I’ve been searching for a way to describe my experience as a third-year medical student until recently, when I stumbled upon two new terms: moral injury and emotional labor. Moral injury is a phrase coined to describe an insult to a person’s moral conscience or values. It happens as a result of actions that transgress his or her “deeply held moral beliefs and expectations.” It was originally used to describe …
Moral injury in medical school
When novice medical students such as myself learn how to counsel patients, the primary didactic focus is on developing awareness of how factors such as racism, socioeconomic status, environmental stressors, and social supports may predispose patients to or protect patients from acquiring disease and mediate adherence. But in this discussion of patients and the decisions that they may make before, during, and after a clinic visit, we often overlook personality.
As …
Under-addressed mediators of adherence: personality in patients
“One of the best solutions to rising obesity and non-communicable disease rates lie in primary care. Medical professionals can influence the U.S. food system indirectly through demand and collective purchasing power by educating their patients to choose and purchase healthier options. Merely improving nutrition education succeeds in shifting people’s thinking about food.
Simultaneous …
Put nutrition counseling in primary care [PODCAST]
The COVID-19 pandemic has devastated America’s health, taking more than 500 thousand American lives, upending the economy, and perpetuating racial
The U.S. …
The pandemic’s epidemic: opioid use disorder and subpar suboxone access
In his novel Buddhism Without Beliefs, Stephen Batchelor observed that “death alone is certain and the time of death is uncertain.” This knowledge should guide us in one of our most important decisions: How should we spend our limited amount of time on earth?
Why do you work so hard?
There are many different reasons why people might work too hard. Often they toil out of necessity. …
Put down the knife: A neurosurgeon explains the importance of a work-life balance
“I have closed my practice, but I have no plans to retire at the age of 52. I have started the journey to become a high school science teacher. There are frequent internet postings and blogs by physicians with strategies to retire young. I suspect that many of us, not near traditional …
Why this plastic surgeon chose to become a high school science teacher [PODCAST]
It pains me to write this. I am tired of pretending. I simply cannot do this anymore. I sincerely wish you well. I do hope our paths will cross again.
I first gazed at you, cautiously intrigued. Coquettish even. Butterflies fluttered when I thought of you. You left me longing for more details. You captivated my heart and mind. I became obsessed with you, wanting to understand your layers and complexities. …
“Definitions ground us in our profession and in our world. Definitions matter because they help us pause, give our body a moment to settle, and our breath time to move in and out. Our racist actions, inactions, and comments are invasive throughout our waking hours, but we can change them if we can …
Words matter: Definitions ground us in our profession and in our world [PODCAST]
It has been over a year now since shelter-in-place orders struck fear into many, forced millions into unemployment, and taught us all the meaning of the term “supply chain.” It didn’t take long before the chants of “flatten the curve” and “support our health care heroes” dissipated. Once more was known, many industries figured out to cope safely while others just decided to cope unsafely. The government stepped …
The coronavirus vaccine is not a political or social issue
“The good news is that imposter syndrome can be quieted with increased awareness and replacing negative internal messages with positive ones. In our work together, I helped Sheila identify the voices, understand the positive role the voices fill (and there is always a positive or protective role), and find specific mechanisms for …
Solving imposter syndrome in physicians [PODCAST]
“I am [sharing] my story as I would like to raise awareness about the dangers of benzodiazepines and advocate for stronger warning labels.”
I paused to wipe away tears before typing the final words of Bobbi’s report into the FDA’s MedWatch online reporting system. Bobbi, a physician assistant, was forced into medical detox by her state medical board after suffering adverse effects from prescription clonazepam. Six years …
The updated benzodiazepine boxed warning: What you need to know
This version of “My Shot” was written and recorded by an anesthesiologist, Bryan Tischenkel, MD, to raise awareness for the COVID-19 vaccine. He wanted to show the public the confidence with which many health care workers are receiving their vaccinations daily.
We all believe in the science behind vaccination. Each patient should speak to their physician about the COVID-19 vaccine.
Not throwing away my shot: Health care workers show confidence in the COVID-19 vaccine
“In the world of medicine, inordinate stress is instead accepted as just part of the job. If you can’t handle the heat, get out of the kitchen — or see a therapist on your own time and dime. I strongly believe that traditional therapy and psychiatry are vital and valuable disciplines- I …
Vulnerability is challenging but necessary for health care professionals [PODCAST]
This week a patient, for whom I served as the primary care physician for over many years, died after an extended illness. I had the privilege of visiting her two days before her death, as she weakened and drew closer to her last breath. It was an opportunity to tell her good-bye.
We were close. She was very smart. She had an engaging sense of humor. She loved college basketball. She …
Another lesson learned: This is what gratitude looks like
“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
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