“Three Fleet enemas?” I ask the nurse. She isn’t much interested in a conversation with me about anything. She is busy.
“This man, so far as I understand it, does not have a colon.”
It looks to me like they want to reconnect his colon,” she says as if I hadn’t said what I just said.
“I am not a doctor,” I remind her, “but I don’t see how that is possible. Too …
3 enemas? For a man without a colon?
“When I first heard about medical schools fast-tracking graduation for students and shifting young residents into high need areas to fight the pandemic of COVID-19, I thought of how panicked those students and residents must feel. Asking them to step in to fight a battle we don’t know how to win, and envisioning them witnessing the suffering and death of multiple …
Protect our medical trainees during the pandemic [PODCAST]
“The USMLE has failed the medical education community, and subsequently, future patients, as medical students will undoubtedly have irreplaceable damage from this experience; however, like all tests, it is possible to learn from mistakes and improve. In these unprecedented times, we as students understand the need to be flexible, but in return, we ask not to be forgotten and left abandoned …
The USMLE needs better pandemic communication [PODCAST]
“The COVID-19 pandemic has turned medical education upside-down. From exclusively virtual pre-clerkship courses, to delayed clerkships, to canceled graduation proceedings, there has been massive disruption. Now, after weeks of speculation, we’ve learned how the pandemic will be disrupting the 2020-2021 residency application cycle. The Association of American Medical Colleges (AAMC) is now recommending that all residency interviews be conducted virtually. While …
Dear AAMC: Please limit residency interviews [PODCAST]
An excerpt from When We Do Harm: A Doctor Confronts Medical Error.
One of the selling points for the electronic medical record (EMR) was that it would be a boon for patient safety. Just having all the medical records in one place is a monumental improvement over …
Does the EMR improve or worsen patient safety?
“The reaction to the COVID-19 pandemic in the comprehensive psychiatric emergency program (CPEP) began insidiously, with an initial sense of unease. Patients are brought into CPEP when they pose a danger to themselves or others. Often they are brought by police, but occasionally they come on their own or with concerned family members. CPEP is a locked unit, separated via locked …
Emergency psychiatry during COVID-19 [PODCAST]
“Over a period of about two years, our city experienced a very large influx of seniors. One nearby town grew by over five thousand people. This, in turn, created a surge of patients coming to the hospital. As most were older, they often had multiple medical conditions. They would almost always require more complex care. The whole system became overloaded because, …
How this emergency room nurse got diagnosed with PTSD [PODCAST]
“As a physician anesthesiologist who has previously been on assignment for Doctors Without Borders in a resource-depleted region fraught with conflict, I’d like to say there’s little I haven’t seen. But now, after four weeks of staffing COVID intensive care units and emergency response teams throughout New York City, I struggle to distinguish between the exhaustion of a distant war-zone and …
COVID-19 from the New York City frontlines [PODCAST]
Career transition is talked about a whole lot more these days than it was in 2004. Maybe I just notice it more now. Back then, I felt like I was the only one doing it. You know how it is when you are going through something difficult, and you feel utterly alone and unsure about what you’re going to do tomorrow? That was me, only I also felt like a …
I transitioned to a non-clinical career. What did that mean?
“Howard wants to go to the hospital. He knows he isn’t doing that great. He says he is having homicidal thoughts.” This from my supervisor, Linda.
Homicidal thoughts on the part of any client get our attention, especially so with Howard, because years before, he killed a man with a gun. I believe it was in a fight.
“He wants you to take him to the hospital, Ray.”
“Sure,” I say. “You think …
The social worker and a patient’s homicidal thoughts
We’ve all heard the phrase, “survival of the fittest.” It suggests that in the competitive, “free market” world, it is the “best” who survives and it’s “the cream” that rises to the top. But is that true for doctors? Do patients get better care when competition rules the health care marketplace?
A few years ago, a doctor from a large primary care group contacted me to give a talk to the …
Why is it hard to find a good dermatologist in a competitive market?
Every year, National Nurses Day is celebrated on May 6 to raise awareness of the role nurses play in society. The date also marks the beginning of National Nurses Week, which begins on May 6 and ends on May 12, Florence Nightingale’s birthday. In addition to the annual celebration, the World Health Organization has smartly declared 2020 the “International Year of the Nurse and the Midwife,” in recognition of their …
Nurses deserve all the respect doctors and patients can muster
The Podcast by KevinMD shares the stories of the many who intersect with our health care system, but are rarely heard from.
We give a voice to those in health care who may not be famous or have a big name. …
30 podcasts in 30 days: Welcome to The Podcast by KevinMD
Those who knew George remembered him as “a big man with a heart to match” and a “good friend,” “good person,” and someone who “took care of people.”
Tragically, George Floyd was murdered on May 25, 2020.
You may have already seen the heartstrings-shredding video showing his excruciatingly slow and torturously savage homicide. As George struggled in his final moments to simply breathe while begging for his life, and onlookers recording the …
George Floyd: Framing police brutality through the lens of an emergent public health crisis
With any new illness comes metaphor. It is humanity’s attempt to incorporate the mystery of disease into our own stories. We like to personify illness, give it human characteristics as a way of visualizing it. We name its actions to help lessen its unpredictability. Tuberculosis consumed. Syphilis punished. AIDS invaded. Cancer grows. COVID-19 quarantines separate and spread fear.
How long does it take for a disease or illness to become a …
The new words from the coronavirus pandemic
Asthma is one of the most common chronic diseases in the U.S., with a prevalence of 15.2 percent. The condition is manageable when treatment is appropriately prescribed, adjusted, and accessed by the patient. However, uncontrolled asthma can impair various facets of life and may even be fatal. This dichotomy is noteworthy, especially when considering how strongly asthma outcomes correlate with other elements of an individual’s social …
Mobilizing medicine: a breathtaking solution to asthma disparities
Imagine there are two individuals who have been admitted to a hospital due to COVID-19, and both desperately need ventilators. One is a 60-year-old with a heart condition, and another is a 63-year-old with chronic kidney disease. Because of resource constraints, you have to decide which patient will be able to receive a ventilator. Both patients’ families are looking to you to help their loved one through this illness. With …
Ventilator rationing is guided by rules that could worsen health inequities
Many people looking in on the world of research have perceptions of brilliant minds at work, rapidly putting forth groundbreaking ideas. While they’re not entirely wrong, I discovered that this arena of fascinating new discoveries is not always so rapid and not glamorous at all.
As a clinical trials research associate, I learned that research is hard. I found that testing and implementing theories and postulations takes time and dedication. I …
The truth about research: Lessons learned by an aspiring physician-researcher
1. Anesthesiologists are your protector
Think about this: An anesthesiologist’s job is to protect you from the harm your surgeon is causing. Seriously. A surgeon’s job, at its very essence, is to damage your body. Now undeniably, it is with the intention of causing greater good and/or fixing something that is already broken. But in order for a surgeon to help a patient, they take a knife, saw, drill, or hammer, …
5 reasons why your anesthesiologist is a medical ninja
As a fourth-year anesthesiology resident, I opened up my email eagerly, awaiting the results of the pain fellowship match. It was official; I was heading to a major academic program in New York City. First came excitement and relief immediately followed by a rush of all-encompassing fear. I had grown up in Arizona my entire life, and the idea of living and training in New York City was daunting, to …
New York City provides residency training like no other
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