There’s always so much to write about, and there’s never any time. I work too much; it’s become evident recently that I need to cut down. I have started noticing that things affect me much more than they ever did; there are days I hide my tears, and days I show my tears, when before the tears would have waited for the occasional (yes, occasional) shower. This is a function …
Please, be kind to your doctor. We need it.
One of the more common complaints that I hear from medical practitioners in jails and prisons (especially new practitioners) is, “These manipulative patients are driving me crazy!” Well, to be honest, I ran into a lot of manipulative patients when I worked in the ER, as well. But it is true that many of our patients in jails are especially …
The 9 types of manipulative patients
Being a medical student is tough, applying for a competitive residency spot is tough, and being a new mother is also very tough. I am one of the lucky women to do all three at the same time. I had my child early August of my fourth year of medical school. The fourth year of medical school is a great time to become a new mother. The schedule is more …
8 tips for having a baby while applying for residency
A gray-haired emergency medicine physician once provided the most succinct view of ED efficiency ever uttered. He said, “Sometimes they ask us to dig a ditch. Then they give us spoons with which to do the job.” Though cynical, it is the view of many. There really is only one problem and a single solution to ED efficiency. The problem is variation. The answer is scale.
Biologists understand variability best. Biologic …
Here’s the secret to emergency department efficiency
The eulogy of a profession should be a relatively uncommon undertaking. And yet, the death of the physician appears to be such a fait accompli that one feels late to the wake. It has been a long and lingering death, like the proverbial frog in the pot, and but there are moments, increasing in frequency in my day-to-day clinical practice when it seems so sudden, unexpected and even surreal. This …
The self-inflicted death of the physician
1. Bipolar disorder
2. History of postpartum psychosis
3. No custody of her children
4. In treatment for cocaine abuse
5. Regular smoker
I digest each of these facts on the computer screen in rapid succession, progressively cementing the picture of Renee Pryce, a 28-year-old woman in her final months of pregnancy.
I’m a first-year resident in a large urban county hospital. In the course of my training, I’ve learned that some people (mostly older doctors) …
Don’t assume your patients’ character based on their diagnoses
Two years ago, something happened that — not to be overly dramatic — changed my life, including my everyday experience of my job as an emergency specialist.
My older brother, Martin died of a rare and aggressive form of non-Hodgkin’s lymphoma that spread despite every treatment that was thrown at it.
When he was dying, I managed to unleash in myself a raging anxiety, which caught me by surprise. In the year …
How this physician does her job while grieving
The boy is three years old and quite curious about the world. He watches his father leave the house and wants to go find him. He looks to his mother but she is napping beside him on the couch, and he would rather not wake her, so he grabs his stuffed dog, Dory, and walks to the door. The door is unlocked, and he heads out of the apartment, wandering …
It was the last week of my EMS elective. I was incredibly lucky to ride with one of the EMS captains who was eager to take me to any call that sounded interesting. We were called to a possible stroke. An 82-year-old woman with sudden-onset unilateral weakness and expressive aphasia. The paramedic and EMT on scene were two I had met before. We actually talked earlier that day about the …
A medical student’s biggest fear
She was a middle-aged female who was life-flighted from an outlying facility to the tertiary care hospital in which I worked. As she quickly rolled out of the elevator, I ran toward her and saw her blood pressure was tanking with her mentation fluctuating. My hair mindlessly placed in a ponytail, my blue scrubs wrinkled, and my nerves a jumbled mess, EMS briefly gave me an account of her history: …
I graduated from St. George’s University School of Medicine in Grenada and now work as an emergency medicine physician at a trauma center in Northern California. To some, that may seem like an extreme jump or a rare success story. The stigma of a Caribbean medical school education is built on rumors — and they’ve run their course. Let’s address some.
1. Students only go to Caribbean medical schools if they …
The truth about Caribbean medical schools
“Relic” – an object surviving from an earlier time, especially one of historical or sentimental interest. Relic derives from the Latin “reliquiae,” meaning remains and a form of the Latin verb relinquere, to leave behind or abandon.
Relics include the physical remains as well as other objects that have been “sanctified” by being touched to the body in life or death.
From high over the bluffs of the Mississippi River Valley near …
A relic to help forever remember tragedy
It was hour thirty, and I was still at the hospital. My shift had technically ended two hours ago, but I was emotionally invested in this patient She was dying. I didn’t want to leave because I was so worried that she would pass the moment I stepped out of the hospital. My colleagues urged me to go home and practice self-care, as if that was going to make everything …
Time for grieving is a necessity for medical trainees
ADVERTISEMENT
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 …
Five days into my emergency medicine clerkship, I had experienced a lot of firsts: My first participation in a code, my first CPR compressions, and my first patient death. This was specifically a code blue for a patient with pulseless cardiac arrest.
An elderly woman was brought in by her family after not feeling well for several days and quickly became unresponsive. As the room flooded with staff, my upper-level resident …
I’m sorry that we couldn’t save you
There are those 25 minutes before my workday begins that I either drive in silence, or blare the radio and jam out to pop hits priming myself for the unexpected hours ahead. When the music is loud, and the tempo is upbeat, it transports me back to being 21 on a summer day in Chicago, before kids and bills, headed nowhere too important, definitely not too fast, stuck in traffic …
Alex and Edward Santos have just returned from a weekend away at their aunt and uncle’s place. They love it there. The couple is in their 20s and spoil the boys with late bedtimes, movies and video games, and home-made cupcakes with chocolate icing and sprinkles. It’s been a long break for Alex, who’s 15, and has been off school for a week. Now, his vacation is almost over, he …
A mysterious case of seizures in the ER
“Triage” is French for “to sort.” It developed as a concept on the battlefield as a way to address injured soldiers and ensure that care was provided to those most in need. In the emergency department, triage is usually the responsibility of a trained, experienced nurse. Patients present to the emergency department, the nurse obtains a history and may perform a cursory …
Change the approach to triage to alleviate ER overcrowding
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
One day while on shift in the emergency department, I looked out into the waiting room at the dozens of people waiting to be seen. Many had been waiting for hours. Some looked bored. Others appeared agitated by the long wait time. One thing that nearly all of them had in common, though, was the presence of a smartphone within arms reach. I wondered, rather than spending their time mindlessly …
Could patients be their own scribes?
Get free updates delivered free to your inbox.
