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 …
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 …
The struggle of being a nurse is real
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 moral and ethical dilemmas of COVID-19
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 …
The opportunity cost of the liver organ shortage in the United States
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 …
I’m sorry: a letter from a pathology resident on the frontlines
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 …
A thank you to emergency physicians
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 …
Truth dies in silence. Sadly, so do people.
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 …
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 …
When a mnemonic becomes dangerous
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 …
Support your local private practice physician. They’re a small business.
When people used to ask me what a typical day entailed for me, I would gladly share the early starts, the long days on my feet in the OR, and on-calls where anything would happen. I would laugh at how I must have a bladder of steel and cry over some of the saddest stories which came through the front door. No matter the stories, though, one thing was a …
All I ever wanted to do was to be a surgeon. But I was pushed out.
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 …
I am a hospitalist and I love my job
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 …
Quotes and songs to help you survive COVID-19
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 …
Hold on to humanity while we still can
It seems that many physicians finally realize that they are expendable. The fact that U.S. health care institutions view doctors (and every other employee) as disposable cogs in a machine is not a new phenomenon. I learned this lesson over a year ago as a vulnerable type of provider – a resident physician.
From someone who has already been …
Are you angry, doctor? It’s about time.
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 …
What does sacrifice in medicine really mean?
On a sticky summer day four years ago, a class of eager medical students and I harmoniously chimed the Hippocratic oath, binding us to the highest standards and code of medical ethics.
As newly accepted and unassuming medical students, how could we understand the sacred nature of this rehearsed and recited ‘covenant?’
While pledging the words embedded in this sacred vow, we were completely unaware that the culmination of our medical education …
COVID-19 and the Hippocratic Oath
I just lost my uncle to COVID-19. I am writing this to honor him because I cannot leave the country to travel to Canada to see him, I could not visit him in the hospital when he needed us the most, I cannot attend his funeral, and I could not tell him in person how much I love him and appreciate everything he has done for me.
He was …
My uncle’s battle against COVID-19
On the front lines, America’s emergency departments (ED) are currently in at the center of a crisis treating patients with COVID-19. Emergency physicians and other clinicians are placing themselves and their families at risk. Yet, there is also another important crisis facing hospital-based EDs: surprise billing legislation. Certain forms of surprise billing legislation have the potential have a substantial and negative impact on how America’s EDs are supported, and our …
The fragile economics of America’s emergency departments
About a decade ago, I had my first doctor-client. And part of what they wanted to discuss was budgeting in order to save more. They just got new jobs and wanted some general planning for the sake of making good decisions.
Software for budgeting and spending history didn’t exist the way it does now. I wanted to provide the best help I could on this topic, and I knew about budgeting, …
The doctor’s budget — remastered
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