Matt was 40, my sister’s age. He was training for a marathon and trying to talk his many friends into joining. He lay in bed with his three-year-old son every night to help him fall asleep. It’s hard to sleep train a toddler with a newborn to nurture at the same time, but he loved spending this time with his two kids and being the dad everyone counted on.
Matt’s best …
“Happiness is when what you think, what you say and what you do are in harmony.”
– Mahatma Gandhi
Burnout among physicians is at an epidemic proportion. National data suggests that more than 50 percent of our workforce is burned out, and this trend has been across the board from physicians in training to practicing physicians. Some of the specialties are more affected than others. Repercussions of provider burnout on health care …
Going to medical school was a dream come true. I was excited; I couldn’t wait. I spent my childhood dreaming about it. It was this amazing fantasy in my head where nothing was impossible, and I would be able to help thousands of people, maybe millions? Biology, physiology, chemistry, physics — they resonated with me. I could not imagine doing anything else. I loved meeting new people. I loved learning …
Practicing medicine at the frontlines is hard. It’s damn hard. Every minute you need to be alert, ready to respond to a potential life or death situation, and be called to another important problem. The current medical practice environment — with excessive bureaucracy, suboptimal information technology, and extreme time pressure with patients — adds exponentially to the mix, and can make for a very stressful job. Make no mistake, even …
My wife and I once canoed across a glacial lake. There were twelve people in our 30-foot canoe. To reach the shore of the Mendenhall Glacier, we had to paddle two miles across a lake. All twelve of us had to paddle together to reach the shore. But what if we had different goals? What if the right side of the canoe wanted to paddle east and the left side …
When it comes to communication in the hospital setting, I have seen many iterations. My favorite version was at the VA on the inpatient medicine unit. Every morning, we all met in the medicine team room to discuss patients on the floor. The team’s social worker, nurses, residents, students, and the attending ran down the list to identify individual patient goals, what’s needed for safe and effective discharges home, and …
Well, today it happened. I participated in my first code.
We were in the telemetry unit (the room where they monitor all the patients who have EKG strips) to ask about a different patient of mine only to find that a patient was coding (lost a life-sustaining heartbeat). With some coaxing from my attending, the other student and I wound our way through the around-20 people standing outside and inside of …
We have embarked upon a unique strategy to assess and manage pain. “Opioids Rarely Help Bodily Pain” is not a catchy phrase but a mnemonic related to educational learning which serves as the cornerstone of a new acute-pain management paradigm. As is known, the evaluation of pain is extremely difficult due to its subjective nature. However, this new evaluation not only accounts for the patients’ self-assessment but, for the first …
“Grandma fell and we’re in the emergency room. She’s very distressed and does not look good. I’m going to put the doctor on the phone.”
I could hear my mother’s voice strain on the other end of the phone line as I braced myself for my conversation with the emergency department physician.
The emergency physician told me that though the work-up was still developing, my grandmother was in respiratory distress, and that …
The rotations on adult medicine and critical care are probably the most challenging ones for the residents doing internal medicine residency. No matter how much we try, we tend to feel overwhelmed, fatigued and swamped sometimes. As we progress into residency, we not only gain knowledge and clinical skills but also learn to tackle the challenges of a busy schedule. Below are some of the tips that might be helpful.
1. …
How did I miss his hypokalemia? Two weeks into my intern year and my patient’s potassium returned at 2.9. Minutes later, he coded. And I felt responsible. As I explained to my partner how my patient had become pulseless after diuresis of his heart failure, she looked at me and said, “Physicians kill patients, it’s inevitable. Has no one told you it’s part of the job?”
There is truth to this …
Based on my clinical experiences, there are ten pieces of advice I would give to any medical student starting their rotations that will maximize productivity and lead to a robust and thriving work environment (your interns will thank you).
1. Do as complete of a workup on your assigned patients as you can. Be thorough with your admission H&P. Think of all the tests, labs and imaging studies you want ordered. …
Think all the way back to your grade school years. Did you know that your personality traits were starting to be honed for the work you do today? Let me give you some examples about myself and see if you can relate.
I remember the praise and exhilaration of being the only kid in the class to get a 100 percent on an extremely difficult second-grade spelling test. My teacher told …
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Why is your hospital always full? Actually, it’s more than full. You have twenty boarders in the ED. You turned your postop recovery unit into an overnight surge center. Every day administrators beg you to please, please discharge patients, if possible before 11 a.m. You’ve hired an army of case managers, dissected the discharge process, and held countless capacity management meetings, but you’re still bursting at the seams.
It wasn’t always …
Florence Nightingale was among the first nurses who started wearing a nurse’s cap.
The cap was derived by nuns and represented those caring for the sick. Hair was neatly tightened into a bun and covered by the cap.
Back then becoming a nurse was typically seen as a female profession, but men were allowed to become nurses too. In 1930, only one percent of RNs nationwide were male.
Growing up in the 1950s …
I’m often asked to write and speak about being a woman physician. I don’t know that any of my male physician colleagues have ever been asked to talk about being a male physician. Many hospital systems have women in medicine groups, and there’s now a National Women Physicians Day. Again, don’t know of the same for male physicians. There’s a part of me that struggles with this, but I …
My story starts like most individuals who enter into medical training. I had the dream that being a physician was my life calling to bring physical healing to others. While I did gain medical knowledge and skills, I also unintentionally developed a jaded mentality. I was quickly introduced to the reality of medical culture in which public embarrassment from “pimping” (a series of difficult intentionally unanswerable questions posed to medical …
Perhaps the most important aspect of a physician’s role is our diagnostic capabilities. Truly, if we cannot identify and diagnose a patient’s pathology with reasonable accuracy, we cannot effectively treat them and may even cause greater harm.
Let’s look back. The year is 1816, and you are a physician evaluating a patient with shortness of breath. The common practice of the time was direct auscultation by placement of the practitioner’s ear …
A male interventional radiologist who is active in the #HeForShe campaign recently told me that he is being pressured to stop advocating for women. My first instinct was the biggest sigh and eyeroll of my life followed by thoughts of locker room peer pressure and boys’ club type discussions.
But the criticism did not just come from men; many women are asking him to stop. That they don’t need a knight …
For Apple iPhone users, the release of iOS 12 included a new feature called “Screen Time.” Although a number of productivity apps that offered a similar snapshot of phone usage were available before this update, I was never interested in quantifying my usage. Now, on a weekly basis, I get a reminder of the exact percentage breakdown of how I’m using my phone.
In true millennial fashion, a review of my …
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