My friend, Lello Tesema, and I were sitting in a restaurant in Harvard Square. It was the first, feverish bit of spring when it seems like the entire city has emerged en masse from their winter dens. We were sitting outside under patio lights, wearing regular clothes instead of our usual scrubs. I should have been happy.
As often happened in those days, I asked Lello if things were ever going …
How to talk with a struggling physician colleague
We were in the middle of the morning routine – sign out between mouthfuls of eggs and homefries – when the call came in overhead, “Code Blue, 9 West. Code Blue, 9 West.” Just like that, our team snapped into action, the continued banter only thinly concealing a change in demeanor: backs straight, jaws set, we walked with a sense of purpose. There was a life on the line.
By the …
Reflections after a medical student’s first code blue
The most important piece of advice I can give to incoming medical students is to be vigilant about how you are feeling day-to-day and to be aware of your actions. As is often said, our personalities, the distinctive makeup that makes us who we are, are set in stone. If you are a mindful person, you’ll stay that way even as you get older. If you are someone who likes …
Why medical students should develop and increase self-awareness
Brittany Maynard was diagnosed with grade 2 astrocytoma, a form of brain cancer on January 1, 2014, her cancer also returned in April 2014, where her diagnosis was elevated to grade 4 astrocytoma, also known as glioblastoma, with a prognosis of just six months to live. She decided to take lethal drugs prescribed by her physician to end her life on November 1, 2014, at her home in Portland, Oregon. Under Oregon’s “Death …
The growing role of end-of-life activists
Several patients seen in our practice recently were significantly and dramatically transformed by the electronic health record (EHR). And not in a good way.
Take, for instance, the patient whose outside chart was reviewed when she showed up in our office for a follow-up appointment after an emergency department visit.
The notes from the emergency department providers, including a scribe and the …
The problem with abbreviations in the medical record
By now, I’m sure most of you probably have heard about the Cleveland Clinic first-year resident who was fired last September when it became known that in 2012 she had tweeted she would “purposely give all the yahood [Jews] the wrong meds …”
The website Canary Mission documented numerous tweets expressing similar thoughts. She has apologized but will likely have great difficulty finding another job as a physician.
This …
Should residency programs review their applicants’ social media history?
I have spent the greater portion of my 20s enduring a premature quarter-life crisis. Patterns of self-doubt and debilitating anxiety became my new normal.
I was rejected from medical school — again.
After taking time to process the reality that I would have to wait another year to re-apply, I fervently journeyed through a messy jungle of introspection that led me to these six lessons. Although I learned more than I could …
6 things learned from being rejected from medical school
This article is sponsored by Careers by KevinMD.com.
Physician burnout is not a novel topic within the health care industry. Numerous studies have been done on the increasing prevalence of its symptoms — from emotional exhaustion and loss of empathy to doubt that one’s work even makes a difference — among today’s practitioners. In fact, a recent …
Do smaller, independent practices have happier doctors?
Pharmacists play an essential role in today’s ever-expanding health care system today. They check for drug interactions, watch for signs of opioid overprescribing and try to determine whether a drug for one condition prescribed by one doctor will negatively impact the patient because of another diagnosis the patient has. In hospital units, their roles have become yet more complex — often serving on various quality committees, managing daily dosages of …
The conflict between pharmacists and their corporate superiors
Many times during difficult patient interactions — when I am not sure about the right thing to do — I let myself be guided by the question: “What would I do if it was my family member?” This internal dialogue usually cuts the clutter and lets me focus on the most important thing: the well-being of my patient. I can step away from the behavioral chaos and guide them in …
Treat your family like you treat your patients
I posted on social media that in 2019, I would compete in Ironman. I wanted to hold myself accountable and was announcing “I could do this.” My primary reason, so I thought, was that “I wanted to grow mentally and physically.”
Since then, I have been training six hours per week on top of my usual daily routine. I have been mentally and physically challenged in ways I didn’t think possible. …
This physician chose not to do a triathlon. Here’s why.
Sustainability is a bit of a buzz word these days. To be sustainable means that you only use what you need, leaving the rest to be used by you or others in the future. Sustainability is a popular topic in environmental sciences and refers to renewable agriculture, good stewardship of natural resources and recycling of waste. What about sustainability in health care?
In health care, we often describe The United States …
My garden has taught me a lot about health care
The woman waiting to see me looked every inch a lawyer or accountant in her black pencil skirt, pink shirt, and a Chanel-style houndstooth jacket. Her ankle boots were reminiscent of those worn by women in Victorian times with a row of small buttons up the side. She had a scarf loosely knotted around her shoulders, and her hair was …
What clothing choice says about a patient
Earlier this year, we put together a list of what we thought were the best medical apps for health care providers. Now at the end of 2018, we’re augmenting that list to give you a full picture of what we think are must-haves medical apps for those in primary care.
Safe Motherhood Initiative: ACOG DII SMI
Quick reference for common obstetric emergencies
Many of us in family medicine practice full-scope …
Must-have medical apps for primary care
I want to share how the era of immunotherapy, specifically immune-checkpoint-inhibitors, has changed the landscape of community oncology practice in metastatic non-small-cell lung cancer, for oncologists and, more importantly, patients.
I want to tell you the story of Joe. A stage IV lung cancer survivor story. (Name and details changed to protect anonymity.)
In 2015, Joe was diagnosed with stage IV non-small-cell lung cancer (NSCLC), adenocarcinoma. He had multiple metastases to other organs. …
A stage IV lung cancer survivor story
I never really had a true mentor. Or role model. I wasn’t sure if they were the same thing, or what the difference was, so I gave up. Sometime in middle school, I remember a teacher encouraging us to find someone we looked up to and develop a mentor relationship. I was 12, looked at my teachers who I thought were old, and ignored that advice.
In high school, I thought …
To my mentor: Thank you. I didn’t know how much I needed you.
We learn about it in school as a formula. There is a checklist that we are given, and we ask our patients these eight questions and then calculate whether or not they have depression. It’s so simple. Anyone can do it! I never once thought that I would be calculating my own score at the prime of my education.
I entered medical school full of hope after years of failures and …
How this student took care of his severe depression in medical school
Stepping into a hospital for the first time as a clinical medical student is a strange dichotomy. There is still so much you have to learn before you will become a physician, but you are quickly thrust into life-and-death situations. One of my early rotations was in the emergency room. As a student, you have no actual authority and must be closely monitored at all times. Many times you will …
I had just witnessed my first patient die
Part 3 of a series.
Patients with advanced cancer are particularly vulnerable to infection due to a compromised immune system. Moreover, the typical symptoms of serious infection, such as fever and chills, may be absent in cancer patients. If not identified and treated early, infection can lead to sepsis, a life-threatening reaction of the immune system that causes organ failure, shock, and death, as …
Why did it take over a week for doctors to initiate treatment?
It seems like natural human tendency to explain ourselves. When we are late to a meeting, we come up with an excuse in case anyone asks. When our kid starts throwing a temper tantrum at the store, people stare at us expecting an apology. In the same way, when we decide that there are things outside of medicine that are more important to us than the job – an explanation …
It’s OK to care more about things outside of medicine
Get free updates delivered free to your inbox.
