I have worked most of the last 20 Halloweens in the pediatric emergency department (ED), so I’ve seen how a split second can ruin your child’s holiday. Here are some things you can do to plan ahead and avoid the ED.
1. Avoid trip hazards
It’s a recipe for mishap. Your child is in a costume that may have long hems or unusual shoes or a mask limiting their normal vision. A …
How do I keep my kids out of the ER this Halloween?
Some of us like to micromanage. Obviously, this trait is useful only for certain tasks that you need to accomplish. Managing money can take some attention to detail, but fortunately, many issues work themselves out if you follow broad principles. How much you should micromanage your daily expenditures really depends on your own tolerance and your individual financial situation. We’ve all seen discussions about the cost of daily artisanal cups …
How much is micromanagement of your time worth?
The Kaiser Health News article, “Spurred By Convenience, Millennials Often Spurn The ‘Family Doctor’ Model,” caught my eye. Millennial patients want “convenience, fast service, connectivity, and price transparency” while doctors and health experts worry about “fragmented or unnecessary care, including the misuse of antibiotics” and loss of “care that is coordinated and longitudinal.” It’s as if the needs of the patients and the concerns of doctors are …
Millennials want convenient care
On a Saturday morning, Michael, a physician, was making his way through the hospital atrium after his weekend rounds. On his way out, he noticed a family he knew well. They were talking quietly and appeared distraught. He asked them if they were okay. They said that the husband’s mother had been admitted overnight with a malignant pleural effusion, and since all beds on the oncology floor were full, she …
Should a HIPAA-questionable good deed go unpunished?
There is a man. He is in my house. I don’t know where he came from. But he just came into my house. And now he is living there. And I am afraid of him. I do not know who he is. There is a man in my house. I am so scared. I don’t know why he came. But he is there. And he tells people he is my …
The man that scares me and the man I love
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 30-year-old woman is evaluated for a 2-month history of diarrhea with three to five loose stools per day. She has mild abdominal cramps, bloating, intermittent nausea, and mild anorexia that has resulted in the loss of 2.3 kg (5.0 lb). She has had no fever or blood in the stool. She works …
MKSAP: 30-year-old woman is evaluated for a 2-month history of diarrhea
An excerpt from Dead Execs Don’t Get Bonuse$: The Ultimate Guide to Surviving Your Career With a Healthy Heart.
The details of the careers and tragic deaths of these CEOs are a matter of public record, and the disruption that followed their deaths was enormous. Take Ranjan Das, for example. At age forty-two, he was the regional CEO of SAP for the Indian subcontinent and the youngest CEO of …
What we can learn from the tragic deaths of CEOs
Cancer is the enemy. So, our immediate desire is to get rid of it, throw it away, and never hear from it again. Current therapies that require living tissue are proving that false. We know that your living tumor tissue is like your fingerprint, unique to each individual patient. It contains information specific to you, your genetic make-up, your cancer and ultimately the thought is, your treatment. If kept alive, …
An excerpt from How to Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and Their Caregivers (Second Edition). Copyright 2018 by Toni Bernhard. Excerpted with permission from Wisdom Publications.
In the years since I’ve been chronically ill, more essential to me than formal meditation has been mindfulness outside of meditation. Mindfulness refers to paying attention to your present-moment experience. It’s as simple as that. There’s no belief system …
The present moment as a refuge
“Passion isn’t a path in the woods. It is the woods.”
-Tom Robbins, “Half Asleep in Frog Pajamas”
I’ve met plenty of accidental physicians. These have been photographers, travel writers, artists, outdoor guides and chefs who awoke one day to find themselves doctoring. Their passions didn’t die — they were just delayed by lifestyle choices. By the time they recognized a need to follow their passion, they were at least partially through …
It’s better to not go into medicine than try to get out of it
Late one Friday night while walking the long and lonely hallways of my hospital, my mind wandered back several years. I recalled my first weekend call as an eager, newly minted nephrology attending. I had met one of my colleagues earlier that morning in the doctors’ lounge, whereupon I had been handed a clunky, black weekend pager. “Welcome to being on call every fourth weekend for the rest of your …
Medicine is a calling and being on call is medicine
On my first day of medical school, my father, a dentist, told me he’d just been diagnosed with stage four pancreatic cancer. Cancer had crept back into my life — except this time not into my body.
At age 12, I was diagnosed with brain cancer. After an aggressive surgery, I was tumor-free for 10 years. Then, at 23, I received the news of an inoperable recurrence.
While going through radiation and …
There’s no textbook for when your father is dying
As an aspiring physician on the pre-med track (a microbiology and immunology major), I believe that creating a strong academic foundation, especially in math and science, is essential for future career and academic success. Growing up in Miami’s more improvised area, Liberty City, quality learning materials were scarce. Even when there were resources for active learning, most students were completely unaware of their existence or lacked the training to make …
How the science of learning salvaged my college career
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There are medical honors so rare you don’t even know they exist. When you’re trudging through the slog of PBK/AOA/other — ultimately meaningless — letters, these seem to be the definition of distinction. Just like every other lesson, a patient taught me what real prestige is.
Well, it wasn’t entirely that Oslerian, it was the patient’s nephew.*
Carl paged me on an ordinary day — a fellow physician, he once saved my …
Your greatest role as a doctor? Storyteller.
I’ve had this idea brewing for a while. It’s taken a while for it to form shape, to work its way from a random niggling thought in my head to something I can articulate with the passion and determination it inspires in me.
On labor and delivery: There is an “I” in team.
Yes, I know. I said something inflammatory. I can almost see heads shaking as you wonder how I could …
On labor and delivery, there is an “I” in team
Have you ever felt so cold? I mean bone-chilling cold. I don’t mean the same kind of cold that northern winters can leave you feeling. I am talking about working in a hospital that is climate-controlled, and you are undoubtedly shivering.
I still remember my first day on the job as a neonatology fellow. I was anxiously walking to the operating room to attend the delivery of a 25-week infant. As …
A physician loves the adrenaline surge
Are my breast cancer and I on the wrong side of statistics, or just caught in the confusing and potentially devastating conflict between medical societies about when women should start breast-cancer screening?
One morning more than a year ago, it didn’t seem like either. As both of my kids cuddled in bed with my husband and me, I …
When breast cancer screening guidelines conflict: Some patients face real consequences
Sometimes things go just the way you want them to, and sometimes they don’t.
Compare and contrast the case of two different patients, and how things went trying to get them the care they needed.
The first patient, let’s call him Mr. Smith, called up one day last week with a brand-new symptom, which after a phone call was ultimately determined to be disturbing enough that he was offered a same-day appointment.
After …
When physicians order tests: a tale of 2 patients
I first posted about this subject a couple of years ago but it’s so fascinating to me I’m writing about it again. I happened to run across this study containing some amazing information. It’s from a publication called The Journal of Voice. The link is to the abstract — the complete article is behind a paywall but I can get it for anybody who’s interested in reading the whole study in …
When babies cry, your tone matters
Within the medical community, there seems to be a prevailing belief that when it comes to business and finance: Well, we’re just not very good at it. Some chalk it up to the lack of financial training we received in medical school. Others say it’s simply not in the physician’s DNA – that our brains are wired differently.
I would disagree.
In reality, I’ve seen many, many physicians become successful …
Physicians have the skills to be entrepreneurs
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