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$34,000 to save mothers and their children from postpartum depression

Physician

May 7, 2019

A swimming pool. Most of a Tesla. Not nearly enough to have your kid swapped out during their sham SAT test. Nor would an ICU bill for a stay that resulted in survival — $48,744 is the cost of that. What costs an alarming amount more is the bill the US Government pays annually on erectile dysfunction medications for servicemen — a whopping $8.7 million according to a 2016 Rand …

The isolation and loneliness that physicians experience

Philip A. Masters, MD

Physician

May 7, 2019

A guest column by the American College of Physicians, exclusive to KevinMD.com.

We are just now beginning to recognize the impact of isolation and loneliness on the health of our patients. Recent cultural and societal changes have led to markedly increased levels of isolation of our patients with a dwindling size and activity of their …

Communities can help women cope with maternal depression

Patricia De Marco Centeno, MD

Conditions and Diseases

May 7, 2019

When a baby is born, people stop acting like themselves. Gruff grown-ups make goofy faces at infants. Nostalgic moms share their birthing experiences with pregnant strangers. Shy kids clamber onto strollers of babies they don’t know, just to coo at newborns.

In some cases, emotions brought up during this motherhood transition can become intense and get in the way of day-to-day functioning, much more severe than the “baby blues.” There are …

Where is the nurses’ lounge?

Trisha Swift, DNP, RN

Health Policy

May 7, 2019

If you have worked in the hospital setting for any length of time, you likely are aware of the physicians’ lounge. It’s the protected space where the hard-working medical staff can escape to catch a break or grab a hot beverage. The physicians’ lounge is absolutely necessary. Medical staff members need a space where they can refuel and exhale the stresses that caring for the sick and dying will often …

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Where is the nurses’ lounge?

Death through the eyes of a medical student

Taliya Lantsman

Medical Education

May 6, 2019

Growing up, I was discouraged from becoming a doctor; I was too emotional. My mother, a geriatrician, worried about my attachment to patients and the volatility of inpatient medicine. To some degree, I understood her concerns; I’m tearful during goodbyes and inconsolable at funerals. Yet my interest in medicine persisted, and I began medical school. In my third-year, I experienced the innumerable emotions associated with witnessing patients’ deaths. I was …

Our terrifying chickenpox problem

Steven Mussey, MD

Conditions and Diseases

May 6, 2019

A Kentucky judge rejected the claims made by a teenager who sued his local health department for temporarily barring students at his school who aren’t immune against chickenpox from attending classes and participating in extracurricular activities.

This article prompted a little thought experiment.

Chickenpox used to be a routine childhood illness. For a couple of weeks, kids who contracted the illness were very contagious and experienced discomfort.

Death was rare, …

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Our terrifying chickenpox problem

If medical students are already experiencing burnout, how are they going to survive residency?

Misha Armstrong

Medical Education

May 6, 2019

My interest in understanding burnout among medical trainees started during my second year of medical school. With Step 1 nearing, I noticed a dynamic shift in my classmates. The growing tension, petty arguments, and constant worry surrounding our futures took over. This led to a research project assessing burnout risk factors that stood out like a red flag on my application for residency. I found most of my interviewers were …

How this physician reconnects with nature

Maria Perez-Johnson, DO

Physician

May 6, 2019

On this beautiful spring day, “Nature is my medicine,” wrote Sara Moss Wolfe. And yes it is mine as well. As Albert Einstein stated, “Look deep into nature, and then you will understand everything better.” Some days that reassurance is all it takes to relax and make things better. Indeed, after a bad shift of 12 hours, all I ever want to do is go outside. It doesn’t matter what …

Why doctors crash planes

Phillip Stephens, DHSc, PA-C

Health Policy

May 6, 2019

Physicians actually make good pilots. But, in 1966 they received a bad rap due to a report published by the FAA’s Chief of Aviation Medicine, Dr. Stanley Mohler. Mohler had a point. Physicians were crashing planes at a higher rate as opposed to the general aviation population. His report would be a cautionary tale for all of us. It would be three decades before we even began to understand why …

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Why doctors crash planes

Why this burned out physician turned to meditation

Jill Wener, MD

Physician

May 5, 2019

There are aspects of practicing medicine that will always be challenging and stressful, even in a perfect system. Avoiding dangerous drug-drug interactions. Keeping up with the overwhelming amount of new data on diagnostic and treatment modalities. Telling a patient that they are dying. The uncertainties of call night.

In addition, medicine tends to attract some pretty type-A, intense, perfectionist people that are all-too-willing to sacrifice their personal needs for the needs …

I’m sorry that we couldn’t save you

Evan Schauer

Medical Education

May 5, 2019

Five days into my emergency medicine clerkship, I had experienced a lot of firsts: My first participation in a code, my first CPR compressions, and my first patient death. This was specifically a code blue for a patient with pulseless cardiac arrest.

An elderly woman was brought in by her family after not feeling well for several days and quickly became unresponsive. As the room flooded with staff, my upper-level resident …

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I’m sorry that we couldn’t save you

Why do I love being a 43-year-old physician?

Vanessa Peters, MD

Physician

May 5, 2019

“Are you the doctor?” was the most frequently asked question I received from patients in my new practice.

The second most common question was: “Are you old enough to be a doctor?” followed by the rather blunt question “How old are you?”

I graduated from family practice (FP) residency in 2002 when I was 26-years-old — younger than most newly minted FP doctors. This warrants some explanation. I didn’t skip several years …

5 parenting mistakes I make as a pediatrician-mom

Lisa Sieczkowski, MD

Physician

May 5, 2019

I have been a medical doctor for 19 years, a pediatrician for 16 years and a mom for 11 years. Being a mom is — hands down — the hardest but also enhances my work as a physician (though I would not admit this before I had my own children). My work at work and my work at home intersect daily.

Since I work in a hospital, I don’t field as …

How rocks and crystals can be more nourishing than we know

Shannon Casey, PA-C

Physician

May 4, 2019

When I was a kid, one of my favorite hobbies was adding to my rock collection. In the summer, I went on road trips with my family to explore the national parks, and at every gift shop, I always gravitated towards the bin of tumbled stones. To me, this was a treasure trove. I looked at all of the stones and was mesmerized by their vibrant colors — from emerald …

Many diseases represent an arbitrary number

Edward Hoffer, MD

Conditions and Diseases

May 4, 2019

A wag once said: “There is no such thing as a healthy person, just one who has not had enough tests.”

As we make every minor deviation from the average into a disease, that jest is becoming uncomfortably close to the way our current medical system behaves.

Part of the problem is that many diseases represent an arbitrary cut-off of a number. Thus, hypertension is defined as a blood pressure above a …

MKSAP: 28-year-old woman with decreased exercise tolerance and ice cravings

mksap

Conditions and Diseases

May 4, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 28-year-old woman is evaluated for decreased exercise tolerance and ice cravings for the past several weeks. Medical history is notable for Crohn colitis diagnosed 6 years ago. Her symptoms flared 3 months ago with increased abdominal pain and diarrhea, and she began therapy with azathioprine and infliximab. Her …

Thank you for letting us be a part of your child’s life. You truly are the heroes of medicine.

Jonathan Kohler, MD

Physician

May 3, 2019

The following is something I wrote for our annual memorial service for children who have died at our Children’s Hospital. But these same thoughts are with me every day.

It’s an honor to be here with you to celebrate the lives of our patients. Thank you for being here. Thank you for sharing your children’s lives with all of us. Speaking for the staff of the children’s hospital, thank you for …

5 things this doctor wished he could tell his patients

Lavi Nissim, MD

Physician

May 3, 2019

1. I am not omnipotent.

As health care providers our ability to treat is sometimes affected by factors beyond our control— limitations in technology, variations in our work environment, and human nature. While we always commit to performing our very best, our best may vary from day to day; if my best is not the best for you, then I will offer you all possible alternatives. Furthermore, not all disease can be cured, nor every malady …

Questions about Public Service Loan Forgiveness that you were afraid to ask

Altelisha Taylor, MD, MPH

Physician Finance

May 3, 2019

As a graduating medical student with around $200,000 in student loans, I’m planning to enroll in Public Service Loan Forgiveness. When I shared this proclamation with my classmates they had mixed reactions and several questions. Just in case you’re wondering the same thing, I’ve answered them all below:

1. What is Public Service Loan Forgiveness?

Public Service Loan Forgiveness (PSLF) is a government-sponsored student loan forgiveness program. If you work in public …

The effect of mobile devices on our collective psyche

Paul Pender, MD

Health Technology

May 3, 2019

During a recent walk at Crystal Cove, a splendid California State Park with miles of pristine coastline, I encountered two young women sitting on a bench with a magnificent view of the ocean. Yet their only view of interest was their cell phone screens. One of them lifted her head long enough to say, “Your dog is cute,” then returned to the rapture of her device. I thanked her and …

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