I am working hospitalist right now. On Friday, a man in his 80s was admitted with difficulty breathing. He had a complicated history, including a heart attack at age 35 with all the subsequent sequela of heart disease. He had an abnormal heart rhythm and was taking a blood thinner for stroke prevention. In addition, he had scarring of his lungs (cause unknown).
He was transferred to us from another hospital. …
“I’m going to write a column about dating you and call it ‘Sleeping with the Enemy,’” I announced from my rocking chair. His rocking stopped. “The enemy?” The rain was falling on the trees in front of my porch and on his parade. “Why am I the enemy?” “You know, clinicians vs. hospital administrators.” “Really?” he naively asked. “Why don’t clinicians like us?”
I was surprised he was so in the …
The stretcher was wheeled into the operating room. I had been in this room on three prior occasions, under very different circumstances. But today, as I lay flat on the table, listening to the small talk around me, I tried to breathe against the weight of the baby and the pressure of the procedure. My husband will later tell me it happened so quickly, but for me, time stood still …
It will start as a minor curiosity. Maybe a student will seem slightly too close to the resident on your team. When the grades are posted, you’ll wonder why you didn’t get honors, but he did. You might wallow for a few days. Make an offhanded comment to your fellow students. Then you’ll let it go and move on. Or so you think. Until during surgery when the scrub nurse …
As the millennial presence in health care becomes more prominent, the climate of the health care system will inevitably change. Speaking from a personal perspective, there is a growing emphasis on lifestyle in the conversation of career choice. Medicine is becoming less and less of a life, and more of a part of life, a part of the work-life balance. We (millennials) also place emphasis on impact. We want to …
Being in a hospital is a scary and frightening time, and it’s easy for those of us at the frontlines — doctors and nurses — to forget that as we go about our busy work days. Patients are at a very low point in their lives and will remember everything about their hospital stay, including all their interactions, for a very long time.
As someone with a keen interest in improving …
I’ve had many opportunities to address physicians across the spectrum of health care settings, from those who run private practices, to those who work in large and small groups, to those who are hospital affiliated and employed. I often ask them the question “who controls the practice of medicine?” The answers I receive vary: government, insurance companies, hospitals, health systems, lawyers, employers and, rarely, patients. But one answer I never …
I burned out early. I was done being a doctor at the end of fellowship. Although I took a job as a critical care physician, I desperately sought to alter my career somehow. I looked into website development, something I had been good at in high school. I took a few refresher classes on my days off and started coding my own sites. Luckily, my first job out of fellowship accepted many …
I’ve always wanted to be a pediatrician because I love kids; if you ask most people who work in pediatrics whether nurses or physicians they may say that. It’s a very common response to the question “Why pediatrics?” Or how can you do pediatrics?” when students and physicians are asked. Yes, we love working with children for many reasons. Some love the unexpected unrehearsed things kids say; they will shock …
“Why do you eat so healthy?” or “Where’s your kale today?” I would hear regularly.
For as long as I can remember, my colleagues and friends have often smirked at my lunch choice. To me, I always ate what I enjoyed (even if it was the occasional french fry), and my diet and lifestyle were all about balance. Growing up, I played competitive soccer for 10 years and knew my performance …
Many patients are referred to me as a psychiatrist to treat their depression. The new patients that come to me for depressive symptoms usually expect that I will be recommending and prescribing an antidepressant for their depressive symptoms because that is what a psychiatrist does, right? Not always.
Often times these patients come to me having gone through several antidepressant trials without any successful resolution of their depressive symptoms. Well, sometimes …
Wellness. It’s all the rage these days as we try to manage our crazy work schedules while still maintaining balance in life. We have wellness committees, wellness workshops, wellness coaches, and wellness apps for our smartphones.
So, then, what does it mean to be well?
To the average person, and to the dictionary, to be well is to be “in good health” or “in a good or satisfactory way.”
However, to those suffering …
So, how do you do it all?
It’s a Monday morning. After a flurry of activities, I am walking into the office at 8:00 a.m. I think back to the past 2 to 3 hours. I was up at 5:30 a.m., and in my workout clothes soon after. I managed to squeeze in a 20-minute workout, thanks to a video on YouTube. I then reviewed my schedule and patient charts for …
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As a medical student, I had nightmares about my first day in the OR: scrubbing incorrectly, contaminating a sterile field, forgetting the anatomy I had so carefully studied the night before. It seemed like the only thing I could do in that artificially lit room was mess up. After a few cases I came to love the routine and ceremony of each surgery: the timeout; the rhythmic pattern of suture, …
How do you describe the feeling when you are at a restaurant, and the waiter sees your coffee cup at less than half full (never half empty) and without asking they refill the cup or better yet, bring you a fresh cup of coffee? If you are like most customers, you have a nice feeling about the restaurant and the waiter as they have anticipated your needs. Usually, this anticipatory …
Here’s a quote that readers will not readily recognize: “It is a pity that a doctor is precluded by his profession from being able sometimes to say what he really thinks.”
I’ll share the origin of the quote at the post’s conclusion. How’s that for a teaser? I’ll give you a hint below.
Physicians, by training and experience, are guarded with our words. To begin, we are never entirely sure of anything, …
The women’s health has a history of being a volatile sector, especially of late. It is an area of medicine where politicians think they can have access to intimate and confidential patient-physician relationships. This is unacceptable and an invasion of privacy.
Voluntary termination of pregnancy. Voluntary interruption of pregnancy. These are the medical terms for what the layperson thinks of as an abortion.
Missed abortion. Threatened abortion. Incomplete abortion. Spontaneous abortion. Septic …
Recently, the ACGME (Accreditation Council for Graduate Medical Education) made the reckless decision to increase work hours to 28-hour shifts for new doctors. Here are the catastrophic consequences of their decision. Here are actual quotes from physicians (de-identified with some patient details changed to protect confidentiality):
“I did my internship in internal medicine and residency in neurology before laws existed to regulate resident …
“I can do that?”
During a recent morning practice session, a resident was presenting a patient who had had several episodes of syncope which culminated in a trip to the emergency room. She had a brief stay there, and on the discharge plan was written “follow-up with PCP and with cardiology.”
We went through her history and physical examination, we talked about how to further …
If you were to sit in on any routine doctors visit, you are bound to hear a few things repeatedly.
“Do you smoke? How much alcohol do you drink, if any? What is your diet like? How much exercise do you get weekly?”
These are questions we are trained to ask as early as the first week of medical school. We are taught to treat not just the conditions a patient presents …
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