Emergency Medicine
Giving medical advice with moral values is deeply personal and takes courage
Imagine delivering testimony to practicing emergency medicine for 30 years on the TEDx stage and my “Real Serious Illness Conversations with Parents” being condemned with this NOTE FROM TED: Please do not look to this talk as a substitute for health advice. This talk only reflects the speaker’s personal views and beliefs. It’s as if to say, “Beware of the doc”… who lets individuals decide how they’ll die …
How major depression strengthened my practice and my faith in God
I had a fairytale courtship, engagement, and wedding to my Prince Charming. We came home, starry-eyed, ready to start our forever together. Within weeks, I began to struggle. Always an extrovert, suddenly going to my family medicine rotation took extraordinary effort. I began to worry about my every word and action. Some days, I said nothing — unsure whether I could form a coherent sentence. I decided to take time …
A story that changed this pediatrician forever
I’m a pediatrician and have been practicing for 29 years. I currently own a solo practice.
Here is a story I wrote years after a patient encounter during my residency in 1993. I didn’t know it at the time, but it was an experience that would shape my career in general pediatrics.
Marcus is the worst case of child abuse I’ve seen to date. He’s two years old. His mom’s boyfriend dips …
I went to Ukraine to help. Here’s what you can do.
I went to Poland and Ukraine in April and May of 2022, hoping to support the Ukrainian people in their defense of their country and democracy itself.
Vladimir Putin had put the world in a vise.
“Let me do what I want, or you will risk nuclear war,” was the implication. We’ve seen this before, I thought. Putin is Mussolini, Hitler and Stalin all rolled into one, and he needs to be …
Health care’s dirty secret
Health care has a dirty little secret. And if you aren’t part of the club, chances are that you don’t know anything about it. Aside from COVID-19, short staffing, and the lack of hospital beds to accommodate those who need them, another crisis has been overshadowed and hidden from public view.
What is the secret? Health care is dangerous.
In fact, so many doctors and nurses are choosing to leave the bedside …
It doesn’t matter where you are in the health care hierarchy
He was in the Ivy League for med school. His dad was an MD, and they lived not too far from this small town. Daddy’s house, a “mini-mansion,” was right around the corner.
After successfully completing his residency, Dr. David became our ER physician. This was a big deal—a big fish in a little pond.
He had an aura of wealth about him. He had an arrogance about him, too.
He was new …
Meet the emergency physician who writes satire [PODCAST]
Ending gun violence in America should be a no-brainer
Brain matter was spilling out the top of the patient’s head in the trauma bay. It doesn’t take a neurosurgeon to know that this is not normal. My pager screamed, “GSW to head – ED Room 1.” Gunshot wound to head – Emergency Department Room 1. As the neurosurgery resident physician on call that night, it was my job to evaluate this patient STAT. I wish I could say this …
Improving access to care in rural America: Keeping rural hospitals in the game
Almost 20 percent of America’s population lives in rural areas of the country, where accessing health care facilities and services can be challenging. The patient-to-primary care physician ratio in rural areas is only 39.8 physicians per 100,000 residents, compared to 53.3 physicians in urban areas.
Rural hospitals work diligently to meet the health needs of the populations they serve, but they have long struggled with staffing shortages, inconsistent patient volumes, …
10 tips for smoothing the transition from resident to academic emergency medicine attending
Congratulations! You made it through residency. On to the next stage of your emergency medicine career – attending-hood (and for some fellowship)!
Here are ten tips we learned during our first year as attendings at an academic emergency medicine department.
1. Efficiency comes with time. Start off making sure you are methodical. Unlike residency, you will no longer have an attending re-ordering hemolyzed labs or ensuring a negative HCG prior to obtaining …
Residency almost killed me — literally
One morning, I was sitting in resident lecture. This time was supposedly protected, but we realized fairly quickly that the work still had to be done, and “I had lecture” never really worked out well as an explanation.
By this time in the week, I had already worked 80 hours, and the luxury of sitting down for an hour in a row was the main upside to the lecture. I kept …
Grief on the front line
Several years ago, I wrote a piece about my experience of personal grief while working as an emergency physician in Australia. The grief I experienced was due to the untimely death of my older brother Martin — a high-achieving lawyer and sportsman — who slowly withered away as he lost his battle with a rare and aggressive lymphoma. It is fair to say that his death broke me, but …
ADVERTISEMENT
Why I’m leaving emergency medicine
I am hanging up my stethoscope and exiting the ambulance bay doors for the last time. I chose emergency medicine to care for critically ill and injured patients, and I’m leaving because this has become near impossible.
I believe it imperative to share some of the reasons that I, and many like me, are leaving a field we once loved, as their ramifications will sooner or later impact you and those …
Teen dies when blood culture protocol botched: What can we learn from this tragedy?
It’s 4 a.m. when a 17-year-old awakens at home with severe left shoulder pain that his worried parents call 911. By the time he reaches the emergency room (ER), he has pain all the way to his wrist.
“Any recent injuries?” asks the doctor.
“Yeah, about three days ago, I was lifting about 200 pounds at the gym and noticed that my shoulder was really sore.”
When questioned further, he admits that he’d …
It’s time to prevent the exploitation of sick people for profit
As a former emergency medicine doctor with ABEM certification, I anticipate questions about why I sought medical care. At this point, my problems are complex, and I need someone with a clear head to weigh in. At every encounter (and there have been nine or ten in three weeks), I have been both shocked and disappointed, as it seems patient well-being is barely a consideration in health care settings in …
Don’t let medicine crush you
The house is asleep, and I can’t turn off my brain. I just cried my way through an episode of SEAL Team, especially the part where two SEALs are opening up to a psychologist about feeling broken. One says he’s tired of pretending he’s OK that he has PTSD and needs help. Later, he breaks down, and his wife folds him in her arms and tells him she’s there to …
The gravity of difficult questions
“I don’t want to be alive anymore.”
My friend Margot was despondent. Her lips quivered. Her eyes, normally the shape of almonds, folded themselves into little triangles when she cried. This kind and gentle woman of 62 years – my neighbor – was undeniably at her lowest point. I was sharing a couch with her during my junior year of college as her composure crumpled before me.
I first met Margot when …
Cardiac callus
I had wanted to take a long motorcycle trip for years, and I finally carved out two weeks to do so. My pal Doug and I packed our gear onto our Harleys and headed out without an itinerary. We would select the day’s route each morning. Initially, we enjoyed spectacular scenery and good times.
After a few days, however, we encountered pouring rain while winding through remote mountains. There was no …
Death and Dvořák
Dvořák Symphony No. 9 in E minor (“From the New World”) – Movement II ‘Largo’: a soundscape like floating beside the clouds in a perfect blue sky. The brass chords flood your ears. The underlying orchestra adds harmonic depth and richness. The English horn solo tugs at heartstrings, sighing at the end of each phrase.
After years spent in numerous youth symphonic orchestras, this performance stands out to me among an …
Past Week
-
Why doctors struggle with treating friends and family
-
Whole-body MRI screening: political privilege or future of care?
-
When racism findings challenge institutional narratives
-
Why women’s symptoms are dismissed in medicine
-
A simple nocturia management technique for seniors
-
Collaborative partnerships save rural health care from collapse [PODCAST]
-
Past 6 Months
-
Why patient trust in physicians is declining
-
The blind men and the elephant: a parable for modern pain management
-
Is primary care becoming a triage station?
-
Psychiatrists are physicians: a key distinction
-
Why feeling unlike yourself is a sign of physician emotional overload
-
Accountable care cooperatives: a community-owned health care fix
-
Recent Posts
-
Collaborative partnerships save rural health care from collapse [PODCAST]
-
Whole-body MRI screening: political privilege or future of care?
-
Why doctors must stop waiting and reclaim their lives
-
The hidden link between circadian rhythm and physician burnout
-
Why addiction is no longer just a clinical category
-
Physician on-call compensation: the unpaid labor driving burnout
-
Subscribe to KevinMD and never miss a story!
Get free updates delivered free to your inbox.
28
pages
Past Week
-
Why doctors struggle with treating friends and family
-
Whole-body MRI screening: political privilege or future of care?
-
When racism findings challenge institutional narratives
-
Why women’s symptoms are dismissed in medicine
-
A simple nocturia management technique for seniors
-
Collaborative partnerships save rural health care from collapse [PODCAST]
-
Past 6 Months
-
Why patient trust in physicians is declining
-
The blind men and the elephant: a parable for modern pain management
-
Is primary care becoming a triage station?
-
Psychiatrists are physicians: a key distinction
-
Why feeling unlike yourself is a sign of physician emotional overload
-
Accountable care cooperatives: a community-owned health care fix
-
Recent Posts
-
Collaborative partnerships save rural health care from collapse [PODCAST]
-
Whole-body MRI screening: political privilege or future of care?
-
Why doctors must stop waiting and reclaim their lives
-
The hidden link between circadian rhythm and physician burnout
-
Why addiction is no longer just a clinical category
-
Physician on-call compensation: the unpaid labor driving burnout
-
