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Strategies to foster meaningful connection during telemedicine visits

Megha Shankar, MD, Meredith Fischer, MA, Cati Brown-Johnson, PhD, Nadia Safaeinili, MPH, Marie Haverfield, PhD, Jonathan Shaw, MD, Sonoo Israni, MBA, Abraham Verghese, MD, and Donna Zulman, MD

Physician

April 28, 2020

The COVID-19 pandemic has upended health care, with telemedicine emerging as a strategy to reduce risk exposures for patients and clinicians. Originating from the Greek root tēle-, tēl-, tēle meaning “far off, afar, at or to a distance,” telemedicine encompasses virtual clinical services. Video visits, in particular, can be effective for many types of clinical care and offer convenience and savings for patients. As care …

Combining emotion and reason in decision making

Robert Frolichstein, MD

Physician

April 28, 2020

We are living in unprecedented times. Times filled with emotion and very little hard science. We are faced with the rapid spread of a new disease that has devastating consequences. The rapid spread is overwhelming our system that is designed for a steady state. Periodically, we are faced with events that overwhelm our system; mass shootings are a prime example. The duration of those events is measured in hours. We …

The power of poetry during a pandemic

Anna Delamerced

Education

April 27, 2020

I come into the peace of wild things
who do not tax their lives with forethought
of grief. I come into the presence of still water.
And I feel above me the day-blind stars
waiting with their light. For a time
I rest in the grace of the world, and am free.

These verses flashed on my computer screen, the glare lighting my face as I sat in my bedroom. I paused my usual work and …

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The power of poetry during a pandemic

The new physician personal statement

Francis Yoo, DO

Physician

April 27, 2020

We write personal statements when we apply to medical school and residency. They serve as a sort of window to our soul, our reflections and aspirations, our physician vision and mission. I was doing some soul-searching, and I found my medical school personal statement. The following is a snippet from it:

I believe that the purpose of medicine, of the restoration of health, is to remind people of their own mortality …

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The new physician personal statement

Please make the tragic death of this physician mean something

Candy Ezimora, MD

Physician

April 27, 2020

I hugged her for the last time on March 15, waving goodbye as she drove away from my apartment complex. On April 15, I got a call that my friend was dead. She had unceremoniously taken her own life, unable to overcome the crippling feeling of hopelessness that plagued her after repeatedly being prevented from fulfilling her dream. The details of her death are devastating and tragic. Imagine being in …

Are COVID-19 lockdowns legal or not?

Meghan Sharma

Conditions

April 25, 2020

The COVID-19 pandemic has raised many questions about how to constitutionally handle a public health crisis on both the state and national levels. Many wonder if a national lockdown can be put in place — a new dilemma that has little legal precedent to follow.

Can individual rights be limited to protect public health?

Short answer: Under Jacobson v. Massachusetts (1905), states may take measures to protect public …

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Are COVID-19 lockdowns legal or not?

Is asking for hazard pay “not becoming of a compassionate and caring physician”?

Elizabeth Hlavinka

Physician

April 24, 2020

New York University residents are seeking compensation for the increased risk they face as they are called to the frontlines of the COVID-19 pandemic, but leadership has declined their request for hazard pay and now stands accused on social media of gaslighting residents.

Residents created a petition, addressed to NYU Langone Medical Center leadership, outlining the increased risk they face as the demand placed on the hospital system “skyrockets.” They ask for …

How microaggressions contribute to impostor syndrome

Jennifer Hunt, MD

Physician

April 22, 2020

I accepted my job as chair of the department of pathology at the University of Arkansas before I turned 40, though I didn’t start until after my birthday. I don’t know if I was the youngest chair in the country, but I think I was the only one with a car seat and a spare diaper in my purse. My memories of those first few months are still vivid, even …

An open letter to graduating medical students

Lilian White

Education

April 21, 2020

I see you.

Studying. Reading the updated guidelines for patients with COVID-19, reviewing differentials, and management algorithms for common chief complaints during this time of restricted direct patient contact. Embracing online boot camps. Completing residency paperwork. Thank you for preparing.

Relaxing. Trying out a new yoga video. Watching Netflix by the hour. Reading a new book. Going for a run or walk. Thank you for re-charging your batteries so you can serve …

Is there a doctor on board? Yes, but we might not be the right doctor.

Andrea Bischoff, MD

Conditions

April 17, 2020

My husband and I travel internationally at least three times a year to give courses with live surgical demonstrations of colorectal conditions in children.

During the past 13 years making those trips, we had our share of hearing the famous announcement in the plane: “Is there a doctor on board?”

Those have happened in many different scenarios including having been on call the night before and therefore being on an almost semi-coma …

Preparing for the next pandemic: Why a one-country approach is needed

Kelli Todd, MPH and Amy Baruch, MD

Policy

April 15, 2020

One needs to look no further than any mainstream news or social media outlet to realize that our public health system and hospitals are overwhelmed. Whether it be the lack of adequate testing reagents to properly monitor the current COVID-19 pandemic or the lack of adequate personal protective equipment (PPE) and ventilators to safely care for our sick, our nation’s health care system is being pushed to the brink. As hospitals …

Coronavirus highlights why America needs a national medical license

Marcel Brus-Ramer, MD, PhD

Policy

April 15, 2020

The COVID-19 pandemic has exposed many vulnerabilities in the U.S. health care system. While shortages of safety equipment and ventilators have been widely reported, the shortage of physicians and staff to manage patients in respiratory failure is also a major concern. Given the reported conditions throughout northern Italy with hospitals operating over capacity and exhausted medical personnel, the same concern arises in the United States. While some may be quick …

The shift from a junior to a senior resident

Justin Dubin, MD

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 …

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

Andy Lamb, MD

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 …

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

Veda N. Giri, MD

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 …

You’re just the anesthesiology resident

Anonymous

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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You’re just the anesthesiology resident

Do viruses infect bones?

Roy A. Meals, MD

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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Do viruses infect bones?

The struggle of being a nurse is real

Samantha Hammond, RN

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 struggle of being a nurse is real

The moral and ethical dilemmas of COVID-19

Rebecca Elia, MD

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 …

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

Omar Haque, MD, Khalid Khwaja, MD, Bapu Jena, MD, PhD

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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