I’m a physician, a husband and dad, a guy who tries to live by the golden rule. But sometimes I’m an escort into sadness and despair, plunging families into the darkest emotional depths with the news I must give.
One particular case from years prior stands out. Mary (whose name and identifying details have …
The toughest task in emergency medicine
Being a health care provider has always come with personal risk. We care for all patients, which includes patients agitated due to psychiatric issues, dementia, acute medical illness, alcohol or drug intoxication or just anger. Patients can be extremely volatile and lash out unexpectedly causing physical injury to their doctor, nurse or another provider. Besides the physical risk, patients can be emotionally and verbally abusive as well- and both types …
7 ways for doctors to stay safe at work
Alex Wubbels, the head nurse at the University of Utah Hospital’s burn unit, was arrested for refusing to draw blood from an unconscious patient. She was absolutely correct, since it was against hospital policy, and constitutional law, to do so.
ZDoggMD dedicated an episode of his Facebook Live show, Incident Report, highlighting the travesty:
“Sir, you’re making a huge mistake because you’re threatening a …
“You’re making a huge mistake because you’re threatening a nurse.”
In Houston, all of my colleague’s offices are closed, and there is limited access to the Texas Medical Center due to Hurricane Harvey. As a virtual medical doctor, there was only one thought on my mind this entire weekend, “How can I help?”
As a Floridian, I have certainly faced my share of natural disasters beginning with Hurricane Andrew, a category 5 hurricane in 1992. Living through Hurricane Andrew gave me …
5 ways virtual doctors can help during a natural disaster
When I finished my medical training almost sixty years ago, I was like many new graduates: I thought I knew it all.
I opened a private office in Los Angeles and paid courtesy calls on the local physicians to let them know my qualifications and my availability for consultation, as both an internist and a nephrologist. (The treatment of kidney disease was then in its infancy, and I was the area’s …
Good clinical care takes more than medical acumen
There is a definite finality to the decision of which specialty a physician pursues. The reasons are as vast as they are individual. Hopefully, the med student has done due diligence and has a solid grasp on what their future entails, at least for the future as far as anyone can confidently foresee. Here is my story.
1. Challenge. No day is quite like another, and life as an emergency medicine (EM) …
4 reasons to choose emergency medicine
An excerpt from The Other Side of the Bed: What Patients Go Through and What Doctors Can Learn.
As soon as I’d opened my mouth, I regretted it. In the hospital, it’s bad luck to say “It looks quiet,” or anything to that effect. At the sound of those words, …
A code in the cath lab that was unlike anything I had ever seen
In his famous novel, Moneyball, Michael Lewis illustrates the phenomenon of professional baseball scouts focusing on all the wrong characteristics when looking at players. He describes how scouts focus on fastball velocity as a way to compare pitchers, despite the lack of correlation between fastball speed and the quality of a pitcher. As it turns out, the most important factor in a pitcher is deception, not a high-velocity fastball. The …
Residents need to learn medicine, not how to pass a test
Victim: Female nurse, age 25
Time: circa 1980
Place: A hospital in a sleepy Southern town with fifty beds, six emergency department beds, one nurse, one doctor and one secretary.
It was an unusually quiet Friday night in this small emergency department.
We all knew Friday was “party day”: pay day, play day, alcohol, pills, drugs, loud music and lots of really bad decisions.
Not only did we cover the entire city, but we also …
A nurse was attacked in the emergency department. This is her story.
After another long shift of patients with colds, bug bites, ankle sprains and sore throats I eagerly looked through the wine selection at the local grocery store. It was my wedding anniversary and nearing 9 p.m. at the beginning of a holiday weekend. While at the checkout line, an elderly woman in front of me thanked me for my service. At that moment, I realized that I was wearing my …
This is what it’s like to be a military physician
I carried it around with me the entire shift. I showed it to my E.R. colleagues, the internists, and even a couple of surgeons. I’d tell them the story. “Never,” one of them said. “Not in twenty-eight years. Never seen that before.”
One of them held the small urine jar up to a light and began unscrewing the lid.
“Don’t!” I said.
“Why not?”
“It stinks. You wouldn’t believe how much it stinks. We …
The abscess that surprised this emergency physician
“So tell me why you think you you’re having a stroke?”
The nice lady, mid 40s, sat on the ER exam table in work-clothes, an anxious look on her face. “Well, I was working the cattle up in the timber, and when I got back to my 4-wheeler my heart was racing, and I was short of breath. My arms were tingling, and so was my face. I’m concerned it might …
This is what practicing medicine in rural America is really like
While Muzak plays (think Kenny G covering John Mayer) and courteous expressions like “excuse me” and “thank you” are exchanged in hospital waiting rooms, behind the front desk, angry patients are firing curse words into the hallway like their mouths are assault rifles with an endless supply of ammunition. Nurses are being cussed out by patients who sound like characters in “Platoon.” And medical professionals are dropping f-bombs. All of …
Why medical professionals have potty mouths
On my first trauma shift as a fourth-year medical student, a young, disheveled man with blood-soaked pants hobbled into the emergency department. Wincing in pain, he offered me a bizarre history of being shot in the leg by a nail gun that went off after he dropped it on some stairs while helping a friend move. He lifted his right pant leg and removed the bloody, tattered bandana wrapped around …
Doctors aren’t cops: We need to change gunshot reporting
“Sorry, excuse me, can I get through please?” I wiggled my way to the head of the bed. Quickly, I set up the necessary intubation tools as the patient arrives shortly thereafter. A frenzy ensues, tubes flying over the patient, people talking over each other.
“Can you draw me up some RSI meds? Let’s get this guy intubated now. Sorry, but I need it quiet in here.” Tube placed, a wave …
The dangers of being overly apologetic
Am I the only emergency physician who sometimes wonders who left me in charge of an ED? I should be confident in managing whatever comes through those ED doors after more than ten years of single-coverage night shifts, but each night I hear a little voice in my amygdala questioning whether tonight will be the night I won’t be able to handle something. Sometimes I feel afraid of the unknown …
An emergency physician frozen by fear, and what she learned from it
So it’s a Wednesday night, and I just got home after completing a shift. I’m beat. My beautiful sofa beckons to me, and my TV seduces me with brainless images and sound. I succumb to the temptation. I turn on Netflix. Too many movies, too many decisions. Screw this; I didn’t just finish up a shift to have to sit and make more decisions. I go to the suggested for …
Have doctors become desensitized to gruesome realities?
As a first-year oral and maxillofacial (OMF) surgery intern, I was the first responder to any facial trauma at a hospital in Queens, NY. Therefore in the past 12 months, I was a primary care provider for numerous facial lacerations of women due to domestic violence. And was a 1st assistant in providing care to patients (both men and women) with orbital floor fractures and mandible fractures due to domestic …
3 lessons I learned about domestic violence in the ER
The redefinition of a potentially functioning medical system in which each individual is able to utilize financially non-prohibitive care into a disjointed balkanized realm of income-based insurance tribes is aided by the protean definitions of the political buzzword “access.” Access to medical care does not entail the ability to reliably obtain medical care much as medical insurance reform is not, in point of fact, healthcare reform. Regardless, the conflation of …
The emergency department and “access” to care
“I’m going to write a column about dating you and call it ‘Sleeping with the Enemy,’” I announced from my rocking chair. His rocking stopped. “The enemy?” The rain was falling on the trees in front of my porch and on his parade. “Why am I the enemy?” “You know, clinicians vs. hospital administrators.” “Really?” he naively asked. “Why don’t clinicians like us?”
I was surprised he was so in the …
Sleeping with the enemy: When a physician dates an administrator
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