These articles are written by anonymous clinicians. They have been selected and edited by Kevin Pho, MD.
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 …
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 …
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 …
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. …
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 …
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 …
“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 …
“Can you make Moana sing,” my four-year-old daughter begs as she widens her dark brown eyes. (My husband insists those are my eyes.)
Apparently, the Disney toy was involved in an accident. A button on the wrist that makes the doll loudly blurt out “See the line where the sky meets the sea!” has become separated from her plastic body. Pink wires stick out instead of forearm bones. I’m a doctor. …
If I have to hear, “There is always a third victim in these situations, don’t forget to take care of yourself,” one more time, I may go crazy.
I wish people would be cognizant of the language they use. According to the dictionary, a victim is, “a person who suffers from a destructive or injurious action or agency.”
Don’t call me a victim. I go home afterwards, completely broken by what just …
Once upon a time, a princess had decided to go on a long journey.
She had been told about what lay at the end of a long and winding path. It was all of the good things the princess had been wanting; happiness, joy, satisfaction, riches, success, and the ability to cure the sick.
The princess prepared for the trip for many years. She had heard of others who had made the …
I was very saddened to learn this past week of another physician who died by suicide. This, the untimely death of a young and brilliant mother of two, is a horrifying tragedy.
I do not write this to pretend I know anything about this recent tragedy. I write this as a sort of case report on myself. I was an at risk physician at one point.
I’ll start where the problems most …
G1P0 or Gravida 1, Para 0. Well, turns out that’s me. It’s very common in the medical field to use this phrase to describe women who have been pregnant but do not have any living children. This could have been due to miscarriage or worse yet, intrauterine fetal demise at later staged pregnancies. Or it could be due to an elective termination. For me, it was the latter.
I had never …
“Our son doesn’t get the flu shot, no one in our family does,” she said, with some emphasis on the “no one,” inviting me to take a swing. Anticipating futility, I reminded myself that our pediatrics clinic was already forty-five minutes late. This was a scrap better deferred.
“Alright,” I said flatly as I moved on with the encounter. This was of course not explicitly, but indeed, implicitly, approving the mother’s …
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I have been a member of a social network for physicians since 2008 or 2009. It’s a network that bills itself as a “virtual doctors’ lounge” and “voice of physicians.” I joined because I thought it would be a great place to continue to interact with my peers, after I’d left the collegiality of medical school and residency behind for private practice.
I’m not sure what subset of physicians participates, but …
I burned out, big and bad. I can see that now. My practice environment had become gradually untenable and every attempt I made to change it was blocked. My call schedule was inflexible and a lot more frequent than when I started my job. The hospitalists and ED kept sending me cases I didn’t feel qualified to manage, but as it was usually the middle of the night and I …
For those who are not avid followers of President Trump or his decisions, often his decisions have far-reaching consequences that affect lives and people. As a health care provider, I understand quick decision making, but also the importance of risk versus benefit and consequences of your decisions. I would like to tell you my story and how his actions have affected my life, the lives of my patients and their …
So let’s step outside our traditional arguments when discussing the health care problem of gun violence in this country. We all know the entrenched opinions of both sides: The second amendment is inviolable vs. there are over 30,000 deaths from guns per year in this country, and why on earth does anyone need an assault weapon? But the city with the strictest gun laws, Chicago, has the most gun deaths, …
In the year it has taken for me to finish my medical residency as a junior doctor, two of my colleagues have killed themselves. I’ve read articles that refer to suicide amongst doctors as the profession’s “grubby little secret,” but I’d rather call it exactly how it is: the profession’s shameful and disgusting open secret.
Medical training has long had its culture rooted in ideals of suffering. Not so much for …
I was sitting next to two of my co-residents during a break in conference this morning, answering emails on autopilot and half-listening to the buzz of conversations around me, when their muffled laughter caught my attention.
“What’s so funny, guys?” I asked them, thinking that a good joke or funny story might break up the monotony of hours of lecture. The reply I got stunned me.
“It’s man talk,” one of them …
I went to medical school to go into family medicine. During my interview when I said I wanted to do family medicine, the interviewer looked me up and down and said, “You know, you don’t have to say that just because you are at (insert name of primary care focused medical school).”
Now, less than two years into medical school, I’m watching with sadness as the “con” side of my pro/con …
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