Over the past few summers, I’ve noticed that I’m fearful of swimming in the deep end of the pool. Gone is the fearlessness of my youth, when I’d venture out, take risks, and somehow just know I’d make it back to the shallow end, where I could firmly stand on a solid foundation.
Somewhere along the way, I had replaced my fearlessness with what-ifs.
What if I get a cramp in my …
3 lessons learned from the deep end of the pool
When a mental health clinic, online referral service, or private practice offers “evidence-based” psychotherapy, that certainly sounds like a selling point. It suggests solid science supports the therapy offered — and that competing services lack this support. But what does this phrase really mean?
“Evidence-based medicine” first appeared in the medical literature in 1991. It cast doubt on physicians’ clinical intuition and anecdotal experience, reminding them that science should guide medical …
What does evidence-based psychotherapy really mean?
The money was so good in the beginning, and it seemed it might gush forever, right through tiny country hospitals in Missouri, Oklahoma, Tennessee and into the coffers of companies controlled by Jorge A. Perez, his family, and business partners.
It was his “secret sauce,” the rotund Miami entrepreneur would smilingly tell people in their no-stoplight towns. The money-making ventures he proposed sounded complicated, sure, but he said they would bring …
The story of a hospital collapse and how small towns were devastated
When a patient comes to see me for a migraine headache, I know that they will leave feeling 100 percent better. They will finally be rid of that pounding, nauseating pain in their head, and they will be happy. And that makes me happy.
Doctors derive great joy from helping their patients. In addition to a strong sense of accomplishment, the ability to reach out and make another life brighter appeals …
It is wrong to exploit physicians’ compassion
“You’re 27-and-a-half weeks pregnant.”
As I lay on the exam table, time froze.
How can this be? I wondered dazedly. I’m a second-year medical student. I’ve just completed a course in female reproduction and endocrinology. How could I have missed the signs?
I attribute my obliviousness to the surgery I’d gone through only months before: the removal of a 27-pound, mucus-filled ovarian cyst. My lack of menstrual periods was nothing new; they’d been …
A surprise pregnancy in medical school
Early into my career as an emergency physician, I was seated in the department with a colleague when I inquired about one of our co-workers I had not seen in a while. “Oh, she’s on the mommy track,” my colleague said and picked up another chart. To me, selecting a career path that sacrificed traditional professional advancement for more time to raise children was legitimate. My colleague’s pejorative “mommy track” …
Why physicians should have golden parachutes
The sound of a clock, hung haphazardly on a colorless cold wall, ticks repetitively — tick, tick, tick. Time continues to pass as my appointment scheduled for three hours ago seems like it will never come. I scheduled this appointment three months ago, and here I sit three hours later. The irony bounces around the room to the sound of the clock ticking. Tick. Tick. Tick.
A door squeaks open.
Just my …
More than three hours late, but somehow still on time
The Washington Post ran this headline: “’Horns’ are growing on young people’s skulls. Phone use is to blame, research suggests.”
The headline is entirely correct except for a few minor points:
No, phones don’t cause horns to grow on skulls
I’ve been living with chronic pain for more than a decade.
It began in 2009 with nerve damage after emergency groin surgery. Four years later, I fell and hit my head. That fall led to a constant headache, a whistling sound in my ear, back and hip pain, tingling and numbness in my hands and feet, electrical shocks …
5 things I wish I had known earlier about chronic pain
It was a simple chief complaint: sore throat and fever. As expected, the little girl’s rapid Strep was positive. Instructions given. Antibiotics sent. This was Peds 101. But for some reason, before mom walked out the door, she made mention of their stay at the shelter.
Although I had seen this child many times before, somehow, I never knew that she was homeless. Nothing in my detailed history and exam had …
Improving health outcomes for children requires us to look at the big picture
Since starting medical school, I have struggled to answer this question. Because medical school is everything. It’s amazing, challenging, soul-sucking, life-giving, exhausting, dream-fulfilling, anxiety-provoking, interesting, and, dare I say, fun? How can I explain to someone that while I’m pursuing this dream, a dream that so few get the opportunity to pursue, that I have felt the lowest of lows but also the highest of highs?
I typically settle for “It’s …
Over the last three decades, surgery has slowly but steadily evolved towards a minimally invasive technique. The standard of care for appendicitis now involves creating three half-inch incisions and using a laparoscopic technique to remove the appendix. This technique uses a camera to see inside the body via a large screen. Instruments that are over a foot long are used. Sufficient research has shown that this minimally invasive technique leads …
The decision to undergo robotic surgery is a more than just about the length of the scar
The science of complexity lays a conceptual foundation for understanding “complex adaptive systems.” What all complex adaptive systems have in common is that they are all bound by the same set of physical laws. Their “behavior,” i.e., growth, maintenance, and death, can all be described using the same set of mathematical relationships. These systems (animals, plants, ecosystems, etc.) are the most productive and functionally effective systems known to man.
Unfortunately, our …
What role does the science of complexity play in medicine?
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One question I get asked a lot lately is this: “Is it OK for me to use CBD oil?”
First of all, CBD oil and associated preparations are types of alternative medications, medicines that might not be mainstream or readily prescribed by doctors, but are nevertheless used by many people on their own. Alcohol and marijuana are two substances that are often used as “medicines” by those that think they function …
Considering CBD oil? This psychiatrist suggests these questions to ask first.
For more than 30 minutes, Robert Findley lay unconscious in the back of an ambulance next to Mercy Hospital Fort Scott on a frigid February morning with paramedics hand-pumping oxygen into his lungs. A helipad sat just across the icy parking lot from the hospital’s emergency department, which had recently shuttered its doors, like hundreds of rural hospitals nationwide.
Suspecting an intracerebral hemorrhage and knowing the ER was no longer …
How closing rural hospitals cost patient lives
What has the medical community, once thought of as the “ultimate team,” finally come down to in 2019? The “back in my day” sigh I often hear from more senior physicians has inspired me to read several books about the history of medicine. As I devoured them from cover to cover, the excitement of medical discovery, the anticipation of the near-miracles that were about to be revealed, and most importantly, …
Should physicians yearn for the nostalgic ideals of their predecessors?
Take one-half tablet three times per day with meals, increasing by half each week until reaching a maximum of three tablets three times per day.
Did you get a new prescription from your doctor? If so, there is a 50 percent chance you will not adhere to label directions. Either the instructions are too complicated, the drugs are too expensive, you do not like the way the medicine makes you feel …
Here’s why your patients disregard prescriptions
Back in 2006, I settled into my career as an emergency room physician. It was then when I started working in multiple hospital groups in several cities in Arizona and Texas to maximize my earning potential.
The strategy worked. I was able to make enough money to service my medical school debt as well as dabble in commercial real estate, buying some duplexes in Central Texas then single-family homes and larger …
Haven’t thought about investing in group homes? You should.
I was a 22-year-old intern, just about to finish my public health internship. I had an ambitious career ahead of me. I was trained as a public health educator. I was doing wellness fairs, writing newsletters, and excited to get to the next stage of my life. I wasn’t yet certified, however, so when all of a sudden a job opportunity presented itself to me and gave me a chance …
I’m a residency program coordinator. My role has changed over the years.
Toward the end of my clinical rotations, I met Salma, a 34-year-old woman who came from Egypt with her family to the U.S. two years ago. Wearing a latte-colored hijab, she was here at the hospital to care for her father, who had a case of congestive heart failure exacerbation with pleural effusions.
When deoxygenated blood comes to the right side of the heart, it gets pumped to the lungs to …
A patient’s family bridges two worlds
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