This year has brought about change — the theme of 2017. As it comes to a close and I reflect back, it is so hard to believe what is going on in the world today, let alone just the United States.
In 2017, I graduated from my internal medicine residency training program, passed my board exam and celebrated my one-year wedding anniversary. I helped my family cope with my grandmother’s progressive …
What do you do when a colleague has cancer?
In an article published by the Atlantic earlier this year, Ryan Park writes that neither truck drivers nor bankers work the kind of gruelingly long hours that doctors — particularly young doctors in their residency programs — do. It is no secret that residency life is demanding and exhausting. Over the last decade, it has also become controversial. Almost a test in itself, as if gauging doctors’ …
The hidden threat of the 80-hour resident workweek
I’m passionate about patient safety. In no small part because I was raised to be. My mom has a lot of letters behind her name (RN, BSN, MSN), and she’s dedicated her career to the field.
Before I was accepted into medical school, I knew about “six sigma,” the “Swiss cheese model” and root-cause analysis. I’d been taught about creating a culture of safety and the example of the airline industry. …
4 problems with the Joint Commission
“Aren’t you cute,” he said as he smiled and squeezed her cheeks. On the start of a new rotation, a medical student walked into clinic and introduced herself to the attending physician.
With all of the news surrounding the Weinstein debacle, Alyssa Milano has urged women to share their stories of sexual harassment or abuse using the words “me too.” What has transpired is that a whole community of women from …
Women doctors: Speak up, because #MeToo
A father and a son are in a car accident. The father dies instantly, and the son is taken to the nearest hospital. The doctor comes in and exclaims, “I can’t operate on this boy!”
“Why not?” the nurse asks.
“Because he is my son,” the doctor responds.
How is this possible?
***
I first saw this riddle in a Washington Post article in October 2016. I was four years out of residency, and for the …
No female physician should have to feel that her gender is a factor limiting her success
Eighty percent of diagnoses can be made based on the history and physical. Take the subjective and objective; throw in some medical history, family history, social history and you can figure out your assessment and plan. Doctors are the detectives of the body and the more facts, the easier it is to solve the mystery.
This is the fictional note that I wrote in my head concerning a fellow physician friend …
A missed diagnosis haunts this physician
It’s 3 a.m., and I’m wide awake. I’m giddy with excitement and scared. I am 41 years old and tomorrow feels like the first day of school all over again. Only it isn’t. Tomorrow is my first day back at the hospital where I work as a surgeon. Tomorrow is also my first day back at work after chemotherapy.
Two months ago, I was diagnosed with breast cancer. I underwent bilateral …
Please don’t tell me how brave I am
I struggle with customer service. I truly never anticipated that it would be such a big part of my career. I never fathomed that it would be something that I struggle with on a daily basis. Well, honestly it does not happen every day and does not occur at every facility that I work at. Yet, it happens often enough that it has affected where I work, how I interact …
A physician struggles with customer service. Can she still be a good doctor?
Dear fellow students,
I am addressing you today as a comrade, a peer, as someone who shares your concerns and understands the pressure and stress you experience in medical school. It is true that medical schools attract very similar kind of people: Medical students are smart, hard-working individuals who are striving for excellence and achievements. They want to help the sick, the poor and the needy and cultivate a sustainable change …
Medical students: Don’t take the easy way
I knew that residency would be indentured servitude for (in my case) three years.
I knew it. I prepared for the fear, the shaming, and the isolation as best I could.
And I have for the past 11 months done OK. I am not the smartest or fastest. But I am told that I am passionate about my patients and have an “adequate fund of knowledge.”
Woohoo. Adequacy!
I have had dark moments. And …
Resiliency training in medicine is a farce
It’s Friday morning in any operating room, USA. Nurses and techs are scrambling to get everything in place before the surgeon arrives because if not, there will be hell to pay. The first patient arrives late, the second patient needs to use the bathroom, the third patient needs blankets before the IV is started … and here he comes … and we’re not ready. The fear is palpable.
Down the street, …
Trauma in the OR. From doctors’ bullying.
He entered the hospital on Monday morning with a list of patients running through his mind. From the time he received a sign out of 22 patients from his colleague on Sunday evening, he was planning his workday. It was a ritual of his to pray and sleep early on Sunday night to prepare him for what lie ahead. What lied ahead was a busy week of inpatient medicine — …
The last patient of the day gets the least care
My husband is a doctor. Similar to any other career, this is what he spends most of his time doing. It’s also our family’s livelihood — how we pay our mortgage, our bills and send our daughter to preschool.
He went to through seven years of training after college, often working all night or even 24-plus hour calls. He’s had to miss family dinners, birthday parties, nights of putting our daughter …
Stop asking doctors for free advice
I once participated in a discussion about a research study that was drawing data from charges submitted to Medicare and patient outcomes. The head of the project was referring to the financial data as costs, and I simply asked, “Isn’t this really charges, what Medicare is being charged by the hospital?” The response was a sort of non-answer, and then the person concluded, “It probably doesn’t really matter whether we …
Charges and costs aren’t the same thing
I am nearing the end of my training at one of the top surgical fellowships in the country. I chose this fellowship not just for the name, but also because the surgeons all seemed like genuine and altruistically motivated individuals. It was two-thirds of the way through fellowship when I found myself in conversation with two male trainees. We were discussing the younger trainee and his girlfriend; he would be …
There’s no place for locker room talk in the OR
I have lived for some time with depression. Most of the time, it is nagging in the background, helped by exercise, family and friends. But a few times, despite my best efforts, it has gotten out of control.
At the middle of my chief year in November, it came to a head. I was under tremendous pressure to apply for fellowship when I didn’t think it was what was best for …
I had depression, and my fellow doctors treated me horribly
Recently, a nurse at Children’s Hospital Los Angeles noticed that comedian Jimmy Kimmel’s newborn baby had a murmur and was cyanotic and brought it to the newborn intensive care unit for further evaluation. That triggered a rush of activity that led to a diagnosis of a congenital heart defect and heart valve problem and surgery to save the baby’s life.
Here’s what the public doesn’t understand: Nurses do this every day. …
An ode to the nurse who saved Jimmy Kimmel’s baby
I’ll be honest, when I first matriculated into medical school, I didn’t even know what a USMLE Step exam or clinical clerkship was. In fact, the first time I ever heard of them was from another applicant on the interview trail. I have always been a take-it-one-step-at-a-time type of person, but eventually, I would have to succumb to the pressure and ask upperclassmen about the exam. And what did they …
Should we standardize clerkship grades?
In the not-to-distant past, American health care was the gold standard. It offered job satisfaction and autonomy, was financially rewarding and was considered by many to be the most honorable profession. But as we all know, over the last two decades, increasing health care costs and demands and increasing competition for insurance contracts have changed the face of medicine. Metrics ranging from quality and safety (which are needed and were …
Physicians ceded control of health care. It’s time to take it back.
“Do you have sex with men, women or both?”
This is the way that we were taught in medical school to ask a patient about their sexual history. When we took our sample standardized patient exams, we were scored whether or not we asked this question. In my understanding, this was supposed to be a non-judgmental, non-assuming way to elicit a sexual history.
However, romantic partners generally come before sex (unless we …
Please stop asking about my wife
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