I was cleaning out the top shelf of my closet — a location where, hypothetically, treasures can be found. I came upon something that was wrapped in a nondescript brown paper bag that smelled oddly of mothballs. I cautiously reached inside and found an heirloom quilt that apparently had been passed down through generations. I had discovered it an estate sale, and now it had finally come to rest in …
The patchwork quilt of my medical care
“Let’s start the powwow,” a man with a brown jacket and braided ponytail said with a smile. Nineteen adults and one child filled the back conference room of the hospital. The hospital had made an industrial cylinder of coffee for the meeting, and it was almost completely drained. I hung the stethoscope around my neck, knowing I wouldn’t use it as anything but a prop to signify my training and …
A family meeting in Navajo Nation
As a “dinosaur” emerita professor of pathology who still teaches medical students, I have witnessed some of the United States Medical Licensing Examination (USMLE) Step 1-induced climate changes compellingly. No, I am not a reactionary yearning for the past. Medical education has never been perfect. In the not too distant past, students were taught in an environment ruled by arrogant, dogmatic autocrats. Some things have changed for …
Is there room for dinosaur professors in today’s medical schools?
After a severe fracture or removal of a tumor, what happens if a segment of bone is missing? The bone ends will try to grow into one another just as they do after routine fractures, but the lack of immobilization and the gap may be insurmountable despite how hard the bone tries to repair itself. The void instead fills with gristle-like scar tissue, which cannot restore stability. A wobbly false …
In the era of the recognition of vast burnout in medicine, particularly amongst medical students, there needs to be a call to address structural problems in medical education. One particularly low-hanging fruit is the Step 2 Clinical Skills Exam (Step 2 CS). The exam has a relatively short history. The National Board of Medical Examiners (NBME) developed the exam for American medical students Read more…
The case against the Step 2 Clinical Skills Exam
I am a young physician practicing medicine in the “motherland” of God-gifted Ethiopia, which is located in eastern Africa, south of the Sahara Desert. I want to share my personal story, as well as to expose some of the serious problems facing physicians and patients in my country.
I started medical school, which requires the highest academic performance of any career path when I was 18 after completing secondary school. Despite …
Speaking out about practicing medicine in Ethiopia
I know what kinds of things I’m supposed to tell you. I know that your other would be advisors will usually stick to the same basic messages: “Keep reaching for your dreams” or “your hard work is all worth it in the end” or “your education will lay the world at your feet.” These platitudes are all well and good, but honestly, they’re forgettable. And pretty words don’t always translate …
To struggling medical students: Meet the physician who conquered the “no’s”
Recently, a friend’s mother asked me how to best support her daughter’s decision to breastfeed her first grandchild. The new grandmother questioned her ability to encourage her daughter’s decision because she had not breastfed her own child, and this lack of experience made her feel unqualified to provide support. With mixed emotions and a lingering sense of guilt, this new grandmother wanted to learn, from a pediatrician friend, how best …
Bottle-feeding grandmothers vs. breastfeeding daughters: advice from a pediatrician
On October 23, 2018, the Mega Millions lottery jackpot was 1.6 billion dollars, making it one of the largest lottery jackpots in history.
The hospital was abuzz with chatter in the week leading up to the drawing. Discussions about the possibility of becoming an instant billionaire were just too good to resist.
During that week, I found myself sitting at the nurse’s station in one of the ICUs at midnight. A nurse …
If you won the lottery, would you quit being a doctor?
Language matters. The use of the word “provider” may seem innocuous, but it is significant both for patients and physicians.
For patients, it has been perhaps the most pronounced step — if not leap — away from transparency. (Who is who? Nurse, doctor, chiropractor, podiatrist, psychologist? Doesn’t matter — everyone is a “provider.”)
For physicians, the ramifications have been two-fold. One on hand, the use of the word is a demotion by …
Language matters: the not-so-innocuous provider effect
There’s always so much to write about, and there’s never any time. I work too much; it’s become evident recently that I need to cut down. I have started noticing that things affect me much more than they ever did; there are days I hide my tears, and days I show my tears, when before the tears would have waited for the occasional (yes, occasional) shower. This is a function …
Please, be kind to your doctor. We need it.
Your bed could be watching you.
OK, so not with a camera.
But if you have any of a variety of “smart beds,” mattress pads or sleep apps, it knows when you go to sleep. It knows when you toss and turn. It may even be able to tell when you’re having sex.
Sleep Number, one company that makes beds that can track heart rate, respiration and movement, said it collects more than …
Smart beds and sleep apps: Don’t sleep on their data collection practices
As a female orthopaedic surgeon, I am often asked how I ended up in this field. Although seeing women in orthopaedic surgery is becoming more common, we are still makeup only 6 percent of the orthopaedic surgeons in the U.S.
I actually had no idea what orthopedic surgery was before medical school. In fact, I started medical school thinking I would be an internist, but it really didn’t take me very …
The inspiring story of a female orthopaedic surgeon
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Last Thursday I got up at 5 a.m. to bake a lasagna. Admittedly, lasagna for breakfast is not my typical go-to, but last Thursday was the last session of a year-long advanced faculty development course on teaching skills that I co-direct and teach.
In one of our first sessions of the year, we used the ice-breaker, “What would you choose for your last meal?” In the past, when I’ve asked this …
How acknowledging others can keep us from burning out
Like many primary care physicians in this health care marketplace, I found myself operating on a hamster wheel of volume care, seeing more and more patients and spending less and less time with them. The pressure on my practice, my patients and my staff was unsustainable. With new regulations and declining reimbursements, there was no way to provide the levels of support and service that are so important, especially to …
Putting patients first by letting patients go
As an incoming resident physician, I need disability insurance. Although a group policy is offered through my employer, it doesn’t provide enough coverage to adequately cover my monthly expenses or insure my future income. Thus, I purchased an individual long-term disability insurance policy. This is what I discovered:
1. Disability insurance is expensive. A substantial number of people use disability insurance, so companies raise the price to cover the payouts and ensure …
9 things I learned when purchasing disability insurance
I’ve been a doctor for a bit under a year now. I am a family medicine intern, working in blocks at a city hospital, wearing a lot of different hats. Sometimes I’m on the labor and delivery floor, helping new lives begin; sometimes I’m on the family medicine service, caring for ill patients who may be dying. Some of the moments that have stuck with me the most this year …
Talk with family members about their wishes long before you think you’ll need to
Two recent patient experiences prompted this post. In the Wall Street Journal, Dana Hawkins-Simons described several years of being seen by specialist after specialist for her complaints of tiredness, dizziness, ringing in the ears, palpitations, shortness of breath and “brain fog.” She finally researched her symptoms and demanded that she be checked for vitamin B12 deficiency, which turned out to be the cause of her symptoms.
Recently, the …
When should you be tested for vitamin B12?
I’ve always thought that I’ve understood illness and mortality very matter-of-factly. You live your life, you’ll most likely end up with some medical conditions along the way, and ultimately everyone’s life will come to an end because the body is not designed to function indefinitely. And do I cry at every funeral I attend? Absolutely. I understand physiologically and pathologically why things happen, but also realize human relationships will always …
How families maintain hope of improvement, regardless of logic and science
“You were a Secret Service agent, Mr. Smith?”
“I was indeed. For Presidents Ford and Carter.”
“That’s incredible. What were they like?”
“Well, President Carter would get up at 2:00 am and ask us if we’d like to go on a walk. Since most of the staff worked nights, I walked with him. We would walk for hours and talk shop. Carter is the most interesting man I’ve ever met and had the …
A father and grandfather: A patient’s life lived in full
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