“A lot of times, people don’t know what they want until you show it to them.”
– Steve Jobs
I was rusty.
I felt rusty, at least.
It had been forever, seemingly, since I attended patients as an emergency physician.
A couple of years earlier, I’d been sailing along happily in my clinical career when a cancer diagnosis blew in like a hurricane, shredding my sails and dumping me into a sea of medical and …
Are virtual doctors actually useful?
An excerpt from Ballad of a Sober Man: An ER Doctor’s Journey of Recovery.
As if I needed more reminders of my imperfections, I had Maggie and the Kidney Stone Lady, forever. Little Maggie, the cute five-year-old from early in my career who came in with her …
A sober emergency physician returns to work, just in time to face the COVID-19 pandemic
I love being an emergency doctor. I loved my residency, my co-residents, and my attendings.
I love my training: watching, learning, treating.
I love the emergency department, the vastness, and the variability of emergency medicine.
But I am tired.
I am tired of feeling like a workhorse, a production line made to just churn patients in and out.
I am tired of being told that my worth as a doctor is based on my time …
I am tired. But I still love emergency medicine.
I am about to express a wildly under-advertised piece of advice: Our nurses are our most valuable resource. This reality has been true for physicians for many years, but with months of lost time on in-person rotations, it will be true for us more than any other class.
My career in medicine started while working as an ED tech. It was a night shift job to get me through my degree …
Nurses are our most valuable resource
There are many jobs where people work long and hard. But I will assert that none train as long and hard, and at so much expense, as doctors/surgeons that manage the emergencies for their specialties and take night call, on top of managing a full-time practice.
The key point I am trying to make is that doctors, as a profession, basically agree to “show up.” That is what sets us apart …
Doctors show up. Until they won’t anymore.
I was reading this article in the New York Times about Dr. Lorna Breen, and it literally took my breath away. This awful pandemic has claimed so many lives, in so many different ways.
Sadly, it made me think of a medical school classmate of mine who took his own life a few years ago. He arranged for this to post to Facebook:
A message for health care workers: Be kind to yourself
“Doctor, I can’t wear a face mask, can you write me a medical excuse?”
My first reaction was a resounding No. COVID-19 cases are surging in many parts of the country; we’ve only just emerged from our own deadly surge in Boston. It’s essential that we employ every measure we can to prevent spreading this deadly virus—and that includes universal masking.
But then this patient described how she had …
The challenge of trauma-informed care in the age of COVID
Working within the nation’s poorest large city, our pediatric emergency department (ED) serves as a safety net for the most vulnerable. We are witnesses to parents stretched beyond their limits – juggling raising a family amidst the stress of work, financial strain, community violence, social injustice, and the many other heavy weights they quietly bear when they bring their children to the hospital. These social needs powerfully influence …
How the pandemic created an opportunity to support families
One of the last things my dad said to me before he passed was, “remember to always look at the big picture.” He said this many times throughout my childhood and teenage years, but it never quite resonated until I was thinking about it in retrospect.
As I near the end of my intern year, my dad’s words hold true. As an emergency medicine resident, I am often running on adrenaline. …
Why it’s so important to look at the big picture
First and foremost, a mental health crisis is a medical emergency well within the sector of public health. Therefore, the question of who should respond to mental health emergencies is one in which physicians and all medical providers should have a say. Medical providers should not only be aware of the systems in place to respond to mental health crisis but must advocate for patient safety as a measurable outcome …
Who should be the first responders to mental health crises?
This June has entered without the typical parades, rainbow flags, and jubilee. As the coronavirus lingers and the optimistic case for controlling the spread of COVID-19 casts a long, somber shadow over sections of the country, Pride seems like an afterthought. As a gay emergency physician, and someone who never found particular importance in the Pride events I’ve attended in the past, I wanted to share why Pride matters …
What every clinician needs to know about Pride
With COVID-19 continuing to spread, some might assume that the one place to avoid is a hospital emergency room. After all, the space is filled with health care providers who work in close contact with sick people.
This assumption could be harmful to a person in need of emergent medical care, and now, thanks to a study we recently conducted, we also know it’s likely incorrect.
Our study found that health care …
Is COVID-19 contraction risk lower in ER than in routine activities?
I am a pediatric trained emergency physician working in a level 1 trauma center. Our region is not an epicenter for COVID-19. Like many pediatric departments, our volumes are returning but were less than half of normal for months. Social distancing has not only flattened the curve for COVID-19, but it has also made our usual summer viruses all but disappear. Where are all the enteroviruses?
In pre-COVID times, after a …
Pediatric emergency care during a time of strict social isolation
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I work as a resident in Australia’s busiest emergency department. Well, it was the busiest at a recent count anyway. The department is housed in the city of Gold Coast. The city sprawls across a beautiful stretch of beach. When I wake up, I turn my head to see the sun hanging out over the Pacific ocean. I can’t think of a better way to start my days.
Whether it’s on …
The intricacies of working as a doctor with a spinal cord injury
It was a beautiful Spring day. My wife and I were returning from UNC-Chapel Hill after visiting our oldest son. Driving on Highway 54, I suddenly saw a young woman on the left side of the road frantically waving her arms and screaming. Behind her, a pickup truck had crashed into a tree. I immediately stopped the car. That’s when I saw him. Lying, unmoving, on his back was a …
Do patients’ needs come before the needs of our families?
They are physicians, mentors, partners, mothers, sisters, friends, colleagues – but most evidently, at the moment, they are heroes. I (virtually) sat down with five women physicians, at all points in their medical careers, who are working in several of the largest emergency departments in Texas, to talk about their experiences with the COVID-19 pandemic.
One of the themes that I heard from each of these physicians was that the inevitable …
These are the doctors under the PPE
While recently on board an international flight, an in-flight medical emergency was called approximately one hour into a ten-hour journey. The overhead page most travelers may have heard while on a plane, “Is there a doctor onboard the aircraft?”
The air hostess quickly led me to the front of the aircraft where an elderly passenger had vomited a substantial amount of blood in the bathroom and near her seat. I requested …
Anyone can help in an in-flight medical emergency
I wake to a WhatsApp call. It is my aunt, who lives in India. “We are all worried about you,” she says. “All of us here are praying for you. Make sure that you stay safe.” Coincidentally, she is a nun, so I’ll take her prayers whenever I can get them. I promise her that I will stay safe, and then I get ready to enter the ER. I don …
Scenes from the COVID battlefield
When I found out that health systems across the country contract with prisons for hospital laundry and other services, the same systems that train medical students like myself, someone dear to me was in prison. Each time I walk into a patient’s room and see fresh linens, when I wear fresh scrubs, I am still flooded with my friend’s calls and letters. Imagery of being surrounded by only concrete. Without …
We seem reluctant to remember that people incarcerated are exactly that: people
On December 30, 2019, Li Wenliang sent a message to a group of fellow doctors warning them about a possible outbreak of an illness that resembled severe acute respiratory syndrome (SARS) in Wuhan, Hubei province, China, where he worked. Meant to be a preemptive confidential message, he encouraged his colleagues to protect themselves against possible infection. When the local authorities became aware of his report, they summoned Dr. Li to …
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