I swiped this editorial cartoon by Steve Sack from the redoubtable Dr. David Gorski’s blog, who goes by the nom-de-web of Orac. Recent epidemiology shows reducing the fraction of vaccinated children in the population rather promptly leads to a resurgence of the diseases vaccines protect against. This is the concept of community or herd immunity. …
Why demanding a randomized controlled trial for vaccines is disingenuous
Sanjay Gupta. John Locke. Jill Stein. Charles Krauthammer. What do they all have in common?
If you guessed that they are all physicians, then you’re right.
Less salient, however, is the fact that all of them pursued passions outside of medicine. (Dr. Gupta is an Emmy Award-winning medical reporter. John Locke was a physician-philosopher. Stein and Krauthammer both made their mark in politics.) In doing so, they avoided an existential trap that …
Why medical students should not let medicine define them
Anger. Jealousy. Envy. Frustration. I was feeling all the emotions when NYU announced in August that their incoming and subsequent classes would be tuition-free into perpetuity. One consolation: at least I wasn’t one of the chronologically unfortunate that graduated from the school just months, or a year, before that announcement. For them, the time difference was small, but the difference in loans was vast — one year of tuition costs …
You shouldn’t worry about public service loan forgiveness
I remember sitting in my residency academic adviser’s office as I was discussing the plans I had designed for my community project at the end of my intern year. I can only imagine what she thought as I looked at her with a blank stare when she had suggested I should create an original research project around this. “What?” was all I had managed to mumble out of my mouth. …
5 lessons on doing research as a resident
“There will always be suffering. It flows through life like water …”
Those famous lyrics sung by Nick Cave in his Lime-Tree Arbour ring true for many of us. They take on an entirely different layer of meaning for physicians.
Even the very journey of becoming a physician is marked by suffering. While many of our classmates frequented football games, nightclubs, and social events, most of us were studying day and night …
The gift of suffering in medicine
I still remember the warm, fuzzy feeling of receiving my first few interview invitations. Unlike medical school, I received much more “love” from residency programs. Since I was part of the inaugural class of a new medical school, I interviewed for a lot of programs: 16 anesthesiology, six transitional years, and three preliminary medicine programs. After my first few interviews, it became apparent that most residency interviews tend to be …
What I wish I knew on the residency interview trail
An excerpt from Dead Execs Don’t Get Bonuse$: The Ultimate Guide to Surviving Your Career With a Healthy Heart.
The details of the careers and tragic deaths of these CEOs are a matter of public record, and the disruption that followed their deaths was enormous. Take Ranjan Das, for example. …
What we can learn from the tragic deaths of CEOs
“Passion isn’t a path in the woods. It is the woods.”
-Tom Robbins, “Half Asleep in Frog Pajamas”
I’ve met plenty of accidental physicians. These have been photographers, travel writers, artists, outdoor guides and chefs who awoke one day to find themselves doctoring. Their passions didn’t die — they were just delayed by lifestyle choices. By the time they recognized a need to follow their passion, they were at least partially through …
It’s better to not go into medicine than try to get out of it
On my first day of medical school, my father, a dentist, told me he’d just been diagnosed with stage four pancreatic cancer. Cancer had crept back into my life — except this time not into my body.
At age 12, I was diagnosed with brain cancer. After an aggressive surgery, I was tumor-free for 10 years. Then, at 23, I received the news of an inoperable recurrence.
While going through radiation and …
There’s no textbook for when your father is dying
Have you ever felt so cold? I mean bone-chilling cold. I don’t mean the same kind of cold that northern winters can leave you feeling. I am talking about working in a hospital that is climate-controlled, and you are undoubtedly shivering.
I still remember my first day on the job as a neonatology fellow. I was anxiously walking to the operating room to attend the delivery of a 25-week infant. As …
A physician loves the adrenaline surge
Sometimes things go just the way you want them to, and sometimes they don’t.
Compare and contrast the case of two different patients, and how things went trying to get them the care they needed.
The first patient, let’s call him Mr. Smith, called up one day last week with a brand-new symptom, which after a phone call was ultimately determined to be disturbing enough that he was offered a same-day appointment.
After …
When physicians order tests: a tale of 2 patients
Within the medical community, there seems to be a prevailing belief that when it comes to business and finance: Well, we’re just not very good at it. Some chalk it up to the lack of financial training we received in medical school. Others say it’s simply not in the physician’s DNA – that our brains are wired differently.
I would disagree.
In reality, I’ve seen many, many physicians become successful …
Physicians have the skills to be entrepreneurs
I don’t miss making the phone calls in the middle of the night.
“Hi, this is Dr. Yang calling from the psychiatric emergency service. May I speak to Mr. or Mrs. Doe?”
“Yeah, this is Mr. Doe,” he’d reply, his voice thick and slow with sleep.
“I’m sorry to call so late. Your son is here at the hospital.” Take a breath and slow down for the next part. “He’s alive and doing OK at …
The phone calls physicians make in the middle of the night
There’s a lot of financial information out there. Some of it is helpful, and some of it is unhelpful.
I’m sure many of you take notice when the Dow Jones falls 1,000 points in two days.
And even if you don’t usually follow the stock market on a daily basis, when the stock market is dropping, the financial news media will let you know about it.
Because when the stock market is crashing, …
Don’t watch too much financial news
The discharge process has now been recognized as one of the most crucial points at which the actions of doctors and hospitals can have a huge impact on immediate health outcomes for our patients. At a time when 30-day readmission rates are still touching almost 20 percent for Medicare patients (higher for certain patients, with up to a third of these occurring in the first 7 days), there is an …
We can do a better job with hospital discharge paperwork
Failure is a guarantee. “Success” assumes that certain metrics have been set and that the words used to describe those metrics are understood in the exact same way by all parties involved. One patient with parotid cancer and given facial paralysis after surgery was thrilled to be alive. Another is furious about a widened scar.
The brain, primed to act on behalf of the organism, works at times without our input …
Why physicians should embrace failure
This article is sponsored by Careers by KevinMD.com.
Whether you’re looking for a new position or just wanting to connect with colleagues, LinkedIn is a great resource to advance your career. As a healthcare professional, having an online presence can understandably make you uneasy, especially when it comes to concerns about privacy or potential HIPAA violations. However, in today’s technological …
6 ways physicians can improve their LinkedIn profile
In the era of #MeToo, Missy Elliot, Whitney Houston, Tyler Perry, Oprah, Ashley Judd, Gabrielle Union, Teri Hatcher and, now, Padma Lakshmi — keeping kids safe and helping adults heal is our job as physicians. I am a pediatrician — and I am an incest survivor. My perpetrator was also a physician. I bore a dirty secret before I knew what a secret was. The person who hurt me was …
Don’t ignore incest: advice from an incest survivor
The medicine I practiced between 1974 to 1992 is gone. Evidence is the coin of the realm in the courts of modern medicine. The rule “first, do no harm” demands a corollary — be paranoid.
We receive extensive training and licensure to “touch” patients. Any person who is not a physician who cuts into another person commits a very serious crime. The same is true for merely talking with a person, …
Care but don’t touch: Being wise in the modern era
I am both relieved and nervous because they say that the first year is the worst, but now I have the overarching cloud of doom following me around during second year: Step 1.
Now that I’m home, I constantly am wondering how I made it this far — in disbelief that I passed all my courses pretty well. I constantly ask myself if exams were too easy and if I’m just …
Reflections after finishing the first year of medical school
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