My dad is a locally famed and sincere career politician. All my life I have seen him value public service over personal wealth. As a young lawyer, he worked in Washington DC for the Department of Justice during the civil rights movement, and he often shares stories of his tour of duty in 1960’s Alabama. After that service, he came back to West Virginia where he has been elected to …
Donald Trump triggers deep-seated human instincts
To whom it may concern:
I am writing to you with great sadness, but with relentless determination to ignite change. I am a doctor with a disability. Two years ago I began residency training in pediatrics. The privilege was overwhelming as I stood a doctor in the very halls where I had been wheeled in as a patient with a brain tumor. I couldn’t believe that I had actually made it, …
A hospital bullies a physician and threatens termination for her disability
Exercise. Growing up I competed in multiple sports. The physical enhancement of the human body through movement sparked my interest in human physiology and kinesiology. Consequently, my interest in physiology ultimately led me to medical school. It only felt natural, when medicine became what felt like the bane of my existence, that I’d revert back to this pursuit’s humble beginning. Given the fact that time was a scarce resource during internship, …
6 steps to overcoming physician burnout
Medical training in the United States is a long and tedious process. It begins in college, when one must complete the mandatory prerequisite curriculum and take a medical entrance exam; your score on which is directly compared to other applicants, immediately labeling you as a competitive candidate or not. The process of applying requires the completion of multiple comprehensive applications, the compilation of countless hours of research, clinical experience, letters …
Is burnout inevitable during medical training?
Dear Ms. Bresch,
I couldn’t help but notice the barrage of negative press you’ve received lately regarding the significant price increases in EpiPens. A 461 percent increase since 2007, to be exact. People who require this medication for themselves or their children are up in arms about spending over $600 for a twin pack of autoinjectors. Most of these people have life-threatening anaphylaxis if they are exposed to certain allergens. To …
An open letter to Heather Bresch: What is legal is not always ethical
A.J. Smith, a pseudonym of course, walked into my office today, unhappily. Most of her topical medications for acne caused too much irritation. The ones that didn’t, weren’t working. The doxycycline caused photosensitivity in the past. But her friend’s dermatologist gave her isotretinoin, better known as Accutane, and she completely cleared. As such, that’s what my patient demanded. There was only one problem. The degree of her acne didn’t warrant …
Welcome to McMedicine, may I please take your order?
A few months ago, I was on my general surgery rotation on the colorectal service as a medical student. It was in the late afternoon that we started a case of a robotic rectopexy to repair a rectal prolapse. Our patient was a kind and warm 89-year-old woman. The operation finished without a hitch.
As we undocked the da Vinci machine, the resident and I began to suture closed the multiple …
A medical student delays reporting his needlestick. Here’s what he learned.
Hi there,
Allow me to introduce myself.
I’m you.
I’m you 20 years ago, or 45 years ago if you were in the Class of ’72. I’m you one month ago if you were in the Class of 2016. I spilled coffee down my shirt, my hair is kind of a mess, and there are dark circles under my eyes from long hours spent studying.
Sound familiar?
Great. Then you’re in the right place. The …
Medical students need guides to help them navigate the hospital
I’m feeling pretty good about myself today. My patient, recently admitted to home health care, was just not herself, low O2 sats, irregular heart rate with pain on inspiration and feeling a little clammy. While her recent surgery was a neck fusion, it still didn’t completely eliminate the possibility of a pulmonary embolism. Instead of spending 15 to 30 torturous minutes in her primary doctor’s voice mail hell, I made …
Why nurses deserve a place in primary care
Three weeks ago, I changed jobs. I left a high-tech, high-volume teaching hospital in one of the largest medical centers in the U.S. for the greener pastures of a small, private community hospital. Why? I needed a less stressful position, lower acuity patients and to be rid of the madness of commuting.
I am a registered nurse with experience in emergency and trauma nursing, critical care, electrophysiology and cardiovascular surgery. I …
For hospitals to thrive, they need to value nurses
It was the first day of my prestigious internship at the cardiac and pulmonary rehabilitation center. I was a senior in college and eager to apply my knowledge from the field of exercise physiology to make an impact on the people beginning rehab. This was my first real opportunity to work as part of a health care team while proving that this is the right field for me to be …
The bittersweet truth about the epidemic affecting health care workers
I am forced to attend one of these mandatory continuing medical education (CME) events. My malpractice insurance provider has a deal with the state medical association. To get lower rates, I have to be a member of the association and every 2 or 3 years attend a risk management training session.
I make it on time, despite the traffic.
As I walk into the lobby of this rather nice building, looking for …
The state of health care in America: Smell the bacon
Aristotle said, “To avoid criticism: do nothing, say nothing and be nothing.”
Sometimes I wish I was nothing; surely, that would just be so much easier. I screw up all of the time. And I hate it. My latest gaffe was killing our simulated patient by causing him to aspirate. I’m sure no one in my group is still persevering on the events that unfolded during the sim. I also really …
It’s OK for medical students to make mistakes. Here’s why.
Maybe it’s just me, and maybe this is a regional/local phenomenon, but I have noticed a sharp increase in the number of non-physicians who sport their white coats on a daily basis around the hospital.
First, let me preface this piece by saying I have absolutely nothing against any person who partakes in the care of patients; in fact, I commend all the helping hands that routinely dedicate themselves to health …
Should white coats be only worn by physicians?
Three weekday call shifts left and two more weekends. The light at the end of the tunnel is shining bright, and I am relieved to be walking towards it. The only question that remains is what will I have left of myself and my life when I get there?
I started residency with a husband who I loved more than life itself. I was codependent to a fault, never wanted to …
Surgical residency hurt the people that mean the most to me
As I get near the completion of an intense 5-year orthopedic surgery residency program, I had an interesting interaction with our hospitals sub-committee specifically tasked to address duty hour and resident fatigue issues.
As they gave examples from other departments about changes made to their programs regarding duty hours, a clear-as-mud connection was continually made. They spoke of “improvements” made as the result of residents stepping up to serve as whistleblowers …
How duty hour restrictions are hurting residency training
The abandoned retractor clatters dangerously close to the other edge of the sterile field, saved only by the quick reflexes of the scrub nurse. The attending lets out a brief laugh, “I guess we’re using the Madagascar technique,” then it’s back to the operation at hand. Minutes pass as I continue to stand in my assigned place at the attending’s side, prepared to offer whatever meager contribution I can to …
The racism in medical education cannot be ignored
In the hour after I heard the news, I experienced the full spectrum of typical reactions to a physician suicide.
One end of the spectrum came from the attending in a clinic, who when asked if the residents could go home and mourn their friend who just committed suicide, proceeded to tell me a story of how when her grandpa died before a final exam in medical school. She decided to …
A medical resident commits suicide. Here’s how one colleague mourns.
During my first year of medical school, I attended a “speed dating” event, where medical students met attendings from various specialties to get a better sense of what we could do with our lives once we graduated. Older physicians consistently remarked that they decided their future during their intern year. One even said that he waited until the end of his internship to decide on otolaryngology.
I, along with my fellow …
Why the Flexner model is outdated for today’s medical schools
I’m not sure when it happened, but driving into the parking lot that cold winter day, I knew it had. Tears welled in red eyes, snot dripped out of my nose. I felt so alone and lost. My whole life I’d wanted this — the drive to the hospital and wondering whether I would change a life. But as I sat in my car, engine off, I didn’t want that …
If this medical student was a test question, the answer would be depression
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