It’s been a year since I retired from almost 40 years as a pediatrician (most of that time as a pediatric hospitalist). What have I learned? What surprised me?
1. I have finally caught up on my sleep. I have been convinced that I still had a cumulative sleep deficit dating back to med school. After one solid year of sleeping 8-9 hours a night and waking up without an alarm …
So many mixed emotions as I scrolled the multiple acknowledgments on social media this recent Doctors’ Day. Although it is nice to be recognized, are we just supposed to forget the recent hostility and disrespect? Can we ever really thank those on the frontlines who risked their lives during the pandemic? The recognition comes too late for the many doctors and trainees who did not survive. How do we honor …
I had known AR for eight days before she passed away.
AR’s medical record was littered with phrases all too familiar in the field of medicine: she had “poor insight into the severity of her disease” and was “insisting on all resuscitation measures despite poor prognosis.” But quite frankly, I could not blame her. She had been diagnosed with metastatic gastric cancer, bilateral Kruckenberg tumors and additional metastases throughout her abdominal …
I entered my Manhattan apartment around midnight, roughly an hour after observing a transplant team recover kidneys and a liver from a young patient newly pronounced dead. Still wearing scrubs, I sat down on my bed, and, like a ghostly twin or guardian angel, watched myself spill tears.
The scene I witnessed in the operating room that evening as a second-year medical student was at once grotesque and hallowed, shocking and …
Keeping someone alive? I could do that. After all, that’s what medical school taught, ways to save lives. Give me a disease, and I could find the algorithm. Death, however, was murky, messy, and confusing. An algorithm does not exist. There is no uniform response to provide grieving family members at bedside. Death was its own master, chose its own rules, and decided its own course. Death was something I …
“There is a small amount of literature about secondary trauma. This means that the people who respond to trauma (firefighters, police, doctors, EMTs, etc.) experience PTSD from experiences they were not the primary victims of. I haven’t read the literature, and I don’t know what qualifies. I do know …
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.
The refrigerated trucks had not yet left our parking lot when I got an email from the IT department. It was late spring 2020, and deploying a new electronic health record system for the anesthesia department was not front of mind. We …
I am so tired. Not in the usual “hard day at work,” but in a “deep-in-my-soul” tired. I am exhausted.
I am heading into my third year as system medical director, where I lead a system-wide palliative medicine program in rural health.
As in many rural systems, we have issues with broad geographic spread coupled with lower population density and limited resources.
But for those of us working in rural health, there is …
Them: “I have never heard of this.”
Me: “That’s OK, let me explain what is going on. Your child has a condition called multi-system inflammatory syndrome in children, which we call MIS-C. We see this condition after a COVID infection where the whole body becomes inflamed, causing fevers. You get inflammation in the small blood vessels of your eyes and skin, which is why your son has red eyes and a …
Management of medications is sometimes handled sub-optimally, at least in the United States. At the extreme, physicians who prescribe multiple medications prescribe some medications that treat the side effects of other medications. This could be considered physician negligence in extreme cases.
An example was given in a class I took at UCSF (the University of California at San Francisco). UCSF physicians jointly provided remote advice for a physician treating a developmentally …
My 13-year-old daughter was writhing on the floor from pain in her back and belly, a fever, and intermittent chest pains. She was two days out from a spine surgery intended to fix an 8-month-old gymnastics injury. She couldn’t take any steps on her own, and it was a three-person project just to get her from the couch to the chair.
“Go to the ER,” the hospital answering service said.
I tried …
There’s a phrase we use in golf when you hit one good shot after many bad ones: “That was whipped cream on sh*t.”
I used this phrase the other day in a collaborative of coaches whom I had just met (maybe not the best idea). I spoke specifically about my hospital’s wellness committee activities during the past two years during COVID. As chair of that committee, I felt like I was …
As a surgical intern, my days started early, and I was tired as I entered Mr. M’s room that evening armed with a nasal feeding tube and lubricant.
Mr. M was an African-American gentleman in his early 50s. He looked worn and much older than his years. Mr. M had end-stage liver disease and was on the liver transplant list. With a distended abdomen full of fluid, improving his nutrition and …
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A 37-year-old man was diagnosed with Lyme carditis after presenting to the emergency department (ED) with fever, weakness, history of tick bite, and prolonged PR interval of 394 ms (a type of heart block) and positive Lyme testing. In the ED, second-degree AV block was noted intermittently on the monitor but not documented. Both infectious disease and cardiology were consulted, and the recommendation was to continue IV ceftriaxone for 28 …
“There is nothing like staying at home for real comfort,” says James Austen. So, instead of traveling and waiting for hours by standing in a queue, what if health care is provided to you at home? That’s why home hospital care (HHC) is a viable solution for physicians and patients. HHC is an innovative, technologically advanced, and effective care model in which certain patients receive hospital-level care at their homes …
I’m a small-time doc in a small town, and I work at a small hospital in the Midwest, and I’m proud of it. The huge university hospitals (like Cleveland Clinic) get all the glory (especially in society and in the press), but small hospitals like mine drive this country.
It has been really weird working at a small hospital, where it seems like …
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More than half of all physicians in the United States are employed by health care organizations, and the numbers have been trending upward since 2019. Recruiters who work for health systems are tasked with finding the best physicians available, and their roles have become more important than ever. In-house job recruiters, and recruiters contracted with health systems, represent the face of the organization. They are often …
“You have to show proof that you have something wrong with you in order for you to get the medicine. I put forth, and I maintain that if I was white, I wouldn’t have to go through that.”
– Dr. Susan Moore.
In a 7-minute-and-22-second Facebook video documenting her treatment at a suburban hospital in Indiana, Dr. Susan Moore, a Black woman physician, articulated the collective desperation and frustration that was a …
In a world where everything is fast-paced, I believe we miss out on some stuff that deserves our attention.
Just like we need to stop and smell the roses, we need to stop and pay heed to the little life traumas that hit us daily. For today, I will jot down the list of small things that disturbed me and that I didn’t pay attention to.
My patient and colleague suffering from liver …
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A colleague announces he is retiring.
Unknown at the time is the fact that there were a series of fires and suicides committed by patients at the psychiatric facility where he was chief medical officer during the year prior to his departure. State investigators condemned the incidents and found an array of policy failures and procedural errors compounded by staffing shortages due to the coronavirus pandemic.
Another colleague announces his retirement. Unknown …
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