COVID-19 has turned the world on its head. A major problem we have faced since the beginning is that it had already been spreading like wildfire for a few months since the end of 2019 — before most of the world realized that it was time to take action against this respiratory virus. We’ve therefore been on the back foot from the very start.
The blunt truth on why stopping COVID is impossible
Health care has been hanging by a thread for some time — in our community and across the nation. The COVID-19 pandemic exposed weaknesses inherent in an underfunded public health system, a monopolized hospital, and a fractured medical supply chain.
At the beginning of this pandemic, I wrote, “Our lives will not be saved by the government. And lives will not be saved by elected officials or large institutions. Lives will …
Is there hope for COVID with home visits?
“Growing up in Puerto Rico, ‘babas’ (bottles: biberón/botellas) and ‘bobos’ (pacifiers: chupetes/chupón) were very common among the families and children of the island. I still remember our Abuelita giving us milk in our “babas,” so my younger sister and I were sure to fall asleep better. From the time of our births, …
Bottles and pacifiers: advice from a Latinx pediatrician [PODCAST]
On those brisk walks across the hospital, I briefly look over at the instillations from local artists. Those pieces ignite a chain reaction of creative empathy and even critique from both patient and provider alike. In the briefest moment, we mentally collide into the artist’s creation, catching glimpses of their point of view. The result is our engagement in the vital need for our own creativity.
Hospital art fosters a welcoming, …
Creativity in medical school and beyond
“These encounters made my evening shift much more emotional than usual. I am still not sure what it was exactly that evoked such strong feelings of sadness. Was it having a patient who was a health care worker? Was it the rapidity in which all three patients’ conditions deteriorated? Was it …
Why COVID is so emotional for physicians [PODCAST]
As a fellow, I made a list of what I wanted in my first job. I dreamed, prayed, and wished for the contract to finalize. It did. I went to Ohio hoping that this was my first, last, and always job.
Eight years later, I left feeling completely broken. On my first anniversary of leaving, here are the major lessons that changed my life.
1. It’s not my job’s job to make …
Lessons learned from leaving my first job
I have never felt so alone. I was lying in bed with severe abdominal pain. Pain I never had before. Well, at least not for a reason.
As I lay there, I kept thinking, what if I die while I wait until morning. It was the middle of the night. I had not felt well since earlier the week before with a severe diarrheal illness. One that only babies have with …
Alone in the hospital in the midst of a global pandemic
“Iodine-based contrast agents are widely used for CT and other X-ray studies. They light up blood vessels and enhance perfusing tissue. These agents are essential for diagnosing everything from clots, to tumor, to bleeding. Unfortunately, many patients do not get contrast studies they may benefit from, due to unnecessary confusion about …
Think you have an iodine allergy? You may want to reconsider. [PODCAST]
“In the midst of a COVID-19 pandemic, getting a flu shot has never been more important.
Many people are staying indoors, wearing a mask, and washing their hands frequently. In this environment, patients ask me, “With all this social distancing, do I really need a flu shot this year?” The answer is unequivocally, …
Behind the scenes of a hospital’s COVID response [PODCAST]
In some people, COVID-19 causes mild or no symptoms at all. In others, it can cause significant respiratory distress that can lead to death. Once infected with COVID-19, is there anything that someone can do to foster a less severe infection? The answer is likely “yes,” avoid the use of outpatient steroids.
The risk factors for a poor outcome with COVID-19 include age over 65, obesity, diabetes, and a compromised immune …
COVID-19 and the use of outpatient steroids
“If we do not raise objections to this kind of comedy, we are teaching those around us that food allergies can be funny. It is no that surprise that data indicates kids and adults are anxious, embarrassed, and bullied due to food allergies. When we make light of anaphylaxis, we perpetuate …
Food allergies are not funny [PODCAST]
There’s not a perfect financial planning vehicle in existence. Salary deferral plans, like many retirement plans and 457 plans, carry pros and cons. Many hospital systems have a combination of 401(k), 403(b), and 457 plans. The 401(k) is often designed for the employees who make under a certain amount, say less than $150,000 or so. Then the 403(b) with an option to contribute to a 457 salary deferral plan is …
Pros and cons of 457(b) plans: What physicians need to know
Like most modern marriages with spouses in the same profession, ours is one based on an exquisite balance of willful one-upmanship and reluctant admiration. A pandemic with two physicians in critical care medicine, albeit in different disciplines, serves as ample cause for a seismic shift in that equilibrium.
In January, while the balance was still intact, when he remarked that the Chinese authorities should suspend their traditional New Year celebration because …
Science challenges dogma and upends previously held beliefs in its quest for truth
The Lebanese-born former American oncologist Farid Fata committed one of the most malicious acts of greed by a medical professional in recorded history.
Fata spent six years telling otherwise healthy people that they had cancer and needed immediate chemotherapy. He then fraudulently billed over $34 million in charges to Medicare and private insurance companies. Fata will arguably spend the rest of his life in prison, but the …
Getting a second opinion can save lives. It is time we make Miranda rights for patients.
“Early in the pandemic, in thinking of and discussing possible solutions to help protect health care workers, two of my former colleagues and I recalled a device called the Surgical Smoke Evacuator (SSE), which we used extensively since the 1990s when we worked together at the University of Pittsburgh to collect and …
Surgical smoke evacuators and inertia in the time of COVID [PODCAST]
A lot is happening when graduating medical residents are looking for employment after completing graduate medical education. They are finishing their residencies, taking the specialty boards, and trying to decide where they will be spending the rest of their lives. Considering a new job offer can be both exciting and stressful. It is natural in such circumstances to focus on what the job promises, where it is located, and how much it pays—and easy to overlook the fact …
Negotiate your employment agreement after residency
“The medical profession now understands that social determinants of health are probably the most important driver of a patient’s overall health, and these determinants are largely the result of political decisions. Clearly, we have a professional responsibility to teach our patients the science underlying their health issues. Don’t we also have a …
Talking politics in the exam room [PODCAST]
As cases exploded across the country, I watched with horror as I saw people go on with their daily lives as if hundreds of thousands of people were not dying, as if millions were not infected, as if our health care system was not collapsing. I watched our country – a country I once believed in – fail miserably in taking care of its own people.
In …
I am a physician who tested positive for COVID-19. My main symptom is anger.
“Doctors help patients, and they love us for it. We fix bones, replace joints, cure killer infections, and control diabetes with insulin. We use painless scans for diagnosis. Liver, kidney, and heart transplants are now routine. Some patients get cured of lymphomas, leukemia, Hodgkin’s disease, and testicular cancer. Lives are prolonged …
Why corruption is ruining your health care [PODCAST]
Forty-two years ago, when I had finally finished the seven revisions of my first novel, The House of God, my editor said, “Why don’t you add a glossary and a list of The Laws of the House of God.” Writing the Laws, I hardly needed to refer to the text; they just flowed out. The Laws became common parlance, not only tacked up in on-call rooms but even, recently, listed …
The laws of The House of God and Man’s 4th Best Hospital
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