Emergency Medicine

The reality of CPR: a powerful tool with serious consequences

Conditions
January 8, 2023

The shocking scene that unfolded during the Bills-Bengals game Monday evening was a play that I’ve seen countless times on a very different stage. Yet as a hospital physician, watching Damar Hamlin’s on-field cardiac arrest was unexpectedly jarring. Seeing the coordinated and professional medical response on the field was inspiring. No doubt, timely and effective CPR and defibrillation saved his life. As I reflect on the events of that evening, …

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The emotional side of CPR: Reflecting on the challenges of resuscitation in the wake of Damar Hamlin’s collapse

Conditions
January 5, 2023

First, I want to extend my thoughts, wishes, and prayers to Damar Hamlin, his family, and his teammates. Seeing his collapse on television stirred many emotions in me; I can’t imagine what those who were on the field or in the stadium experienced.

As a pediatric emergency physician, I can tell you that anything related to cardiopulmonary resuscitation (CPR) is difficult. America got a real glimpse of the horrors of CPR …

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Working through a pandemic and watching the health care system crumble around me

Physician
December 27, 2022

The first dying patient I saw as a medical student was a man newly diagnosed with lung cancer, a chronic smoker with now oxygen-dependent COPD. In rounds, our medical team stopped outside his room, and the learned men and women pontificated about what to do next with the man. Chemo? Radiation? Both? I pretended to listen and rubbed my chin with feigned discernment, trying to understand the conversation like any …

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Can Medicare advance directives be simple?

Physician
December 25, 2022

Consider Medicare enrollment with the end in mind. In case of emergency, do seniors prefer medical care or holistic care? Might they designate a medical power of attorney or a merciful power of attorney? Do they oblige CPR or sign a DNR order?

The JAMA Network just published Death and End-of-Life Care in Emergency Departments in the U.S. This retrospective cohort study concludes that,

Robust systems of emergency care …

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My personal cemetery

Physician
December 10, 2022

I love listening to podcasts on my way to work, and I was most excited when the second season of Dr. Death started. If you didn’t listen to the first season, it was about Dr. C. Duntsch, a neurosurgeon in the Dallas area who should never have been operating on people. He even left his best friend paralyzed from the neck down due to a botched surgery.

The second season follows …

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A doctor’s journey through constraints and creativity in the ER [PODCAST]

Podcast
November 7, 2022
YouTube video

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Jay Baruch is an emergency physician and author of Tornado of Life: A Doctor’s Journey Through Constraints and Creativity in the ER.

We discuss his emergency …

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My sister went to the hospital seeking help. Instead, she died. [PODCAST]

Podcast
November 1, 2022
YouTube video

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“I am heartbroken at the loss of my sister. No, breast cancer didn’t physically kill her, and for that, I am grateful. Its presence in her medical history, however, quite possibly did as it was apparently used …

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Giving medical advice with moral values is deeply personal and takes courage

Physician
October 26, 2022
YouTube video

Imagine delivering testimony to practicing emergency medicine for 30 years on the TEDx stage and my “Real Serious Illness Conversations with Parents” being condemned with this NOTE FROM TED: Please do not look to this talk as a substitute for health advice. This talk only reflects the speaker’s personal views and beliefs. It’s as if to say, “Beware of the doc”… who lets individuals decide how they’ll die …

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How major depression strengthened my practice and my faith in God

Physician
October 19, 2022

I had a fairytale courtship, engagement, and wedding to my Prince Charming. We came home, starry-eyed, ready to start our forever together. Within weeks, I began to struggle. Always an extrovert, suddenly going to my family medicine rotation took extraordinary effort. I began to worry about my every word and action. Some days, I said nothing — unsure whether I could form a coherent sentence. I decided to take time …

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A story that changed this pediatrician forever

Physician
October 16, 2022

I’m a pediatrician and have been practicing for 29 years. I currently own a solo practice.

Here is a story I wrote years after a patient encounter during my residency in 1993. I didn’t know it at the time, but it was an experience that would shape my career in general pediatrics.

Marcus is the worst case of child abuse I’ve seen to date. He’s two years old. His mom’s boyfriend dips …

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I went to Ukraine to help. Here’s what you can do.

Policy
October 10, 2022

I went to Poland and Ukraine in April and May of 2022, hoping to support the Ukrainian people in their defense of their country and democracy itself.

Vladimir Putin had put the world in a vise.

“Let me do what I want, or you will risk nuclear war,” was the implication. We’ve seen this before, I thought. Putin is Mussolini, Hitler and Stalin all rolled into one, and he needs to be …

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Health care’s dirty secret

Conditions
October 9, 2022

Health care has a dirty little secret. And if you aren’t part of the club, chances are that you don’t know anything about it. Aside from COVID-19, short staffing, and the lack of hospital beds to accommodate those who need them, another crisis has been overshadowed and hidden from public view.

What is the secret? Health care is dangerous.

In fact, so many doctors and nurses are choosing to leave the bedside …

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It doesn’t matter where you are in the health care hierarchy

Conditions
October 8, 2022

He was in the Ivy League for med school. His dad was an MD, and they lived not too far from this small town. Daddy’s house, a “mini-mansion,” was right around the corner.

After successfully completing his residency, Dr. David became our ER physician. This was a big deal—a big fish in a little pond.
He had an aura of wealth about him. He had an arrogance about him, too.

He was new …

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Meet the emergency physician who writes satire [PODCAST]

Podcast
October 5, 2022
YouTube video

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“In the dark radiology reading rooms, only the gentle hum of the computers and the quiet chatter of residents dictating radiology reads break the silence. Among the computers sits Dr. Exner, a senior radiology resident at Hospital …

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Ending gun violence in America should be a no-brainer

Policy
September 29, 2022

Brain matter was spilling out the top of the patient’s head in the trauma bay. It doesn’t take a neurosurgeon to know that this is not normal. My pager screamed, “GSW to head – ED Room 1.” Gunshot wound to head – Emergency Department Room 1. As the neurosurgery resident physician on call that night, it was my job to evaluate this patient STAT. I wish I could say this …

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Improving access to care in rural America: Keeping rural hospitals in the game

Policy
September 11, 2022

Almost 20 percent of America’s population lives in rural areas of the country, where accessing health care facilities and services can be challenging. The patient-to-primary care physician ratio in rural areas is only 39.8 physicians per 100,000 residents, compared to 53.3 physicians in urban areas.

Rural hospitals work diligently to meet the health needs of the populations they serve, but they have long struggled with staffing shortages, inconsistent patient volumes, …

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10 tips for smoothing the transition from resident to academic emergency medicine attending

Physician
September 11, 2022

Congratulations! You made it through residency. On to the next stage of your emergency medicine career – attending-hood (and for some fellowship)!

Here are ten tips we learned during our first year as attendings at an academic emergency medicine department.

1. Efficiency comes with time. Start off making sure you are methodical. Unlike residency, you will no longer have an attending re-ordering hemolyzed labs or ensuring a negative HCG prior to obtaining …

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Residency almost killed me — literally

Physician
September 5, 2022

One morning, I was sitting in resident lecture. This time was supposedly protected, but we realized fairly quickly that the work still had to be done, and “I had lecture” never really worked out well as an explanation.

By this time in the week, I had already worked 80 hours, and the luxury of sitting down for an hour in a row was the main upside to the lecture. I kept …

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Grief on the front line

Physician
September 4, 2022

Several years ago, I wrote a piece about my experience of personal grief while working as an emergency physician in Australia. The grief I experienced was due to the untimely death of my older brother Martin — a high-achieving lawyer and sportsman — who slowly withered away as he lost his battle with a rare and aggressive lymphoma. It is fair to say that his death broke me, but …

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Why I’m leaving emergency medicine

Physician
August 31, 2022

I am hanging up my stethoscope and exiting the ambulance bay doors for the last time. I chose emergency medicine to care for critically ill and injured patients, and I’m leaving because this has become near impossible.

I believe it imperative to share some of the reasons that I, and many like me, are leaving a field we once loved, as their ramifications will sooner or later impact you and those …

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