From the first year of medical school, we are trained in probing into the most personal aspects of patients’ lives; but when it comes to spirituality, we shy away. In a survey of the U.S. general public, the 2008 Gallup Report demonstrated that 78 percent of people believed in God and an additional 15 percent believed in a higher power. Other studies have shown that religious beliefs and …
It’s time to ask patients about spirituality
“What do you want to be when you grow up?”
It’s a common question we ask our youth, and I remember as young child sharing my aspirations with family members. When I answered “I want to be a doctor when I grow up”, I received positive feedback and praise. As an innocent little girl, I had no idea that there were people in the world who wouldn’t be as supportive of a woman in medicine.
Later …
What National Women Physicians Day means to me
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 24-year-old woman undergoes routine evaluation. She is pregnant at 12 weeks’ gestation. Medical history is notable for homozygous sickle cell anemia (Hb SS). She has had multiple uncomplicated painful crises treated at home with hydration, nonopioid analgesia, and incentive spirometry. She requires hospital management for these episodes approximately twice per year. She has declined …
MKSAP: 24-year-old woman with sickle cell anemia
Slave, I am not
Servant, I may be
Arrogant, I am not
Ignorant, I may be
Un-engaged, I am not
However, Quiet, I may be.
Your coat is long, mine short
Your knowledge mile deep, mine mile wide
You have seen 100 patients this week, I have seen 10
You trained for 10 years, this is my first
If I look scared, it’s because I am
If I seem intimidated, I indeed am
If I appear confused, I in fact am
If I …
I demand you consider us humans: A medical student poem
In high school and college, I waitressed in a Dunkin’ Donuts shop that sat between Boston Common and the Combat Zone’s porn shops, strip clubs, and bars. The wages paid for school, clothes, rent, and food. At the time, I didn’t realize this job would provide useful skills for my later medical career, an early pre-med training of sorts.
Look the part. I donned the bubblegum pink polyester uniform that clearly identified …
What this physician learned from being a doughnut waitress
Let’s start with the most important part first. Your primary goal while in residency/fellowship is to become a great doctor. The kicker is that you also have to devote some time to your finances and not completely neglect them. We will outline the few financial items you should worry about while in residency.
Student loans
If you don’t have student loans, go ahead and skip to the next item; however, the unfortunate …
A medical resident’s guide to personal finance
An article released in the JAMA sites evidence that the suicide rate in America has risen by 24 percent in the last 15 years associated with a significant reduction in the numbers of psychiatric beds available. The U.S. has had a lower capacity for psychiatric patients than comparable countries in Europe for years, but between 1998 and 2013 that number dropped even further.
Waiting in the ER for days
This …
Why America fails at psychiatric care
I still don’t know how I did it. I don’t know how I got through life as a lower-level neurosurgery resident. I vividly remember the horrific call nights and weekends. There are certain sensations you get when you have gone weeks without more than two or three hours of sleep at a time. It wasn’t the foggy thoughts that bothered me most, or continually feeling cold, or even when I …
The debate over how many hours an intern can work misses the point
My wife who is eight months pregnant went to a routine prenatal appointment last week. She told the OB doctor that she was concerned she had pink eye. OB providers, along with pediatrics, family medicine, and internal medicine all constitute primary care providers (PCP) and pink eye is a common primary care condition.
Surprisingly, the OB physician referred her to the nearest acute care facility. Attributing this provider’s recommendation as rare …
My primary care doctor sent me to the emergency department
Empathy is the cornerstone of quality patient care. It is no surprise that the fundamental moral code that has facilitated human kindness for thousands of years is what drives physicians to commit to their oath today: Treat others as you would have yourself treated.
When it comes to the disease that is obesity, I can empathize. I’ve struggled with obesity for as long a time as I can remember. There are …
Obesity and empathy: A physician’s New Year’s resolution
It’s October, and I’m a second-year medical student. My best friend Carly and I have just finished a backpacking trip through South America. We fly out tomorrow from Lima, Peru, and we have just one thing left to do: eat shrimp ceviche, the classic South American dish of raw seafood marinated in lime or lemon juice, oil and spices.
We wander along the busy streets until we find the restaurant our …
An order of ceviche, please. With a hospital visit on the side.
“Life is just a short walk from the cradle to the grave, and it sure behooves us to be kind to one another along the way.”
– Alice Childress, American playwright, actor, author (1912-1994)
I am awakened in the wee hours by the sound of rain. Ordinarily I would return to bed in hope of stealing more sleep from night, but this particular day I know I have to rise at 4:30 …
A day in the life of a radiologist
Well, I’m officially that old, bitter resident. I had to walk uphill to medical school 10 miles there and back. “In my day,” medical school was fail, pass, high pass, or honors. I recently found out that the medical school I graduated from has changed the first two years of basic science courses to simply pass/fail (while retaining the honors/high pass grades in clinical rotations). I am so annoyed! Why …
A medical school goes pass-fail: Why this change must happen everywhere
Most third medical students look forward to their psychiatry block. After twelve plus hour days and six day weeks on internal medicine, OB/GYN and surgery, the reasonable hours on psychiatry seems like a dream. While my classmates viewed psychiatry as a break, I dreaded it. This was not my first time on an inpatient psychiatry ward.
My world and fate forever changed when I was twelve years old. Sometimes depression is …
The psychiatry rotation terrifies this medical student. Here’s why.
Halfway through the “Bell Curve,” which is an analysis of differences in intelligence between races, I realized what had been bothering me about Charles Murray’s thesis. It wasn’t the accuracy of his analysis, which concerned me too. It was what he analyzed. The truth, I used to believe, was always beautiful, whether it was what happened in the multiverse at T equals zero or the historical …
The deadly risk of being treated by a male physician
You submitted your application in July. You completed all of your secondary essays by mid-September. Other than one interview that resulted in a waitlist decision you’ve heard nothing but radio silence. What can you do?
Whenever I work with medical school applicants I emphasize that the application process is ongoing because the admissions process is fluid. It is not as if you submit your primary application and secondary essays and the …
Medical school applicants: Waitlisted? Want more interviews? Here’s what you can do.
An excerpt from Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine.
Mark Linzer’s research identified workplace chaos as one of the key predictors of physician stress, burnout, and intention to …
There is a direct connection between inefficiency and burnout
This post is based on a “friend of a friend” situation. Important details have been changed to protect anonymity, but not the basic realities I want to discuss.
A 49-year old man was diagnosed with a rare form of lung cancer about a year and a half ago. This sad situation is compounded by the fact that he was in a stable marriage with a wife and two children, ages 10 …
We must tell sad medical stories too
I was incredibly nervous going into my first day in the inpatient child/adolescent psychiatry unit. “Was this where the truly psychotic kids are? Am I going to be safe here?” I wondered as I casually introduced myself to the staff on the floor. After a morning of sitting in on group therapy led by psychologists and occupational therapists, I calmed down. Against the backdrop of the soothing soft pastel colors, …
The one lesson I learned working in a psych unit
How can a doctor resist an essay entitled, “The Sickness Unto Death?” Kierkegaard, the darkest of the bleak existentialists, begins by asking, “Is despair an excellence or a defect?” Can despair be an excellence?
It is December in Oregon, the rain comes down in sheets, with only a few hours daily of half-light. Kierkegaard’s winters in 1840 Denmark must have felt a lot like this, so I press on.
“In despairing over …
The double meaning of despair in the hospital
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