Yesterday, I couldn’t get up in time in the morning and had to rush to the hospital without breakfast. I was just afraid of getting noticed by anyone from my department that I was a little late. When I reached the outpatient department (OPD), I just got a text from my consultant that he was not feeling well, and I had to see all the patients in his absence. In …
A day in the life: the unseen struggles of an oncology resident
Residents, particularly international medical graduates (IMGs), often navigate a challenging position within health care institutions, where hierarchical structures overshadow their authority and autonomy. This dynamic can leave residents feeling disempowered and vulnerable, underscoring the importance of understanding their rights and protections within their programs. For IMGs, cultural and systemic differences may further amplify these challenges, making knowledge of their rights especially crucial as they enter residency programs.
As a final-year resident, …
Resident struggles: How hierarchical health care systems impact IMGs
In the midst of youthful basketball games and hustling for Taco Bell chalupas, lifelong lessons were learned, leading to diverging paths and, ultimately, tragic loss. We called him “The Backboard Bully.” He’d find his spot at or near the free-throw line and shoot the ball at the perfect trajectory for a bank shot. We hated him for it—that is, when we weren’t on his team. If he was your teammate, …
The backboard bully: the roles we see can be all the difference in who we become
“I maybe have a tiny shred of compassion.”
A doctor I know wrote this in reference to a person they’d never met, a person who had been verbally abusive to many health care professionals. A person who was a prospective patient.
A tiny shred of compassion. Maybe.
I had met the patient in question, was the physician caring for them in the hospital. I was trying to find a PCP who would take …
A doctor’s struggle for patient care
Older physicians often bemoan what’s perceived as a decline in professionalism during residency training. Caps on the number of inpatients assigned to an intern or resident. Duty hour limits. Wellness retreats. While these may be imperfect, they’re at least aligned with or heading in the direction of what is the right way to balance the rigors of a lifetime of training in and practicing medicine with the safety, quality, and …
Bridging communication gaps in residency training
I recently concluded my application cycle with an acceptance, and I’ve been catching up on the news regarding medical school admissions. Admittedly, I’m disappointed. Also shocked by how much can happen while being occupied. It kind of felt like Neo getting out of his “bubble.”
Simply put, the MCAT is still important and should remain so, at least until other forms of assessment, such as the Situational Judgment Test, are refined …
Is the MCAT still vital for medical school admissions?
“There is no greater agony than bearing an untold story inside you.”
– Maya Angelou
Since my teenage years, I have been watching Bollywood movies of all sorts. Maybe people from the subcontinent like them because no one can relate to these movies other than them.
My favorite hero was Sushant Singh Rajput. I liked him for his personality, his sweet smile, and the genuine look he had in his eyes. When he …
From Bollywood dreams to bipolar reality: a doctor’s journey
“Today is the first day of the rest of my life!”
I’m sure you’ve heard that many times before; I’m sure I have. But in my obscure point of existence in this endless universe, that statement has never been more accurate than it is today.
Being a physician has been a flame burning inside my chest my entire life. I decided on it when I was three years old, and aside from …
A doctor’s path to recognizing her own humanity
The banner in front of the ED where I work proclaims “magnet hospital.” “Magnet” status tells patients and visitors that the care from nurses (and ED technicians and patient care associates staff under their auspices) is so good that the ED should be a magnet, attracting patients and nurses to come here and inspiring other EDs emulation.
For many years, our ED’s annual census has been 100,000 patients. One might think …
From task-oriented to goal-driven: the power of habits in “magnet” hospitals
As a child, I was a daydreamer, especially in algebra class. Picture this: my teacher, reminiscent of Droopy Dog but on a heavy dose of barbiturates, droned on from the textbook. And just like that, my mind would escape – soaring out of the window of my quaint Midwestern high school, wandering around the courtyard square.
Back then, several businesses on the square were small physician offices. You could spot white-coated …
The lost dream of a small-town doctor
Imagine this scenario.
You’re negotiating the sale of your widget. Despite your earnest efforts, you hit a deadlock. The buyer, after consulting an expert on “fair market value” for widget prices, firmly states they won’t purchase your widget for $5.
In a new tactic, you turn away from the customer, shed your white coat, don a pair of Groucho Marx glasses, and pivot back.
“I’m the CEO of WidgetCorp. Ten bucks, take it …
The middleman dilemma in health care
If you find yourself heading down a rabbit hole pursuing a diagnosis, consider using a Markov chain to get back out. No, it’s not a physical chain. It’s a metaphorical chain.
In mathematics, statistics, and research, a Markov chain is a series of branching events where the options of what comes next at each branch point are not limited by what happened at a previous branch point. That is, each step …
Escape diagnostic rabbit holes with Markov chains
If there is one root cause of all the disgruntlement among health care workers, it is that we lost autonomy due to hospital consolidation. Relationships are largely about leverage. With rare exceptions, a single doctor cannot dramatically impact the bottom line of a hospital chain, whereas the loss of your professional income—particularly for those of us geographically rooted in an area with few alternatives—is devastating.
The beauty of locums is that …
Empowering health care workers amid consolidation
It’s a busy day in the emergency department. The waiting room is full, and we are short-staffed. I just read an email from administration that morning about how our treat and release times are “slipping,” and in the same breath, they remind us of the importance of patient satisfaction. There are many patients in the department with chronic medical problems or chief complaints that could be interpreted as non-emergent. I …
Emergency department burnout: a cry for change
How did I get here? Heading to the highest place I can find, in contemplation of jumping and falling to my death. I had always feared death before this point, but now it seemed the only logical solution. I seemed to have it all going my way. So why would a medical resident in a coveted training program in one of the most beautiful parts of the country, with a …
Overcoming depression: a medical resident’s journey
I am writing to express my extreme disappointment in my specialty’s national board organization and its lack of response to the tragedy still unfolding in Israel. Ophthalmology oral boards are currently scheduled for 10/20/2023 through 10/22/2023, and I have received multiple notifications this week regarding testing logistics but not a single reference to a terrorist attack on the scale of the bombing of the Twin Towers in New York City. …
Disappointment with a specialty board’s response to Israel crisis
When I received an email from her in March, it was exceptionally helpful and genuine. You could tell she exuded that class president energy and was a true leader. Dr. Mortimer sounded excited for residency to begin.
We met each other across the green at the mandatory, unpaid 4-day orientation. She seemed laid-back and content. I remember the one week of electives we were granted was scheduled early for her. By …
The cost of silence: Dr. Nakita Mortimer’s tragic story
After she developed a serious complication, she wanted to know the facts plainly stated. I told her the treatment would change her quality of life; it would be hard but doable. To this, she replied, “Now, don’t bullsh*t me, I don’t like bullsh*tters.”
These words were uttered by my resilient, 75-year-old patient undergoing peritoneal dialysis. She had recently developed one of the most dreaded complications of this treatment: calciphylaxis.
Her strong will …
A patient’s resilience and the challenge of dialysis
An excerpt from The Adventures of Dr. Anonymous.
During the COVID pandemic, I wished I could put out a public service announcement for physicians, patients, and families about end-of-life care. Palliative care is critical to hospitalist practice and one of the least discussed fields of medicine. It also is a major …
Open conversations about end-of-life care
A phrase commonly heard is “reproductive rights,” and while there is some variability in what this entails, in most cases, this includes a woman’s right to choose not to be sexually active, to say no to unwanted sex, to access contraception, to receive appropriate and adequate care during pregnancy, and to seek abortion. By definition, rights are “a moral or legal entitlement to have or obtain something or to act …
Understanding reproductive rights: complex considerations
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