Thirty-six years ago, I arrived an hour early for my first medical school patient care rotation at the East Orange, NJ, VA hospital. Over the years, ‘I’ve seen and learned (and unfortunately also forgotten) a lot about medicine and life. I have been writing down wise nuggets since that first year and keep reviewing and adding at times.
Here are 36 random reflections in honor of these 36 years that I …
36 things I learned in 36 years of medicine
Being a first-generation college student is hard. Being a first-generation college student and being pre-med is even harder. And since education and income are closely linked in the U.S., it’s no surprise that many first-generation college students also come from a low-income background.
I fell into this category.
My parents did not finish high school, and money was always tight. I had never heard of pre-med until I got to college. I …
To first-generation college pre-medical students: Your future patients need you
To fill an assignment in an undergraduate medical sociology class, my friend and I made an appointment with the assistant administrator in a local hospital. After the interview, we proceeded towards the exit by cutting through the obstetrical wards. We passed an exhausted young doctor with a stethoscope draped over his neck and hunched over a stack of charts. He glanced up as we passed, and we introduced ourselves as …
The secret to ending cynicism in medicine
I am one of those lucky souls who actually likes their job. Since I completed my pediatrics residency two years ago, I have been working in urgent care settings. What’s not to like? I get to see a wide variety of patients, I’m always learning something new, and I get to finish my encounters with a high-five from an overeager toddler. If you’re a general pediatrician like me, that’s the …
The scourge of the pediatric urgent care fellowship
On several occasions, most recently during a press conference in March 2019, Speaker of the House Nancy Pelosi has advocated changing the voting age to 16. Pelosi told reporters that lowering the voting age would increase engagement in politics among younger Americans and would help drive a higher level of voter awareness and turnout.
Speaker Pelosi is not the only prominent lawmaker to advocate for a lowered voting age. Also in …
Don’t lower the voting age, says this neurosurgeon
I am a small-town family physician, and I am blessed enough to be living my dream.
You see, I have always wanted to be a doctor. I cannot think of one other occupation choice that has ever entered my brain. I have wanted this since I was four-years-old, and I can remember in vivid detail telling the world this was what I was destined to be.
So what happens when your dream …
Medicine is my passion. I love my job, but I am human.
Recently, thousands of new residency and fellowship graduates have earned their wings and will be, mostly metaphorically, hanging out their shingles. Sadly, though, as the excitement of finally finishing training after decades of schooling wears off, even great work can become routine.
There is a parable about three men laying bricks. When asked what they were doing, the first man said, “Laying bricks.” The second man said, “Building a church.” And …
How to rekindle your love of medicine
At the moment, I should be studying for my first round of boards, but there is something I can’t get off my mind: sacrifice.
If you ask a medical student what they have had to sacrifice to study medicine, the list could go on for days. It could be small things like watching their favorite teams play or being caught up on current events. But more than likely we will list …
I will not stop sacrificing for my medical career
When I decided to become a doctor, little did I know that medical school and residency would be like a hazing for future physicians. We are broken down mentally and physically and then remade in the image of the “strong” doctor and to admit to being sick is equivalent to being weak. We are publicly shamed for admitting we don’t know the answer to daily pimping on morning rounds. We …
Here’s what I wish I knew as a resident
Although Arnold Knutsen and I “met” virtually five years ago, we only first spoke on the phone recently when he called to share his story. He’s the eldest member of the online benzodiazepine support group we cohabitate. His posts in the group always reeked of desperation, and there was a palpable sense of urgency to his pursuit of a cure for his situation. It was clear …
Are benzodiazepines “the worst thing that’s ever happened to people”?
Health care providers may have one of the most dangerous jobs out there — and it is only getting worse. Nearly 74 percent of workplace assaults occur in the health care setting, and health care accounts for almost as many serious violent injuries as all other industries combined. The statistics are alarming. Seventy-eight percent of emergency physicians report being targets of workplace violence in the …
Workplace violence in the health care setting is a public health emergency
Locum tenens is a great way to make a living or earn some extra income. But frankly, there are some groups of physicians who should not even consider doing locums work. When you pair the right person with the right job, you can get employment bliss. But when the wrong person takes a job, both the employer and the employee are often unhappy.
I believe everyone should enjoy the work they …
Considering locum tenens? Think about these factors first.
Here is a standard emergency department situation, played out all across America today.
Patient X has schizophrenia. He takes medication, but only until he feels better. He is calm when he takes it, but sometimes aggressive and assaultive when out of treatment and off medications.
Patient X decides to leave town and drive somewhere else because he is angry at 1) family 2) significant other 3) health care system 4) situation.
He is …
The default for psychiatric patients: “Send them to the ER”
I’m a physician married to a physician. Initially, I did not think I would face obstacles because of our dual career paths. I would soon learn; however, professional and personal sacrifices would be necessary for us to achieve our goals. This is my story as a training physician and a “single” mom, including some of the challenges I experienced being married to a physician.
I met my husband in the first …
I had the distinct pleasure working with family physician colleagues in Sweden recently. It was a similar experience to a trip I made to Britain about five years ago that I also wrote about. I got to spend some time watching one of my colleagues care for her patients in her surgery (they use the same description of a clinic as the British).
I got to spend some time watching …
An American physician in Sweden. Here’s what he thought about its health care.
Health care is a tough job to work in — whether you are a doctor, nurse or any other professional. We are dealing with matters of life and death, our patients expect (and deserve) the best from us, and we always have a hundred-and-one things to do at the frontlines of medicine. I remember reading somewhere when I was a teenager that a career in medicine would be a “mentally, …
Why you’re an unhappy physician
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 23-year-old woman is evaluated for 2 weeks of painful lumps on her legs. The lumps persist for several days and make it difficult for her to go to work as a waitress. She is a college student in Ohio where she has lived her whole life. She has …
MKSAP: 23-year-old woman with painful lumps on her legs
I, like many physicians, am the only doctor in my extended family. To say that they are proud is probably an understatement. I’ve been a practicing physician for seven years now and yet my grandmother each time I see her greets me with, “There’s my doctor grandson.” I have worked quite hard to get to where I am, and I enjoy what I do. I, too, am proud to be the …
The line between family member and personal doctor
“Burnout” has been a buzzword circulating in the medical community quite a bit lately. The World Health Organization has just recognized the term as an official medical diagnosis as part of ICD-11.
One moment you’re graduating medical school, full of hope and excitement for residency. The next moment, you’re overly stressed and working insane hours every week. Honestly, it isn’t a huge surprise that nearly half of all physicians …
The pros and cons of being a part-time physician
Some drugs are used for indications beyond their original FDA approved ones that make complete sense. I mean, if old seizure medications help nerve pain, it might be reasonable to try new ones for the same purpose if everything else fails.
Sometimes the broader use of a medication leads to additional FDA approved indications. One good example is bupropion, Wellbutrin, for smoking cessation. It even got a new name for that indication, Zyban, …
The art of off-label prescribing
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