I wasn’t as happy as I expected to be when I walked out of the hospital on my last day in medical school. But then again, there was little to celebrate — my last few patients had terminal cancer, a stroke, and end-stage liver disease from alcoholism. I signed off my patients to my resident, and so, my medical school career came to an unceremonious end. I thought to myself …
Why medical writing is essential to medicine
The residency interview trail quickly becomes a lonesome journey, so when I was on it this winter, I’d usually have the hotel room television turned on for some background noise and often find myself watching ESPN’s SportsCenter. On my last interview in Philadelphia, the show was featuring the high flying phenom Zion Williamson, who’s set to be drafted this year to the NBA. When I finally returned to home in …
The sigh of relief on Match Day quickly changed into a sobering reality
Back when I was a third-year medical student, I would sometimes bike to the hospital campus early enough to catch the groundskeepers cleaning the promenade in front of the medical school before the foot traffic arrived. Discovery Walk, as it’s called, is a beautiful promenade with stone murals commemorating the significant discoveries made at Stanford. It’s a beautiful scene, especially during sunrise or sunset, which many of my classmates have …
The difference between learning medicine and doing medicine
I recently attended a small dinner hosting Robert Lefkowitz, MD, the winner of the 2012 Nobel Prize in Chemistry for his discovery for G-protein coupled receptors. Throughout the night, the conversation traversed a diverse range of topics — from his adventures in Stockholm, Sweden to his work-life balance — but his remarks on one particular subject stuck with me. It turns out that Dr. Lefkowitz, when interviewing candidates to work in …
Standing on the shoulders of the basic science researchers who came before us
We recently had a patient who arrived on our service in the intensive care unit after a complicated surgery. The surgery left him close to dying, and he was immediately put on life support and given heavy sedatives.
Ventilators breathed for him. Special drugs kept his heart beating. A continuous pump acted as his kidneys, filtering out his body’s toxins and infusing the cleaned blood back into his veins anew.
He had …
Treating the patient’s body is not synonymous with treating the patient
The common critique of surgeons from their medical colleagues is the scant amount of time spent with their patients. As the argument goes, surgery is more impersonal than other specialties and those who practice it see their patients in one dimension.
In some sense, they aren’t wrong.
For those who wield the scalpel, speed and efficiency are a priority. It’s a philosophy perfectly illustrated during morning rounds, the daily tour of patients …
The doctor will see you now. But only for a minute.
One late evening on pediatrics call, a frantic young couple brought in their few weeks old baby. She had spiked a fever which refused to go down and was fussier than normal. The cause of her symptoms could have been anything — at best, a mild respiratory infection, in which case we would simply watch her and manage her symptoms, but at worst, it could be meningitis, an infection attacking …
The art of medicine is slowly being pushed out. Is that a good thing?
In the mid-1800s, Ignaz Semmelweis, then a professor at Johns Hopkins, proposed something outrageous: Doctors and medical students working in the maternity ward should wash their hands before delivering babies because doing so could reduce infant mortality. For proof, he performed a rigorous experiment that showed babies delivered by midwives, who traditionally did wash their hands prior to deliveries, had rate of death that was five-fold lower than those delivered by doctors.
He …
Science and medicine are seemingly at constant odds
My mind usually starts to wander around the third or fourth hour of retracting a fat flap or holding up a leg during a long operation. I start by guessing how many times the attending has done this particular procedure. Is it his hundredth time doing it? If he was one of the older attendings, perhaps it was his thousandth one.
As a neophyte in the operating room, I still relish …
Learning surgery one stitch at a time
Running has been a constant in my life, and it always will be. I’ve gone on runs in snowstorms and 100-plus degree heat waves, Christmas mornings and birthdays. That hour or so dedicated to running is sacred, reserved for a few minutes to clear my head, a sort of reset button to each day. I’m surrounded by nothing but the sound of shoes hitting the pavement and gasps of heavy …
Is work-life balance possible for doctors?
In an oft-cited psychology experiment from the 1960s done at Stanford, toddlers were isolated in a room with a table on which sat a single marshmallow. If they could resist the temptation to eat it, as they were told by the experimenters, they would be rewarded with two marshmallows later on.
If we replaced these toddlers with medical students as the subjects, the experimenters would have run out of either marshmallows …
Does medical school ever pay off?
In medical training, each morning begins with pre-rounds, a sort of prologue to the work day that gives us a preview of our patients’ conditions. Like a daily ritual, we arrive in the hospital as the sun begins to peek over the horizon and proceed to visit each of their rooms. Some of them are still sleeping, but we wake them up anyway to needle them with questions. Any pain? …
How do you talk to a dying patient?
I recently saw a patient who, against all odds, survived an aortic dissection. Miraculously, he was alive after the wall of his aorta — the largest and most important vessel in the body — began to rip apart. Aortic dissections are so violent and agonizing that a large portion of these patients don’t survive. Yet somehow, my patient was still able to sit upright in his chair and recount his …
The single most important lesson for doctors in training
A few weekends ago, I saw a patient with bloated shins at our school’s free clinic, and I marked in my notes that she exhibited “peripheral edema,” an esoteric phrase that means little to those outside of the medical community. That experience only highlighted the tendency in medicine to inflate common bodily functions into opaque medical jargon. Its use can be frustrating for patients who are trying to understand their …
The core of the scientific process is how we ultimately serve our patients
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