There’s currently an image in heavy circulation making its way around the internet of a hospital patient’s chest tattooed with the words “Do **not** resuscitate,” accompanied by what is assumed to be the man’s signature. This 70-year-old patient arrived at an emergency department unconscious with elevated blood alcohol levels. He did not have any form of identification on him, and his health care providers did not have an identifiable means …
My alarm went off at 4:15 a.m. I lay in bed dreading the day ahead of me. By 4:50 a.m., I arrive at the nursing home where I was doing a geriatric rotation. A stack of charts and a patient complaint list was awaiting me. On the list were the usual suspects: a follow up for lab results, a fall, abdominal pain. And at the bottom was a note on …
I keep a spare set of scrubs in my car. It’s an act of preparedness, informed by experience. A couple of months ago, I came out of an ED room after performing a particularly unsavory procedure and noticed that my left knee was wet. Disgusted, I shared my misfortune with my coworkers, and all of them had the same sympathetic response; they mirrored my grimace and cautiously offered hope: “Maybe …
Despite the fact that most people will have had the misfortune of visiting the emergency department (ED) at some point in their life, I find that many folks do not really understand what happens in the ED.
1. Emergency medicine is a specialty. Yes, we actually did residency training to learn how to work in the ED. This training lasted three to four years after medical school and is sometimes followed …
I remember just moving to Atlanta and having breakfast with a new-found friend I had met while working at a hospital as a registered nurse. The food at our chosen eatery was far from great. But I must say, my friend’s enthusiasm for life, specifically living in Atlanta, was fulfilling enough to make me forget the chef’s lackluster culinary skills. She was warm, outgoing, adventurous, somewhat inquisitive — just what …
Multiple state leaders, including Maryland Gov. Larry Hogan, and even President Trump have declared states of emergency in response to the opioid epidemic. Policymakers claim to be battling this public health crisis on all fronts, but one arena continues to be conspicuously ignored: our prisons and jails.
Roughly half of all incarcerated individuals suffer from addiction. And in the two weeks following their release, former prisoners are 129 times more likely …
“In Puerto Rico, we call those plants morir vivir,” said a patient who sat by the side of the road while we checked her blood sugar. When I reached to touch the small fern, it swiftly closed its leaves shut, and then after a few minutes cautiously reopened. As a young doctor I was fascinated with the poetry of the name. “It’s just like us Puerto Ricans,” she smiled.
The holiday season is stressful enough without having to try to fit a visit to the emergency department (ED) in your schedule. Getting medical care on a major holiday can be especially difficult because most, if not all, offices and urgent cares are closed. This can make the ED wait longest around the holidays. Here are some tips to keep you out of the ED this holiday season.
Politics are divisive. That should not be a shock to anyone. However, the political climate in the USA at the moment is more than just divisive. Lately, I have noticed that there is an underlying disdain for those we disagree with in a way that even my grandparents say they have never seen in this country. The current political climate pervades nearly every aspect of our society, from pop culture …
Patsy loved playing bingo every Wednesday night. Her boyfriend of three years loved watching her daughter Jenna who was a tiny and pretty six-year-old her momma called “princess.”
Even though they weren’t related, Jenna called Patsy’s boyfriend “Uncle Billy” at her mother’s behest.
And Uncle Billy made Jenna shyer and quieter than she usually was. He’d walk in on those Wednesday nights and demand a big hug and kiss on the cheek …
Triage Note: Fish hook in eye. No bleeding. Tetanus up to date.
It’s a sunny weekend during cottage season. A young woman is rushed into the ER as she cups both hands over her left eye. She’s in shorts, and flip-flops, and she’s hyperventilating. Her friends follow, hands similarly cupped over their mouths. I read the triage note. I’ve never seen this before. I’ve removed dozens of fish hooks — it’s …
Here’s some advice for your career in health care: Leave the country as soon as possible.
This has nothing to do with the president’s attempts to euthanize the Affordable Care Act. Or with EMRs, Medicare reimbursements, or the burnout surveys you get from your employer, who also sends emails aimed at getting you to work faster and more efficiently.
It’s none of that. You need to leave the country, just for a …
Jim Johnson is the director of the West Virginia Office of Drug Control Policy, and an advocate on the front lines of the opioid epidemic. During his previous job as the police chief from Huntington, WV he spearheaded a comprehensive initiative of education, syringe exchanges, and Naloxone distribution that has shown promising results in a community where up to 10 percent of the population is plagued with opioid dependence. His …
To accomplish certain tasks, we need a little help from our friends. No one can do it all, although many of us are more resourceful than others. Some folks are adventurous and dive into a new arena with excitement. They may be tinkerers who aren’t afraid to play with new gadgets. Sure, they might break some china, but they are apt to widen their skill set and enrich their lives. …
It is not unusual to see a patient for a timely transition of care visit after a hospital admission and within a minute of entering the exam room know with all the bones in your body that this person needs to go back into the hospital.
The funny thing is that when that happens, if the patient has Medicare, we may indirectly suffer financially from such “avoidable readmissions.” We belong to …
I have picked up Mr. Reynolds (not his real name). He is a frequent visitor to the ED for alcohol intoxication. He was found drunk on a street making a scene, and a good samaritan called him in.
Paramedics bring him in. He is not bashful about showing his discontent for his arrival to the ED. He promptly flips off the charge nurse and continues to verbally berate the paramedics. The …
Let’s get one thing straight: You already have kick ass skills as a physician, skills that are valuable outside of clinical care settings. So whenever my physician friends turn to me for advice on making a transition in their career, I have to remind them: It’s not about learning new skills, it’s about translating your existing skill set to new business applications. Think digital health startup CEO, chief medical officer, …
My grandmother was filled with grief as she told me by phone about life on the island of St. Thomas after Hurricanes Irma and Maria had blasted through it. “Tears keep running from my eyes uncontrollably because everyone on the island is suffering,” she lamented, then paused, too sad to continue. I could picture her in her …
I wonder what the best thank you any physician has ever received? I think this one is mine. This recent thank you was for our efforts to not save a child but for simply allowing this family to have a few more days with their infant who ultimately passed away. This amazing thank you has deeply and positively affected me so much …
It’s every emergency resident’s dream to be part of a big procedure: The rush of a heart-pounding, adrenaline-filled moment of slamming in a chest tube, “criching” someone or being part of the big show — a thoracotomy. The holy grail. Cracking a chest, performing intracardiac massage, cross-clamping the aorta. A last-ditch effort to pull a patient away from the clutches of the grim reaper. A typical level-one center hums to …
