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.
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“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
“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. …
This is what foreign doctors have to deal with
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 …
This physician isn’t a victim. She’s a survivor.
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 …
What a burned out physician looks like will surprise you
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 …
Why it’s important to protect Roe vs. Wade at the state level
“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 …
The reckoning of medicine in the post-fact world
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