Physicians actually make good pilots. But, in 1966 they received a bad rap due to a report published by the FAA’s Chief of Aviation Medicine, Dr. Stanley Mohler. Mohler had a point. Physicians were crashing planes at a higher rate as opposed to the general aviation population. His report would be a cautionary tale for all of us. It would be three decades before we even began to understand why …
Can someone please tell me the exact moment when fleece pajama bottoms became the fashion sensibility of America?
I can’t pinpoint the moment exactly, but several years ago I began to notice that many of our ER patients were presenting for treatment wearing nice fluffy fleece bottoms. Men. Women. Old. Young. These fleece bottoms seemed to be enjoyed by a variety of the population. Most of these earlier bottoms for the …
Fleece pajama bottoms in the ER
Like many pediatric intensivists, I care from time to time for victims of child abuse in the form of what is often called “shaken baby syndrome.” This syndrome is a characteristic constellation of finds that happen when a strong person grasps a child around the chest and aggressively shakes the infant. It was first described by Caffey, a pediatric radiologist, fifty years ago. The baby may have …
Important new information in the tragic cases of child abuse
This notice appeared on a general surgery news website in early February.
I don’t know who has been long anticipating this, but I’m pretty sure it’s not people on medical Twitter. My informal, nonscientific Twitter poll garnered 707 votes with 87 percent of those responding saying they would not allow their residents to participate in a reality television show.
Many of those who …
Should medical residents appear in reality TV shows?
The heavy young man curled on his left side is in the ER for a pain in his backside. The sweaty blue dragon on his chest smells like fear.
“It’s an abscess. I’ll have to open it. It’s gonna hurt.”
“Can you put me to sleep? I hate pain.”
I can. Should I? Remember Michael Jackson? I do.
His neck would make a Hereford bull proud; he’s missing a chin but he’s got a …
Can you put me to sleep? Why ER physicians have to say no.
I was working a few days ago and pulled a tooth. Mind you, it’s not something I do with any regularity. However, it was a very sweet little lady who was too weak and ill to get to the dentist and had other issues. That lower incisor was loose, and constantly in the way. Furthermore, it was painful.
I had seen her for something else in the emergency department. I took …
An emergency physician does a tooth extraction
Matt was 40, my sister’s age. He was training for a marathon and trying to talk his many friends into joining. He lay in bed with his three-year-old son every night to help him fall asleep. It’s hard to sleep train a toddler with a newborn to nurture at the same time, but he loved spending this time with his two kids and being the dad everyone counted on.
Matt’s best …
A tragic Fentanyl story without redemption
Last week I took the naloxone challenge. I walked up to a pharmacy window, waited in line, and requested naloxone from the pharmacist. She showed a supportive but knowing look, and I became acutely aware of the four people in line behind me. After giving her my name and date of birth, she was able to pull my insurance info from prior visits, and I left with a dose of …
A man in his fifties is wheeled into the emergency department on a gurney hoping he’ll still be around to cheer from the sidelines at his daughter’s next soccer game. A little girl on the pediatric floor upstairs simply hopes her tummy stops hurting. A woman in the clinic explains her puzzling symptoms and hopes that this is the specialist who will finally be able to ascertain why she hasn’t …
Hope is essential in every field of medicine
I started my medical career late. Really late. By that time, I’d lived a few lives. I’d earned a boatload of initials. I’d changed husbands, languages, and continents. I’d written a useless novel, and I’d been a Mary Kay lady.
One day over lunch as I was looking for something to do with myself, my husband suggested medicine. I spent the next nine years immersed in my medical training, feeling guilty …
Why are we hemorrhaging emergency nurses?
I’m an ER doc. I care for patients. All patients: Those who need to be in the ER; those who don’t; those who wouldn’t be there if they knew better. For them, for you and for fun, I’ve got some tips to keep you happy, safe and away from my ER. Enjoy.
1. Never, ever say “hold my beer and watch this!” Besides “I do!” they are the most dangerous words …
If you’re in the emergency department, it’s probably the worst day of your life. You’re scared, confused, anxious, sad, maybe emotionally numb.
You were at home with your husband and witnessed him have a cardiac arrest. He was unresponsive, and he wasn’t breathing. You felt hopeless because you didn’t know how to help him, but you called 911. They rushed him to the hospital, and you followed the ambulance. By the …
A scribe’s haunting view of emergency medicine
“Grandma fell and we’re in the emergency room. She’s very distressed and does not look good. I’m going to put the doctor on the phone.”
I could hear my mother’s voice strain on the other end of the phone line as I braced myself for my conversation with the emergency department physician.
The emergency physician told me that though the work-up was still developing, my grandmother was in respiratory distress, and that …
The most loving thing: end of life and saying goodbye
The new Holy Grail of business, Customer Satisfaction — CSAT to her close friends — is a measure of how products and services supplied by a company meet customer expectations. In a marketplace where businesses compete for customers, CSAT is a key element of strategy.
Why?
Money.
Satisfied customers buy. They come back and buy more. They tell their friends, who’ll buy too. If satisfied, they’ll return and buy more. That’s gold for …
Every time I call a friend, all I have for them is more work. I’ve never yet called to say: “I hope you’re having a great day. Why don’t you take a break and have some fun? You’ve worked enough.”
Nope. I only call to give them extra work. Whether it’s 2 a.m. or 2 p.m., I need you to get away from your bed/lover/high horse and come take my patient. …
An emergency physician with no friends
This article is sponsored by Careers by KevinMD.com.
Whether you recently completed your residency as an emergency medicine (EM) physician or are ready to move on from your current position, potential locations for work are undoubtedly a big factor in determining which emergency physician jobs you’re willing to consider.
If you have children, location is especially important, because you want …
5 things emergency physicians should consider when looking for jobs
I never really had a true mentor. Or role model. I wasn’t sure if they were the same thing, or what the difference was, so I gave up. Sometime in middle school, I remember a teacher encouraging us to find someone we looked up to and develop a mentor relationship. I was 12, looked at my teachers who I thought were old, and ignored that advice.
In high school, I thought …
To my mentor: Thank you. I didn’t know how much I needed you.
Stepping into a hospital for the first time as a clinical medical student is a strange dichotomy. There is still so much you have to learn before you will become a physician, but you are quickly thrust into life-and-death situations. One of my early rotations was in the emergency room. As a student, you have no actual authority and must be closely monitored at all times. Many times you will …
I had just witnessed my first patient die
About two months ago, a 15-year-old Native American male was riding around in a stolen car on the reservation. “M” and the driver were drinking. And somehow, after he exited the vehicle at 4 a.m., the car struck him. Hours later, it became clear that something was wrong. M was transferred to our pediatric hospital as a trauma and was found to have an unstable vertebral fracture. Conservative treatment with …
Non-therapeutic relationship or human kindness?
1. Murphy’s Law as it applies to the ER: If something can go bad, it will do so in a hurry. If it can’t possibly go bad, it will still find a way.
2. Clock’s First Rule: All the patients will crash at the same time. Usually when the computer system goes down.
3. Clock’s Second Rule: The sickest patients will come just before the shift change.
4. Haste’s Theorem: The healthier the …
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