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Anonymous

These articles are written by anonymous clinicians. They have been selected and edited by Kevin Pho, MD.

Conditions

A nurse won’t let this patient die

The sun sets a cascade of pink and yellow in the window of an ICU room. The slow hum of ventilation dampens the buzzes and beeps from machines. I stand in a room inundated by equipment. A machine to monitor…

The sun sets a cascade of pink and yellow in the window of an ICU room. The slow hum of ventilation dampens the buzzes and beeps from machines. I stand in a room inundated by equipment. A machine to monitor vital signs with purple, green, blue, and red on a black background displays peaking and rolling waveforms. Two IV poles with twelve pumps click and murmur sounds of fluid migration …

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A nurse won’t let this patient die

Education

Give your psychiatric patients a reason to trust

I had been diagnosed three days prior, given lithium to stabilize and a benzodiazepine to sleep. I went home. Things did not get better. I had been admitted just that morning after a long, confusing night in the ED. I…

I had been diagnosed three days prior, given lithium to stabilize and a benzodiazepine to sleep. I went home. Things did not get better.

I had been admitted just that morning after a long, confusing night in the ED. I did not yet understand the severity of what had happened — or even what had happened. The mania was still mostly euphoric and speckled with bursts of joy, but between these …

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Give your psychiatric patients a reason to trust

Physicians

Burnout is death by a thousand cuts

I think I’m finally burned out. And it’s been a long time coming. It likely started when my private physician-owned emergency group got bought out by one of the big corporate groups. The changes were small at first. Turning us…

I think I’m finally burned out. And it’s been a long time coming.

It likely started when my private physician-owned emergency group got bought out by one of the big corporate groups. The changes were small at first. Turning us into hourly paid employees instead of an RVU-based salary. Shiny new VPs and directors sending us emails. Things seemed fine for a while. Then came the many, many emails about better …

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Burnout is death by a thousand cuts

Physicians

A physician got a DUI. The physician health program didn’t help.

A physician health program, PHP, is a state agency that is responsible for advocating, treatment referral and physician monitoring, residents and medical students who have substance abuse disorders, psychiatric disorders and/ or boundary issues. There are two ways of becoming…

A physician health program, PHP, is a state agency that is responsible for advocating, treatment referral and physician monitoring, residents and medical students who have substance abuse disorders, psychiatric disorders and/ or boundary issues. There are two ways of becoming a part of these programs, self-referral or be reported. Currently, 47 states have a PHP, and the issue is that there is no set guideline and several variables in the …

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A physician got a DUI. The physician health program didn’t help.

Education

When a medical student is victim-blamed

After third-year medicine, I was required to withdraw for handing in an assignment late. It was a paragraph of self-reflection; I couldn't believe I was being kicked out for something so seemingly inconsequential. My dealings with the faculty became increasingly…

After third-year medicine, I was required to withdraw for handing in an assignment late. It was a paragraph of self-reflection; I couldn’t believe I was being kicked out for something so seemingly inconsequential.

My dealings with the faculty became increasingly hostile and negative. I realized that my fellow students had to band together. Otherwise, there will be no change. I have to say that at my medical school, they have been …

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When a medical student is victim-blamed

Conditions

“I did not want a baby”: A medical student faces her hardest choice

I did not want a baby. As a 26-year-old third-year medical student who had quite recently ended a far from ideal relationship -- of this, I was certain. On vacation, in New York City, walking in Soho carelessly, I laughed…

I did not want a baby.  As a 26-year-old third-year medical student who had quite recently ended a far from ideal relationship — of this, I was certain.

On vacation, in New York City, walking in Soho carelessly, I laughed with my friend Noelle over the fragility of condoms. “Trust me,” I said. “They break.”

How many months in my sexually active life did I apprehensively count and recount the number of …

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“I did not want a baby”: A medical student faces her hardest choice

Physicians

Our healers need healing

I woke up to him, pacing the bedroom. Within an hour, I was pacing the ER at his bedside. Our experience at one of the country's best-ranked hospitals lasted only three days before we were discharged home. What led us…

I woke up to him, pacing the bedroom.

Within an hour, I was pacing the ER at his bedside.

Our experience at one of the country’s best-ranked hospitals lasted only three days before we were discharged home. What led us there will last a lifetime in our minds. When faced with your own mortality (or that of your husband’s), you are forever changed. We are grateful for his continued recovery from myopericarditis. …

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Our healers need healing

Physicians

The stages of grief when a physician is sued

It’s hard to describe the feelings I had when I received my first letter of intent to sue. I think I went through the Kubler-Ross stages of grief — denial at first, of course. This denial didn’t last long since…

It’s hard to describe the feelings I had when I received my first letter of intent to sue. I think I went through the Kubler-Ross stages of grief — denial at first, of course. This denial didn’t last long since the letter was clearly addressed to me — first, middle, and last name.

Anger was almost immediate … I was immediately upset at the deceased patient’s family who were bringing the …

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The stages of grief when a physician is sued

Policy

How non-physician practitioners are pawns of large health care organizations

During our family trip to Walt Disney World this past year, we got the Disney Dining Plan. It turned out to be a lot of food. On the last day of the trip, we each still had two sit-down meals…

During our family trip to Walt Disney World this past year, we got the Disney Dining Plan. It turned out to be a lot of food. On the last day of the trip, we each still had two sit-down meals and about five snacks apiece to go through. Needless to say, we ended up leaving with a bunch of soda and cheap candy and still felt sick from all the …

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How non-physician practitioners are pawns of large health care organizations

Physicians

A physician’s career as an opioid prescriber and addict

I sat in the back seat of a police patrol car handcuffed with a mind imprisoned by addiction. My day had finally arrived after months of a manhunt by state detectives for operating a fraudulent prescription enterprise to support my…

I sat in the back seat of a police patrol car handcuffed with a mind imprisoned by addiction. My day had finally arrived after months of a manhunt by state detectives for operating a fraudulent prescription enterprise to support my obsession and compulsion with cocaine. No more unmarked police cars staked outside the crack houses that I frequented or my mother’s home or in pharmacy parking lots waiting to capture …

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A physician’s career as an opioid prescriber and addict

Physicians

A pediatrician speaks out against combining sibling appointments

Imagine your typical yearly physical. It’s probably booked for 20 to 40 minutes. Since you, like many of us, may see your physician only once a year, it is important for you to have your physician’s complete attention and to…

Imagine your typical yearly physical. It’s probably booked for 20 to 40 minutes. Since you, like many of us, may see your physician only once a year, it is important for you to have your physician’s complete attention and to have all of your concerns addressed. Some of these concerns may be of a sensitive – even embarrassing – nature. Your physician may likewise ask you some probing questions about …

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A pediatrician speaks out against combining sibling appointments

Education

An interview with a medical student who failed the boards

The first two years of medical school are geared towards learning enough so you can pass your first round of boards. All the sleepless nights and the tears can be overwhelming, but to finally get to the finish line is…

The first two years of medical school are geared towards learning enough so you can pass your first round of boards. All the sleepless nights and the tears can be overwhelming, but to finally get to the finish line is an incredible achievement. It reinforces that these first two years were worth it and that you learned some things along the way.

However, some students don’t receive the same good news. …

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An interview with a medical student who failed the boards

Physicians

It is wrong to exploit physicians’ compassion

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…

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 …

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It is wrong to exploit physicians’ compassion

Conditions

The decision to undergo robotic surgery is a more than just about the length of the scar

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…

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 …

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The decision to undergo robotic surgery is a more than just about the length of the scar

Physicians

Don’t make me choose between motherhood and my career

A debate highlighting gender discrimination in medicine currently rages within the pediatric hospitalist medicine community. The debate centers on the board certification process for "grandfathering" for the new pediatric hospitalist subspecialty which effectively excludes women on the basis of motherhood.…

A debate highlighting gender discrimination in medicine currently rages within the pediatric hospitalist medicine community.

The debate centers on the board certification process for “grandfathering” for the new pediatric hospitalist subspecialty which effectively excludes women on the basis of motherhood.

For those not familiar with “grandfathering in,” this is the process by which a new subspecialty may grant board certification to physicians who have been practicing in the specialty. The alternative option …

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Don’t make me choose between motherhood and my career

Conditions

What are patients’ responsibilities for their health?

I expect my patients to develop or sense responsibility in connection to their health because I believe personal responsibility creates the basis for a constructive, therapeutic relationship and healing process. My experiences as a patient have made me understand how…

I expect my patients to develop or sense responsibility in connection to their health because I believe personal responsibility creates the basis for a constructive, therapeutic relationship and healing process.

My experiences as a patient have made me understand how difficult it can be to maintain a sense of responsibility. I often yearn for clarity and a “gameplan,” but instead find myself confronted with medical guideline gray areas and conflicting treatment …

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What are patients’ responsibilities for their health?

Conditions

UpToDate? Information my cardiologists didn’t have.

I have always felt lucky and relieved when a cardiologist told me I seemed to be fine despite my heart condition. My condition, referred to as congenital, complete AV block, is estimated to affect between 1 in 15,000 to 22,000…

I have always felt lucky and relieved when a cardiologist told me I seemed to be fine despite my heart condition. My condition, referred to as congenital, complete AV block, is estimated to affect between 1 in 15,000 to 22,000 live-born infants. The electrical block is more commonly seen among older, adult patients where it presents an acute pacemaker indication.

Researchers do not know very much about what causes the condition …

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UpToDate? Information my cardiologists didn’t have.

Physicians

I’m sorry: Why I lost my love for medicine

I'm sorry you are sick. I'm sorry you had to wait a long time in the waiting room. I'm sorry you haven't gotten your pain medications. I'm sorry I don't have an answer. I'm sorry the department is busy. I'm…

I’m sorry you are sick. I’m sorry you had to wait a long time in the waiting room. I’m sorry you haven’t gotten your pain medications. I’m sorry I don’t have an answer. I’m sorry the department is busy. I’m sorry it’s loud. I’m sorry I don’t know why it smells in here. I’m sorry your neighbor is screaming. I’m sorry you are in pain. I’m sorry you are uncomfortable. …

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I’m sorry: Why I lost my love for medicine

Education

I will not stop sacrificing for my medical career

At the moment, I should be studying for my first round of boards, but there is something I can’t get off my mind: sacrifice. If you ask a medical student what they have had to sacrifice to study medicine, the…

At the moment, I should be studying for my first round of boards, but there is something I can’t get off my mind: sacrifice.

If you ask a medical student what they have had to sacrifice to study medicine, the list could go on for days. It could be small things like watching their favorite teams play or being caught up on current events. But more than likely we will list …

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I will not stop sacrificing for my medical career

Social media

The risk physicians take when going on social media

I am at a conference that is encouraging physicians to engage in social media. This is something I was always a proponent of. I felt strongly that as physicians, we help set the tone of accurate medical information. Especially now…

I am at a conference that is encouraging physicians to engage in social media. This is something I was always a proponent of. I felt strongly that as physicians, we help set the tone of accurate medical information. Especially now in this age of disinformation and “alternative facts,” our voices are crucial.

I used to be an active Twitter user. I had 21,000 followers and was verified — with a blue …

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The risk physicians take when going on social media

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