I see a teen with depression and/or anxiety. Sometimes that teen is mine.
And while I can certainly opine over the lack of mental health resources for our children and teens — you have to be a certain age, you have to have certain insurances, if you’re uninsured or underinsured, you can see a community health professional but only for eight sessions — what I really get frustrated with …
When the teen with depression and anxiety is yours
Primary care physicians already have a lot of competition from retail clinics, urgent care clinics and telehealth services that cater to consumers. Now they’re facing a new threat from the “virtual primary care plans” that insurance companies have launched recently. These are health plans that prioritize virtual visits with doctors hired by telehealth services over in-person visits to primary care doctors.
For years, some insurance companies have been offering online urgent …
PCPs could counter virtual plans by increasing telehealth visits
The differential diagnosis is a cornerstone of the profession of medicine which epitomizes physicians’ critical thinking skills. It is not an antiquated tradition of by-gone eras. The practice of medicine has been positively impacted in the past century by revolutionary scientific advancements, standardization of medical education, and transformative societal changes. Its overlap has provoked some unfavorable changes in the practice of medicine with the business of health care. The differential …
An ode to the differential diagnosis
“Let’s meet in the middle and listen to what’s happening in communities. All across U.S. communities, there are pockets of promise and programs focused on family interventions, behavior change, and health disparities, but there are many obstacles to true change. Currently, the work relies on visionary champions within a community, but …
Weight stigma in children and teens [PODCAST]
Whether you like her or not, Meghan is speaking openly about suicide. For that, I am thankful.
In her interview with Oprah, The Duchess of Sussex shared her suicidal thoughts—and how she was obstructed from mental health care, told to “tough it out” and keep smiling. The Duchess needed a doctor. Yet doctors are reported to have the Read more…
Duchess vs. doctor: Why Meghan Markle’s mental health matters to me
One year ago, on March 14, I worked my first of many COVID shifts as a hospitalist at a large academic teaching institution in Chicago. In the beginning, I think most of us on the front lines felt a strange combination of duty, fear, and exhilaration. There was this novel virus, the world was shutting down because of it, and while the rest of society was stocking up on toilet …
Reflections on a year of COVID
Three years ago, I met Dr. Boyce Fish*, the ER physician revived after suicide. I also met Rachel Dawson, wife of Dr. Chris Dawson who killed himself and his two children.
We all sat in red ballroom chairs in a room with nothing in it, but it felt full. All the lights were dim, and I was privy to the darkest innermost thoughts …
Physician suicide: We need safe spaces to talk about it
“When you’re applying to medical school, it’s remarkable how much four years or more of intense work can come down to one single day. The medical school interview is high stakes: studies have found that interview performance is the most important factor in admissions decisions.
While your MCAT score and your GPA …
Medical school interview secrets [PODCAST]
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