I am affiliated with the institution where Dzhokhar Tsarnaev is currently hospitalized. I am friends with people who have treated him. I’m trying to stay away from those people; I would be unable to help asking them about him. They might be unable to help talking about him.
There has been a flurry of emails and red-letter warnings cautioning people here not to talk about Mr. Tsarnaev or look him up …
Dzhokhar Tsarnaev and his right to privacy
Emergency physicians experience burnout at a rate of more than three times that of the average doctor and more than anyone else inside or outside of the medical field, according to a study published in the Archives of Internal Medicine. The study surveyed over 7000 physicians in more than two dozen specialties and compared them with almost 3500 working adults …
Why are emergency physicians burning out?
On April 15, 2013, my kids and I were in Stamford, CT, visiting with my sister, Precy, and her family. I had been reading when an email came up, stating a bomb had gone off at the Boston Marathon. I immediately turned to Twitter where #BostonMarathon had already started trending.
There before me, gruesome details emerged, coupled with …
After the Boston Marathon, a reflection on New York
You get a terrible headache. What do you do next? Take ibuprofen and try to sleep it off? Call your primary care physician (PCP) for an appointment? Dial 911 for an ambulance to take you to the emergency department (ED)? What if that headache comes with a cough and shaking chills?
Would an ad influence your decision?
I came across this image …
Would an ad influence your decision to go to the ER?
When the American College of Emergency Physicians (ACEP) decided not to join the Choosing Wisely campaign, I was among those who expressed disappointment with this decision, in part because I have long been a proponent of efforts to encourage more cost-effective care in the ED. In fact I had already independently done a significant amount of work in the Read more…
Choosing Wisely: Less dogmatic language is needed
I was sitting in the resident workroom at Massachusetts General Hospital (MGH) when my co-resident showed me the text from her sister: two explosions had shaken the finish line of the Boston marathon. Though news sites had not yet published the headline, it was immediately corroborated by the cacophonic wails of ambulances heading towards us and our shock was quickly replaced by the urge to learn more and to do …
Being a doctor in a time of crisis
Not long ago I noted a certain older patient’s name on my schedule. I really dreaded seeing her. It’s not that I dislike her–in fact she’s one of my favorite patients. It was just that I hated the prospect of seeing her looking as poorly as I knew she would. She’d been through so much: an accident resulting in devastating injuries followed by painful surgeries, and, worst, in the middle …
After the Boston Marathon: Trauma itself can bring strength
A city is free. A town is celebrating.
I sat and watched the local news station announce that the second suspect in the 2013 Boston Marathon bombings had been taken into custody and was being transported to a nearby hospital.
I am relieved. And thankful.
Then I wonder. I wonder about the hospital that this suspect is being transferred to, and I wonder about my colleagues. What are the nurses, the doctors, and …
Treating the enemy still requires respect and professionalism
It has been weeks since the Boston marathon bombings. The hospitals in that city, by most accounts, were remarkably well prepared, expertly and compassionately caring for the injured innocents. Emergency response was fluid and efficient. As tragic as the events of April 15 were, the health care workers of Boston were beacons of inspiration for a city in shock.
Yet these heroics do not represent the most impressive actions performed by …
Dzhokhar Tsarnaev and the true cost of upholding the Hippocratic Oath
Hi. I’m a 44-year old emergency physician. And I’m an addict.
My addiction came to light when my Press Ganey scores plummeted after I started to stand up to the chronic pain and frequent ER patients.
The fact that I have an addiction was reaffirmed when I went to my state’s Prescription Drug Abuse Summit. When I saw so many professionals from varying fields (medicine, law enforcement, pharmacy, education) assembled, I realized …
I’m addicted to prescribing pain medications
I did not want to go to the emergency room. I really didn’t. Resisting the idea, I lay doubled over with the worst abdominal pain of my life for 12 hours, unable to eat or drink or move, and finally vomiting before I considered it. I was well aware that this sequence of symptoms made me a textbook case of appendicitis, but I still consulted an ER doctor to ask: was …
I’ll be a doctor soon, but I can’t understand my hospital bill
A version of this column was published in USA Today on April 1, 2013.
Prescription drug abuse is a growing national tragedy. One of the biggest culprits is opioid painkillers, such as Oxycontin and Percocet. Shockingly, more than 200 million of these types of drugs are prescribed annually, and they account for more than 16,000 deaths a year. And for every death, significantly …
Curb prescription drug abuse by following Mayor Bloomberg
When you work in an urban hospital, sometimes it’s difficult not to become jaded.
There are certain neighborhoods that generate a disproportionate number of patients for some emergency departments. Meth is rampant. Marriage pretty much nonexistent. More bars than there are restaurants. Domestic abuse frequent, but prosecutions rare. Police know people more by their street names than by their real names.
South Heights was one of those neighborhoods.
The emergency department frequently treats …
Working in an urban ER: We need more moms like this one
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If I’m learning anything from working locum tenens jobs, it’s that there is a wide, mind-numbing variety of electronic medical records (EMR) systems in place around the country. At my primary work site, we use Med-Host. Like every EMR, it has some bugs. But having seen other systems in other places, it’s clearly a Cadillac product in a great, big car lot of Yugos.
I’m not going to disparage other systems …
EMR tips for locum tenens doctors
Mrs. Smith (not her real name) fidgeted in her chair in my examination room as I scanned the radiology report she had given me. She had visited the emergency room the previous evening with severe abdominal pain that had eventually been diagnosed as gastritis, or swelling of the stomach lining due to a virus. During her evaluation, the ER physician had ordered a CT scan of her abdomen and pelvis. …
Reduce the chance that you will be harmed by an incidentaloma
Today the road all runners come,
Shoulder high we bring you home
And set you at your threshold down
Townsman of a stiller town.
-A.E Housman
As the afternoon’s events unfolded, I sat glued to my computer screen between patients. My life has really been a tale of three cities—Houston, Boston and San Diego. Boston was where I did my residency training, met my husband, had my three children and my first “real” jobs. I …
What happened in the wake of 9/11 saved lives in Boston
A few years ago my best friend ran the Boston Marathon. She came back glowing, proud that she’d qualified, amazed by the crowds and energized by the feeling of community. Never once did she think that she could have died from a bomb exploding at the finish line.
America seems to be facing tragedy after tragedy. From the Aurora shootings, to Sandy Hook Elementary, to the Boston Marathon bombings, each time …
After the Boston Marathon, we are just like the rest of the world
“Daddy, a bomb blew up in Boston!”
That was how my 4-year old greeted me when I came home this evening.
Of course, I already knew about the horrific attacks during the Boston Marathon, first on Twitter, then realizing the gravity of the event as mainstream media caught up.
I practice in Nashua, NH, which is about 45 minutes north of Boston. But …
Boston rises in the wake of tragedy
Has anyone else noticed the growing presence of ultimatums in medicine today?
The New England Journal of Medicine published a discussion of the ethics of not hiring smokers. My hospital adopted this policy six months ago, and they are not alone. There is a tobacco blood test that new employees have to pass. If they fail, they can look for a job elsewhere. I do not know the exact details, but …
The rise of ultimatums in medicine: Do they work?
Flexibility is important these days, perhaps more than ever before. I’m reminded of this almost every time I order lunch at a fast food joint: “I’d like a double cheeseburger, please, with ketchup only.” “You mean ‘only ketchup,’ don’t you?” “Okay, a double cheeseburger with only ketchup.” “Right, got it, coming up!”
So many changes on the medical care horizon and everyone speaking a slightly different language — it’s bound to …
With health reform, flexibility is important
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