The shift from a junior to a senior resident

Physician
April 15, 2020

For physicians, residency is the most critical time for growth in clinical and surgical skills, professionalism, and medical knowledge. Your residency training — for better or worse — shapes your future career as a physician. Your surgical technique, clinical decision making, and bedside manner are all, to some degree, a reflection of where you trained.

Interestingly enough, there are only two residency years with formal titles — the intern and chief …

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How nurses made me a more compassionate and caring person, and a better physician

Conditions
April 14, 2020

I have had the privilege to serve alongside hundreds of nurses in the nearly 40 years since I started medical school. This includes inpatient and outpatient settings and 20 years of leading medical missions around the world. There are five amazing nurses in my family as well. I have learned from every nurse with whom I have served. This has made me a more compassionate, caring, and empathetic person, and …

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Health care workers during the COVID-19 crisis: superheroes or human-heroes?

Conditions
April 14, 2020

This essay is for my colleagues. When I say “colleagues,” I am referring to all health care workers who are currently working on the frontlines of the COVID-19 crisis or are engaging in patient care at any level. This might be an unconventional essay coming from a doctor, but I wanted to send out my thoughts and heartfelt wishes for the well-being of health care workers during this time. Health …

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You’re just the anesthesiology resident

Conditions
April 14, 2020

You always knew they didn’t care about you.  The administration, I mean.  But you knew that going into it.  It’s just four years that you have to endure until you can be respected, until you make the big bucks, until you’re treated like a human being.  Four years is not that long.

But you knew this going into it. That they didn’t care.  You’re just a resident.  Now more than ever, …

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Do viruses infect bones?

Conditions
April 14, 2020

Viruses typically invade our bodies through an opening. Think gastrointestinal flu, COVID-19, AIDS. Our bones, however, are normally protected from any outside exposure, so they should be safe, right?

The short answer is yes and no. Of course, knowledge is power, and we need both right now, so here is a nuanced answer.

Patients with smallpox frequently complained of bone pain. Epidemics in Prague in 1891-1892, in Boston a decade later, in …

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The struggle of being a nurse is real

Conditions
April 14, 2020

As I struggled my way through nursing school, I never expected my first job as a nurse to feel like this; I was too busy dreaming of the day when I could hold the title of registered nurse.

I never expected to come home crying. I never expected that, at times, I’d mumble the words “I hate my job.” I never expected many of the challenges I face daily— but here …

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The moral and ethical dilemmas of COVID-19

Conditions
April 13, 2020

In all of my thirty years of medical practice, I have never encountered the degree of moral and ethical dilemmas as those created by COVID-19. None of us has experienced anything like this. At no time in our history has all of humanity been at risk for contracting the same potentially deadly disease. And never in my entire career could I have imagined that we would be so woefully unequipped …

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The opportunity cost of the liver organ shortage in the United States

Conditions
April 12, 2020

The first five liver transplant recipients were all dead within 23 days. The year was 1963, the surgeon was Dr. Thomas Starzl, and the operations were actually deemed a success for their surgical complexity. Since then, liver transplant (LT) has evolved from an experimental, often fatal procedure to the standard of care for end-stage liver disease (ESLD). Compared to the 0% 30-day survival rate of LT in 1963, the most …

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I’m sorry: a letter from a pathology resident on the frontlines

Conditions
April 11, 2020

I hope that this letter finds you (and myself) alive and well after all this COVID-19 craziness ends. I never really got the chance to explain everything when I was taking care of you. It wasn’t your fault you ended up at the hospital when you did, and you deserved so much better.

First of all, I was a pathology resident. A redeployed pathology resident. Actually, redeployed …

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A thank you to emergency physicians

Conditions
April 10, 2020

I want to write a letter of thanks for all the sacrifices you have made for our nation during this COVID-19 pandemic.

Thank you for all the lives you have saved.

Thank you for fighting to save all the lives that were lost.

Thank you for leaving your homes each day, not knowing if or when you will hold your children or see your spouse …

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Truth dies in silence. Sadly, so do people.

Conditions
April 9, 2020

I have been writing columns for physicians for twenty years.  And year after year, I have had physicians say this: “I’m glad you said what you did. If I said it, I’d be fired.” There are variations on the theme, but they’re much the same.  Twenty years, and far more than 20 years, during which the alleged health care leaders in America have been routinely muzzled because they aren’t supposed …

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The guilt of a retired nurse

Conditions
April 9, 2020

I am 64 years old. I was a nurse for 34 years, retiring a year, and three months ago, I worked on the medical-surgical floor, ICU, and the last 30 years, in the emergency room. I retired because I’d had enough.

This year has changed me. My life no longer revolves around my ER job. I am not exhausted from 12-hour shifts, taking at least a day to recover. I no …

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When a mnemonic becomes dangerous

Conditions
April 9, 2020

Fat.

One tiny word. One voluptuous, full-figured concept.

Several weeks ago, amidst a conversation regarding the risk factors for cholelithiasis (i.e., gallstones) during a chief concern small group session for preclinical students, my preceptor ushered in an aurally convenient yet unsettling mnemonic utilizing alliteration that has apparently been in the works among medical education for a while now, known as “the 4 Fs”: female, fertile, forty, and … fat.

Yes, you read that …

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Support your local private practice physician. They’re a small business.

Conditions
April 8, 2020

Small businesses are a vital part of our economy. They are ubiquitous and take on numerous forms, including traditional brick and mortar spaces, kiosks, and online enterprises. They enhance our most basic capitalist principles, such as innovation, entrepreneurship, and competition. Many small business owners give of their hearts and souls, viewing their employees and customers as family. When the COVID-19 pandemic hit and with it the necessary sweeping measures of …

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I am a hospitalist and I love my job

Physician
April 7, 2020

About a year ago, I had an interesting encounter on my way back home to Texas after visiting my parents. I was casually chatting with an older female acquaintance as I got situated on the plane. She asked me what kind of medicine I practice. This woman is in medicine, not a physician, but knowledgeable about the varying specialties. I told her that I was an internist working as a …

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Quotes and songs to help you survive COVID-19

Conditions
April 7, 2020

I’m a cardiology fellow on the frontlines of the COVID-19 pandemic. Like many, I know suffering. In 2017, I lost my father to rapidly progressive dementia. I was postpartum at the time, and he did not even know I was ever pregnant. My stepfather — my father since I was eight years old — the only man who appreciated me and celebrated all my uniqueness and success, passed away …

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Hold on to humanity while we still can

Conditions
April 7, 2020

Washington State has benefited from an early response to COVID-19; organized and isolated, the curve seems to have flattened. Within our hospitals, we continue to prepare for the worst. This includes addressing the reality of limited resources and an insurmountable number of patients, a “crisis” standard-of-care.

For many health care workers, fatigue and fear of exposure pale compared to the emotional toll of countless COVID-19 tragedies. At the forefront of our …

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What does sacrifice in medicine really mean?

Education
April 6, 2020

Just another day as you work into the depths of the night. Medicine engulfs your life as your focus is centered on your responsibilities for tomorrow. You may or may not have time to sit down and enjoy a meal in silence. You may or may not have the opportunity to say good-bye or hello to a loved one. I hope we all had the foresight to realize what we …

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