As I progress further in my medical career, I often feel that there are expectations of me that I have never been trained for. Teaching and feedback are large parts of my training that I do not always feel we are adequately prepared for. Feedback constitutes a large part of how we become better physicians. However, this commonly comes in the form of written feedback, and there is limited time …
The value of in-person feedback
“I can imagine the horror of watching a colleague being attacked. I worry about the coworker who Lynne protected that day, since being a survivor can be so bittersweet. I can feel the shock of how quickly the violence escalated, tasting the bitterness from the desperation of being so alone …
A nurse’s story of health care workplace violence [PODCAST]
While I lack certainty in my faith, a church has always been a sanctuary. And while I land in church rarely, and even less in this pandemic, when I’m in one, in any country across the globe, a certain feeling comes to me. My favorites are old, gothic, with a musty smell and an imposing altar, windows of colored glass, and soft candlelight—a hushed sense of solitude, of peace. I …
Unyielding physicians. My congregation. Hold me up.
With the recent onset of the Delta variant rendering havoc on an already strained economy and weary population post- the rabid COVID-19 surge, there is much debate on effective policies that negate the harmful outcomes of viral acquisition. The B.1.617.2 Delta variant originated in India and is among the most easily transmissible form of the novel SAR-CoV-2 pathogen, apart from the Alpha-Britain isolated, Beta-South Africa isolated, and Gamma-Brazil isolated forms. …
Looking at the studies behind masks
The current COVID pandemic has brought into stark contrast the woeful state of medical data collection and data sharing in the United States. It has been a central goal of Health and Human Services (HHS) to at first encourage and later mandate sharing clinical data across multiple electronic health records. Unfortunately, progress has been slow and actual clinically useful widespread adoption of shared medical data remains an aspiration. Here, we …
Sharing medical information between EHRs: 4 different approaches
“The first amendment protects your right to free speech. But it does not make you more right, more ethical, or more kind. And nor does it give one license to rewrite history as has been occurring since July 27th, adding insult to our experience. Let me break this down.
On …
When clinicians are bullied at a school board meeting [PODCAST]
Patients die. This is a tragic truism in the world of medicine. Usually, the patients who die are elderly. Patients die from diabetes and kidney disease, or from alcohol abuse and liver failure, or from heavy smoking and lung disease. Or patients die from cancer.
As a physician, I take these deaths in stride. I try to provide comfort care as they lay dying. Patients often pass into a dreamlike state, …
Patients should never underestimate the self-flagellation of the physician
She was an ICU downgrade. Hospice care is what they told me. We added her name to our list, and my senior resident told me she was now my patient. I did not have a clear story. Sepsis? Complications? The ICU note was lengthy. Rounds were coming up, and I needed to see all my patients.
I went into her room. She was breathing slow. Oxygen saturation dipping. Unconscious. I asked …
“Call the family. Let them know she passed away.”
According to the WHO, 10 to 20 percent of COVID-19 patients experience lingering symptoms for several months following infection. What we know as long COVID is now termed post-COVID condition as of October 6. Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually three months from the onset of COVID-19, with symptoms that last for at least two months and cannot be …
A COVID long-hauler shares her story
“Is your health care organization reeling from a bad EHR implementation?
There have been rumblings from hospital leadership and congressional committees about the Veterans Administration (VA) Hospitals’ implementation of the Cerner Corporation electronic health record (EHR) replacing the VistA EHR. The $10 million EHR overhaul has been controversial since the staggered …
How to recover from a bad electronic health records implementation [PODCAST]
“HIV has been a blessing in my life.”
Lola was a 48-year-old woman living in Denver when I interviewed her in 2002 about her HIV-positive diagnosis. She said the diagnosis improved her life in important ways; she had received income and housing support, nutritional assistance, health insurance, medication assistance and primary and infectious disease health care based on that diagnosis.
She said her sense of life’s purpose had changed, her basic needs …
HIV/AIDS vaccine underscores need for better health access
My youngest daughter just got married to a fine young man. She was beautiful and radiant.
As I gave my daughter away when the minister told me to, I sat down next to a picture of my deceased husband. He passed away four years ago.
Lisa was our last child. Most likely, she saw the truth.
She saw the way my husband treated me after the other two children had gone off to …
Domestic violence: May the circle be broken
Here — outside with nature — this was where I needed to be. It was raining cats and dogs, unlike the light drizzle earlier in the day.
Earlier in the day.
Earlier in the day, I could still see the casket go into the ground, adding finality to the affair as if death was not final enough. Goodbye, Baba. I was yet to cry. That was why I needed to be here. …
What my father taught me about language
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“Scarcity has, in many ways, defined the COVID-19 experience in the U.S., from shortages in personal protective equipment to ICU ventilators and hospital capacity, to COVID test kits, to drugs like Remdesivir in hard-hit states. These shortages have added impetus and new dimensions to existing conversations around health care …
Is COVID a turning point for sustainability in hospital supply chains? [PODCAST]
Nothing like a tragic global pandemic to make everyone rethink their careers. This past year and a half have brought a lot of changes to the workplace. Many of us don’t want to go back to the way things were. According to a Pew Research Center survey from late 2020, of the 71 percent of employees working from home because of the pandemic, more than half, given …
Can medicine transcend beyond the clinic walls? I’d like to see us try.
In the past week alone, I have heard the following comments from pediatricians on the front lines: “I’ve been practicing for 21 years, and I’ve never seen things this bad”; “I have been called uncaring because my patient had to wait an hour. But I couldn’t tell my patient that I was running behind because of a suicidal patient”; “I’m considering leaving clinical medicine because it seems like there is …
The pediatricians are not alright
Surgery to remove the gallbladder is a relatively late intervention. The first laparotomy was performed in 1807 in Danville, Kentucky, and surgeons like Billroth and Kocher, were removing thyroids and even parts of the esophagus as early as the 1870s; the pricklish gallbladder was not completely excised until 1882. For years previously, the medical and surgical dogma was that the gallbladder was an essential organ and couldn’t safely be …
“Technology continues to evolve every day. In the near-term future, portable and easily deployable robots will allow surgeons all over the world to perform minimally invasive surgery in an increasing number of procedure types and become even more effective surgeons. To achieve our goal of having a future surgeon workforce …
Robotic surgery’s impact on training the next generation of surgeons [PODCAST]
Sometimes I really look forward to something new. An alien race arriving on earth would be a nice start. I think we could all use a change in the news cycle. Because I am very tired of thinking about, talking about, and especially treating COVID-19.
In all of my years of medical practice, I have never seen anything that taxed the system and caused so much mayhem, while simultaneously producing such …
Trapped in a cauldron of suffering, medical staff are weary
According to the Smithsonian Magazine, diamonds are formed deep within the earth, about one hundred miles down in the upper mantle. As you might imagine, it is quite hot in that part of the planet, and there is a tremendous amount of pressure bearing down in that location. The brutal combination of pressure and heat is what it takes to form diamond crystals.
Now, we can’t actually travel there or even …
Clinicians are diamonds in the rough
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