Emergency medicine

2,327 articles · Since 2004

Articles, page 62

Medical training is a product of willful preparation

October 15, 2013Oct 15, 2013

I have been a loyal patron of the Karma Hair Salon in New Haven, Conn. for at least the past 15 years. Whenever my hair looks good, it is thanks to Karma and owner Cheryl McMahon's expert attention to my…

I have been a loyal patron of the Karma Hair Salon in New Haven, Conn. for at least the past 15 years. Whenever my hair looks good, it is thanks to Karma and owner Cheryl McMahon’s expert attention to my unruly head (the thickness of my hair — a good problem, I know! — could give a yak envy; and I have more cowlicks than several small countries). If ever my hair doesn’t look …

Physician voices

Our words leave the most lasting impression

Denitza Blagev, MD

October 13, 2013Oct 13, 20133

“Sticks and stones can break my bones, but words can never hurt me.” I learned this saying when I came to America, but before that, I learned a different story. A wood cutter got lost in the forest, it was getting dark and cold. He met a bear, who offered him to come to his den. The man entered and said “It stinks in here!” The next day the woodcutter …

Patient voices

Life and death in a hospital ravaged by Hurricane Katrina

Sheri Fink, MD, PhD

October 13, 2013Oct 13, 2013

An excerpt from Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital. At last through the broken windows, the pulse of helicopter rotors and airboat propellers set the summer morning air throbbing with the promise of rescue. Floodwaters…

An excerpt from Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital.

At last through the broken windows, the pulse of helicopter rotors and airboat propellers set the summer morning air throbbing with the promise of rescue. Floodwaters unleashed by Hurricane Katrina had marooned hundreds of people at the hospital, where they had now spent four days. Doctors and nurses milled in the foul-smelling second-floor lobby. …

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Conditions and diseases

Reinventing the pain scale in the emergency department

Rob Brandt, MD

October 12, 2013Oct 12, 201315

All people are gifted. As an emergency room physician, I see a wide variety of gifts, such as yodeling, knitting, and swearing (mostly swearing). One gift I rarely see is math. As a whole, the U.S. sucks at math. When compared with other nations, the U.S. ranks 32nd in math (though first in confidence). Despite this, we expect mathematical coherency …

Physician voices

What do we do with the extreme elderly?

Janice Boughton, MD

October 10, 2013Oct 10, 201312

A 100-year-old woman is brought to the emergency room by a concerned friend because she can no longer get out of bed to get food or go to the bathroom. Other than being unwashed and a little confused, she is fine. Her electrolytes are pristine, her electrocardiogram the definition of normal, her blood count and chest x-ray perfectly mirror the expected physiology for her age. Even her urinalysis is normal. …

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What do we do with the extreme elderly?

Patient voices

A patient’s perspective on domestic violence

Melissa Travis, PhD

October 6, 2013Oct 6, 201322

I often read advice to doctors about how to screen for domestic violence. I was that woman for many years. I was that child and I know for a fact my pediatrician knew but was afraid to report it. And…

Physical violence while brutal, doesn’t compare to the controlling, creeping intimate fear sustained in such relationships. My then husband came with me to some of …

Medical education

Being a good medical student doesn’t mean you’ll be a good doctor

Amy Faith Ho, MD

October 6, 2013Oct 6, 201325

There is a saying that you enter medical school wanting to help people but exit it wanting to help yourself. It may be a cynical view, but a realistic one. The criteria for being a good medical student are far different from being a good doctor. Medical education may be breeding a legion of self-serving, grade-grubbing, SOAP-note spewing machines rather than …

Drugs and prescribing

Physicians are fearful of fulfilling their duty to treat pain

James Patrick Murphy, MD

October 6, 2013Oct 6, 201316

I recently testified before the Medical Licensing Board of Indiana regarding the pending emergency rules for physicians prescribing opioids for chronic pain. The session went on for four intense hours -- ten minutes of which had been promised to me.…

At my turn, I stated my name, told the Board I hailed from Indiana’s prescription ground zero, gave a brief summary of my credentials, thanked the Board, the American Academy …

Physician voices

Force feeding in Guantanamo: Why doctors shouldn’t participate

Michael Kirsch, MD

October 3, 2013Oct 3, 20132

Nearly every physician regards himself as an ethical practitioner. Nearly none of us are, at least not fully. There is no bright line that separates ethical from improper behavior. Indeed, it is because the boundary is fuzzy that ethicists and the rest of us wrestle with contentious controversies. It is, therefore, expected that ethicists are divided on many issues, much as the U.S. Supreme Court is often split in its …

Physician voices

How to ensure you receive the right amount of care

Leana Wen, MD

October 3, 2013Oct 3, 20132

In a recent blog post, I discussed the harms of a new epidemic: too much medical care. We also don’t want the opposite. In fact, much of the driving force leading to overdiagnosis and overtreatment is this fear of rationing.…

So what can you do to ensure that you obtain just the right amount of care?

It isn’t easy — if it were, if there an algorithm that would give …

Physician voices

Leadership and management define the core of emergency medicine

Anoop Kumar, MD

September 30, 2013Sep 30, 20133

History’s great achievers -- a Napoléon, a da Vinci, a Mozart -- have always managed themselves. That, in large measure, is what makes them great achievers. These are the words of Peter F. Drucker, father of modern management theory. They…

History’s great achievers — a Napoléon, a da Vinci, a Mozart — have always managed themselves. That, in large measure, is what makes them great achievers.

These are the words of Peter F. Drucker, father of modern management theory. They are especially relevant to emergency medicine today. The founders of our specialty and the wave of emergency physicians that followed them have carved us a unique position in the house of …

Medical education

As I held this man’s icy hand, my paradigm shifted

Amanda Xi, MD

September 28, 2013Sep 28, 20135

It was a quarter past six in the evening. The day team had just completed their signout to us. As we sat quietly along the periphery of the trauma bay getting oriented to our list of patients, a small army…

He was rolled into the first slot. From behind the desk, I tried assessing how serious the injuries were, but the …

Patient voices

A 77 percent success rate is good enough for a guy without insurance

Andrew T. Gray, PA-C

September 26, 2013Sep 26, 201320

The doctor was adamant. "This is America, not Sweden," he told me. "We operate." How did this happen to me? I wondered, looking at him across the ER exam room. How could I, a healthcare provider, not have insurance? I…

The doctor was adamant. “This is America, not Sweden,” he told me. “We operate.”

How did this happen to me? I wondered, looking at him across the ER exam room. How could I, a healthcare provider, not have insurance?

I had woken up that morning with a mildly upset stomach. Nonetheless, I’d gone to my job (begun only six weeks earlier) as a physician assistant at a Beverly Hills HIV clinic. I’d seen patients …

Physician voices

Why aren’t hospitals more attentive to the needs of patients?

Leslie Kernisan, MD, MPH

September 24, 2013Sep 24, 201336

In a recent post, Dr. Ashish Jha raises this issue as he relates his own story of coming to an ED with a very painful dislocated shoulder. Unsurprisingly, prompt treatment of his pain was deferred while staff diligently completed registration,…

On the bike path where Jha took his initial tumble, people went out of their way to …

Patient voices

How I almost missed a patient’s incredibly powerful story

StorytellERdoc, MD

September 23, 2013Sep 23, 20135

He was an ornery kind of fellow, evident by his scowl and beady, glaring eyes that greeted me upon my entrance into his room. The nurse, thankfully, had given me a heads-up on this eighty-five year-old gentleman's demeanor. With her…

What I wasn’t ready for, though, was this man’s physical appearance. He was extremely small in …

Physician voices

Why I love my job as an emergency physician

Brian Drummond, MD

September 21, 2013Sep 21, 20135

Walking into each room to greet my next patient often reminds me of Forrest Gump: “You never know what you’re going to get.” It’s challenging to have only one chance to get it right but I love being an emergency…

Today, an older lady has slipped at home and she’s taped to a hard backboard with a rigid neck collar in place. It’s routine for all patients involved in …

Physician voices

My patient experience wasn’t an outlier

Ashish Jha, MD, MPH

September 20, 2013Sep 20, 201355

On a warm and sunny August Sunday, I was rollerblading with my kids on the Shining Sea Bikeway. On mile nine on the trip, I hit a tree root, went flying, and landed on my shoulder. I could tell immediately that something was wrong — I couldn’t move my arm and was in the worst pain of my life. Feeling for my left shoulder, it was obvious that I had …

Read more…

My patient experience wasn’t an outlier

Conditions and diseases

A case of paralysis, cured in the emergency department

BirdStrike, MD

September 18, 2013Sep 18, 20132

I open my car door to walk in to work. I’ve never heard crickets as loud as the ones this summer in Georgia. A wall of steam-heat blasts me simultaneously as a giant bzzz! bzzz! dive-bombs my ear. Man, it’s…

I open my car door to walk in to work. I’ve never heard crickets as loud as the ones this summer in Georgia. A wall of steam-heat blasts me simultaneously as a giant bzzz! bzzz! dive-bombs my ear. Man, it’s hot in Georgia. And the bugs! I think to myself. I walk slowly towards the ED doors, barely moving, but still breaking a sweat. I walk through the double doors now …

Health policy

The Affordable Care Act ignores simple issues of human nature

Edwin Leap, MD

September 17, 2013Sep 17, 201358

The Affordable Care Act (ACA), aka Obamacare, is law. And its implementation is moving along slowly, but steadily. You have to give credit to the folks who believed in it, whether grass-roots supporters or highly placed politicians. They rammed it…

The Affordable Care Act (ACA), aka Obamacare, is law. And its implementation is moving along slowly, but steadily.

You have to give credit to the folks who believed in it, whether grass-roots supporters or highly placed politicians. They rammed it down the American gullet like a lead ball down the muzzle of a Hawken rifle. The problem is, once it goes off, the whole thing is going to explode.

The reasons are …

Physician voices

What does it mean to be a doctor and a patient?

Rebecca Crow, DO

September 14, 2013Sep 14, 201311

It is a doctor’s duty to take care of patients as has been our job since the first physician quoted the Hippocratic Oath. However, what happens if this distinction becomes somewhat blurred? What does it mean to be a doctor…

An experiment I inadvertently took on after feeling sick the night prior to my last day of wards. In my most resilient form I pushed forward with the …

Emergency medicine

Articles, page 62

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