I started internship July 1, 2008, as a terrified 25-year-old blank slate. Most days started with a combination of nausea and dread as I pumped myself up in the resident parking lot — conveniently located a mere 1/2 mile from the entrance to the ivory tower I called home.
The days were long. The nights were longer. Every month I had the chance to be a brand new idiot as a …
A physician’s return to the ivory tower
We all have that one patient. That one patient who can always find a way to turn a good day bad, who just knows how to push your buttons in all the wrong ways.
Who’s that patient for me? Let’s just call him Elton Reed.
Oh, Mr. Reed … where to begin with him?
When we first met, I remember being so excited and energized by him. He just had this fresh feeling …
The one patient that drives physicians to burnout
My name is Dr. Uchenna Umeh, and I am an immigrant (physician).
As far back as I can remember, I’ve always wanted to be an architect. My journey to becoming a physician started somewhat as a dare. I was born in Nigeria, the first child of six children from middle-class parents. My father served in the Nigerian air force; my mother was a banker.
Towards the end of my secondary education (I …
An immigrant physician’s journey
To me, my white coat symbolizes a willingness to care for my fellow man, and every day I strive to fulfill that challenge. But even the brightest white coat has a few stains. Growing up in a small Midwestern town, I just didn’t “get” the homeless community. They were completely isolated from my day to day life. Surrounded by my local community, I just assumed that the homeless were either …
The paths to homelessness are more complicated than we think
“Tell me something you love.”
I love warm chocolate chip cookies — straight out of the oven.
“Thank you. Tell me something you love.”
I love to read, to write, to dance. I don’t know yet if I love medicine.
We were gathered in a ballroom, a group of doctors and dancers, to explore the art of medicine through movement. I sat cross-legged, looking into the eyes of a person I did not know, …
I want to learn how to love medicine
Trends or challenges have been a part of the fabric of social media for a long time. They have ranged from the benign ice bucket challenge (which raised millions for research on amyotrophic lateral sclerosis) to the highly dangerous Tide pod challenge (which involved eating laundry detergent capsules). All of these internet phenomena involved videotaping an individual who performed a bizarre physical action for the …
The problem with extreme social media challenges
I’m probably in the minority on this, but I’m not a fan of the NYU School of Medicine free tuition program. Now I’m all for debt relief for medical students who start their careers with a mortgage. I was one of them. After 13 years, I’m still one of them! I’m also for any initiative that drives more medical students to career paths like primary care, where massive debt makes …
The unintended consequences of free medical school
The landscape of health care has changed nearly beyond recognition in the past decade. If you’re a veteran of the profession, you’ve seen the other side of things — you once had the chance to live the dream, to swim in the pool of autonomy and self-employment, to call the shots and act on behalf of the patient without the constant supervision of bureaucracy. If you are new to the …
The effect of private equity in medicine
Nobody punched me in the face. Maybe I would have preferred being punched in the face, though. And yes, I was bullied. I’m not going to talk about my own experience in this post however, because I already have post-traumatic stress disorder from the experience. I’m not ready to revisit it in detail yet.
I don’t need to talk about myself to tell you about bullying in the medical arena. I …
These are the stories of how physicians are bullied
We are human, we are not indestructible. We have feelings and emotions that can get hurt, probably more than the average person based on the careers we have chosen. Yes, we will pass up on our well-being (such as sleep, hygiene, exercise, relationships with family and friends) to be there for our patients. To receive our critical training to be able to care for others. This is our sacrifice, and …
We’re doctors, but we’re humans too
Will physicians go extinct? Artificial intelligence, legislation, profit motives in the health care industry, and clever lobbying by non-physician providers may all contribute to our demise. However, I believe the existential threat to our profession stems from the ranks of physicians themselves.
1. Unwillingness to embrace activism
Pathologist and writer Rudolph Virchow once said: “The physician is the natural attorney of the poor.” Like most physicians, my goal is to provide evidence-based …
4 reasons why physicians will become extinct
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 49-year-old woman is evaluated during a follow-up visit. She is overweight and has hypertension and type 2 diabetes mellitus, both of which are well controlled. For several years, she has attempted to lose weight through various commercial diets; dietician-monitored, calorie-restricted diets; and physical activity. She has worked with a behavioral therapist, and …
MKSAP: 49-year-old woman with obesity, hypertension, and type 2 diabetes mellitus
So last week, I did the bravest thing I have done in a very long time — I quit my job. Yes, I put in my 60-day notice. This was my dream job post service in the U.S. Air Force. I had dreamed of working in this establishment for months before my service time was up. I could not have been happier when I joined their team, a group practice …
Why this physician quit her job
The upgraded responsibility and authority given to starting residents is both a blessing and a curse. Suddenly, the need for co-signatures vanishes. There is greater autonomy in clinical practice. Residents get paid. However, residency can also be a time of significant stress. Residents are forced to navigate the demands of preceptors, other residents, medical students, nurses, patients, family members, and administrators. Residents have very little control over what they do, …
10 ways to make residency less stressful
“It kind of strips you of any pride that you have. It was very humbling.”
As a care manager, Mary helps patients follow their care plans by coordinating medical visits and community resource referrals, but this was the first time Mary shadowed one of her patients out in the community. At the food bank, Mary watched her patient, who was living with diabetes, receive one box of macaroni along with other …
How to be aware of patients’ non-medical needs
Imagine spending days or even weeks in an emergency room without treatment for a broken leg or painful kidney stone.
Patients in psychological crisis across the country are living this exact scenario. Long waits in an ER, hospital room or prison for an inpatient psychiatric bed, otherwise known as psychiatric boarding, are their unfortunate reality.
Rewind to over 50 years ago — as institutionalized patients were gradually integrated into communities, the availability …
Let’s talk about the psychiatric boarding crisis
Dear first-year medical students,
Welcome to medical school — congratulations! You have worked, sacrificed, waited for this moment for many long years, have left blood, sweat, and tears along the tracks of your life marathon. This is the first checkpoint in your journey. You’ve made it. Your loved ones are right here cheering your accomplishments, there are many. That new, freshly-pressed, short white coat makes you look like an absolute stud(ent). …
Welcome to medical school. Welcome to the rest of your life.
I began practicing as an internist/nephrologist in the early 1960s. Having rented an office in Los Angeles, I introduced myself to the local medical community and set out to build a practice.
With a growing family, a mortgage and an office to support, I was hungry for patients. Hospital emergency rooms were good referral sources, so I took ER call at three different hospitals.
Late one Friday night, I got a call …
You can’t always expect a miracle, but you can always hope for one
Have you ever been the only customer in your local supermarket? Although the experience can be a bit unnerving, at first, you soon start to notice the advantages: No line at the deli, no pushy shoppers, no carts jamming up the produce section. As you breeze through checkout, you think to yourself, “Gee, I could get used to this.”
Now, imagine walking into an empty waiting area at your local emergency …
3 ways to decrease emergency department wait times
Recently, a respected allergist reassured his audience: the mortality rate for food allergy is very low. The risk of dying in a car crash is much greater than the risk of dying from food allergy. The implication seemed to be that the anxiety around food allergy is misplaced. Though any loss of life is too great; statistically, food allergy deaths are rare. To the food allergy community, it just doesn’t …
Food allergy: Death is not our only fear
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