Emergency physicians, nurses, and residents writing on KevinMD from the emergency department: acute care, the realities of the ER, boarding and overcrowding, violence against staff, and medicine practiced under pressure. Most contributors work in emergency departments. For what emergency physicians and nurses have said about being assaulted at work and told it was part of the job, see Violence against health care workers: what physicians and nurses say, in their own words. For what emergency physicians wrote in the first weeks and months of the pandemic, see COVID-19: what physicians wrote as it happened. For what emergency physicians and pain patients have said about opioid prescribing, see Opioids: what physicians and pain patients say, in their own words. For what physicians in the highest-burnout specialty have said about burnout since 2009, see Physician burnout: what physicians say, in their own words.
June 2020 will mark 15 years of my departure from flying the friendly skies. I have had the privilege of working as a flight attendant for JetBlue Airways from 2001 to 2005. Today, I am proudly grounded as a physician specializing in pediatric emergency medicine.
Gratitude is a positive mindset where you see your life and experiences as a gift. Practicing gratitude is a powerful way to reduce stress and build …
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How working as a flight attendant made me a better physician
April 2020 was to be a month of personal milestones. I would be traveling to Mexico with sixty closest friends and family to marry the woman of my dreams. Twelve days later, I would celebrate my thirtieth birthday. Suffice it to say, I was looking forward to April with the excited anticipation of a child on Christmas Eve.
But that was before COVID. Before all eyes were focused on the novel …
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A physician wedding in the age of COVID
Dr. Lorna Breen, an ER physician in New York City, killed herself after working the front lines in the pandemic. Her death has created a call to action. The headlines read that healthcare workers are suffering; they are heroes; they need support. Dr. Lorna Breen was 49 years old. I am 49 years old. I am also a successful ER physician on the front lines of the pandemic. I can’t …
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I have been thinking a lot about Dr. Lorna Breen
As an emergency medicine doctor who trained in the Bronx, I decided that I must return to NYC in solidarity. This is the first time I have taken an assignment with my colleagues’ collective burnout as the focus of my intention. Previously I have placed the needs of my patient population first. As this COVID-19 pandemic continues to burn throughout the human species, I marvel at how crisis breaks down …
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How ironic it is to be applauded for keeping our oaths
With COVID-19 still consistently creating setbacks in the health care community, we see yet another issue for medical students because of this pandemic. In prior years, the traditional medical student would be expected to be part of a team assisting medical professionals in the field, developing relationships with future mentors, and gaining the experience necessary to take on the difficulties presented in that given field. COVID-19 has been altering the …
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The crisis of rotation availability during a pandemic: a medical student’s ethical conundrum
Like many physicians not initially on the front line of the COVID-19 pandemic, I watched with growing dread as stories from doctors and nurses started coming out from hot spots first in China then in Italy and then Seattle and New York. Seeing their faces and hearing their voices, I was struck by their exhaustion and fear but also by their sense of responsibility and duty. I wanted to help, …
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Bearing witness: the physician’s role in a time of crisis
As my surgery rotation commenced, I fully expected to be immersed in the unfamiliar territory of “scrubbing in” and “sterile fields.” While I discovered the difference between vertical and horizontal mattress sutures, two specific patients I encountered on this rotation opened my eyes to issues beyond the operating room (OR).
After scrubbing out of a four-hour surgery, my attending requested I begin a consult in the emergency department for a possible …
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Patients who slip through the cracks
Two years ago, I shared my thoughts on the joy of family medicine. Two years ago, I was a senior resident working in Ann Arbor, thinking about who I will be when I graduate. Two years ago, my biggest worry was if I could finish my notes in time for sign out and meet friends to play volleyball. Today, I come with mixed but honest feelings considering recent events.
As I …
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A family physician is redeployed to the emergency department
Across our country, Americans are under a stay at home order. People are toiling over the hardships of juggling so many things — childcare, homeschooling, working, or not working — all at once. The day that society can rejoin the public sits like a mirage of water in the desert of their isolated lives. Health care workers yearn for that day as well. In the hospital, that day …
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Will social distancing turn into doctor distancing?
Currently, over 60,000 people in the United States are projected to die from coronavirus. While this is lower than earlier predictions, it is still an appallingly high number. As two emergency medicine physicians, we have been steeling ourselves for the grim task that lies ahead of us in the coming weeks and months. We will continue to go to work to try and provide the best care we can to …
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Emergency physicians want you to have the talk about end of life care
Do all physicians and scientists not on the frontlines of this pandemic feel this, or is it unique to women? Women in medicine and science have long struggled with the sense of never having “done enough” and have pushed themselves even harder to get the same recognition accorded our male colleagues. Does that make us more vulnerable to guilt, or are we holding ourselves to unreasonable expectations? We arranged to …
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The guilt of not being on the frontlines of the pandemic
Doctors today can help more people, and prevent the spread of disease more effectively through communication, than we ever could by seeing patients one-at-a-time in person. I have realized that instant human connection through technology makes us more powerful and faster than a virus.
I began my career as a physician in the pre-iPhone era. The only way for the sick to seek medical advice was to …
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Why I feel grateful to be a physician today
Among industrialized nations, only the United States endures the current public health epidemic of firearm-assisted injury and death. In 2018, nearly 40,000 people were shot to death in the U.S., while proponents of the Second Amendment continue to protect it at all costs — fighting even common-sense measures such as limiting access to felons and the mentally ill. On both sides of this debate, opinions are lobbed as facts; these …
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Approach the gun violence epidemic like we do with coronavirus
My husband and I travel internationally at least three times a year to give courses with live surgical demonstrations of colorectal conditions in children.
During the past 13 years making those trips, we had our share of hearing the famous announcement in the plane: “Is there a doctor on board?”
Those have happened in many different scenarios including having been on call the night before and therefore being on an almost semi-coma …
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Is there a doctor on board? Yes, but we might not be the right doctor.
I can’t stop mentally drafting my obituary. A coworker snaps a picture of me in full protective gear, holding a respiratory swab, and I wonder how this photo will age. I wonder about the folly of our actions now, four health care workers seated together at a computer bank in the emergency department. Likely seeding toxins back and forth as we idly banter during our shift, trying to stay calm …
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From a clinician on the frontlines: I can’t stop mentally drafting my obituary
I was about to step out for an evening shift when I caught a small quiver in my wife’s lip as she was saying good-bye. This drew me up short. I could tell that she was worried about me; it occurred to me she had a point.
I’d had about a week off, and in that time, my co-workers had begun seeing more and more COVID-19 patients. Now, it was my …
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My wife was worried as I left for the ER. She had a point.
I want to write a letter of thanks for all the sacrifices you have made for our nation during this COVID-19 pandemic.
Thank you for all the lives you have saved.
Thank you for fighting to save all the lives that were lost.
Thank you for leaving your homes each day, not knowing if or when you will hold your children or see your spouse …
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A thank you to emergency physicians
