An excerpt from Yankee Doctor in the Bible Belt: A Memoir.
There are patients you can help. You can see them through a crisis, give them a magic medicine that makes everything better. There are others where there is little you can do. Their distress is beyond cure. The following story is about one person I could help.
Tony Bowman is a man in his early …
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I have a friend. He is non-medical, just a person who knows a lot of people. He grew up on the rough side of town.
He has lost five friends or relatives this past year, he tells me. All to Fentanyl overdoses.
Most were young, in their twenties or thirties. Two were friends of his son, who is in his early thirties.
Most had been on prescribed opioids for a confirmed back injury—a …
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My heart goes out to the doctors who write about the unbearable burdens of doctoring in a corporate setting, feeling driven to see more patients than they want to within the span of an 8-hour clinic day. They’re tasked with dividing their time into shorter and shorter clinic visits, devoting more time to inputting data points into the EMR rather than engaging in meaningful patient conversations.
I have experienced both ends …
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I retired as a physician at age 70, when COVID-19 came to town and the clinic I was working closed. During these past three years, I have had the luxury of a long view of my career. Every now and then, I feel the urge to pick up my stethoscope again and return to the practice of medicine. I’m tempted by the several good aspects of being a doctor.
The good
The conversations …
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I was in my first year of medical school when I discovered I was pregnant. This was not a planned pregnancy, as no one would intentionally plan to have a baby during medical school, as it is extremely difficult to manage both. However, there I was, and to my surprise, I was happy about it. I had previously thought that I was infertile after trying to get pregnant for five …
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I read KevinMD regularly. I see a lot of stories about how broken medicine is: how doctors are retiring, leaving early because they are overworked or underappreciated, or being manipulated by corporate medicine. All these complaints are valid. There are also articles about how residency is brutal and causes mental distress to trainees, with the onerous hours and unrealistic expectations. That, too, is true. Medical training, at least in my experience, is …
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I worked in rural Kentucky for 20 years, all of it in poverty clinics. I suspect I got to know my patients better than someone working in a specialty clinic in a big city. The challenges and rewards of doctoring are unique to each specialty. But these are the challenges and rewards I experienced in primary care in the backwoods.
I learned that doctoring is hard. People always come in complaining …
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As doctors, we have all been guilty of anchoring bias, which means we put too much weight on the first complaint. When a patient presents to the clinic with a complaint that sounds vaguely like a headache due to a sinus infection, we whip out the script pad and write a script for Augmentin. We tell them to return if they are not better in two days. That latter statement …
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By this title, I mean whether it is a good idea or not to hire a scribe to enter data into the electronic medical record (EMR) system.
I favor having a scribe. I came of age with paper charts, and I found the transition to EMR tricky and time-consuming.
My chief argument favoring scribes is that scribes can save doctors a lot of time. And by saving time, scribes can also help …
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An excerpt from Yankee Doctor in the Bible Belt: A Memoir.
Doctors like to solve puzzles. These are ideally diagnostic puzzles. The following is a story about a patient whose illness was unsolvable: the pieces of the puzzle did not fit together. No matter how you tried to force a diagnosis out of the disparate pieces of data, it did not …
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I traveled to Denver to California via train in mid-October. The train is aptly named the California Zephyr.
It is a 33-hour trip, across the high mountains of Colorado — with magnificent views of rocky canyons flanking the Colorado River – and through the scrub deserts and subdued, pink-hued mountains of Utah and Nevada.
The trip was lovely. My husband and I had gotten our COVID booster shots two weeks prior. We paid …
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Patients die. This is a tragic truism in the world of medicine. Usually, the patients who die are elderly. Patients die from diabetes and kidney disease, or from alcohol abuse and liver failure, or from heavy smoking and lung disease. Or patients die from cancer.
As a physician, I take these deaths in stride. I try to provide comfort care as they lay dying. Patients often pass into a dreamlike state, …
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I was working as a doctor in a Kentucky clinic when I first met Mr. Stroud. The year was 2013. Mr. Stroud was memorable for several reasons. The first reason? He was blue.
He was a 45-year-old stocky guy, pleasant in demeanor, with blue eyes and red hair. His skin was also blue. His lips especially. He did not seem to be unduly distressed, however. He was pleasant in demeanor, although …
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Last March, I was working in a small primary care practice on the west side of Denver. COVID-19 came to town. On Thursday, March 12, we were told the schools would be closing. On Friday, we were told that clinic staff had to wear masks — and the clinic had to start testing patients for COVID-19.
The only problem? There were no medical-grade masks to be had. Not through the state …
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