An excerpt from Rethinking Health Care Ethics.
Health professionals have not been well served, or at least not well enough served, by the academic community of bioethicists — the philosophers, theologians, lawyers, and social scientists of various sorts who have come to dominate, worldwide, the diverse fields of health care …
Why bioethicists fall short of connecting with clinicians
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 …
The personal and professional challenges of women physicians
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 …
Compassion, respect, and camaraderie are keys to fight physician depression
When I was a third-year resident, I was invited to join a practice owned by a doctor who had once been my chief resident. This was considered by all of my fellow residents to be the plum job in town, and I was thrilled. The doctor, whom I shall call “John,” was smart and funny and had a huge practice that he had purchased from a retiring physician. We figured …
A physician’s ex-business partner is in prison. Here’s what this doctor learned.
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 …
It’s time to update the stethoscope
“Ms. Taylor*?”
“Yes, it’s me. I’m so deeply sorry to you and the team. You all helped me so much when I was here. But I started drinking a day after I left and blacked out.”
Two weeks ago, Ms. Taylor was found by her sister lying unconscious on the bathroom floor after a week-long alcohol binge. Next to her was a suicide note.
“My depression is robbing me of my freedom. I …
Do whatever it takes to conquer this depression. Now and forever.
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 …
Why would any woman discourage a man’s advocacy or support?
I cannot begin to count the number of misspellings that I have witnessed of my first name. The number of “As” and the pronunciation confuse both first-timers and my closest friends. Its spelling on my first elementary school report card set the rhythm for things to come, from high school diplomas to wedding tabletop cards. And as I wandered around stateside for college and medical training, different interpretations led to …
What happened to the first name in medicine?
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 …
A physician’s addiction to social media
We were in the middle of the morning routine – sign out between mouthfuls of eggs and homefries – when the call came in overhead, “Code Blue, 9 West. Code Blue, 9 West.” Just like that, our team snapped into action, the continued banter only thinly concealing a change in demeanor: backs straight, jaws set, we walked with a sense of purpose. There was a life on the line.
By the …
Reflections after a medical student’s first code blue
Brittany Maynard was diagnosed with grade 2 astrocytoma, a form of brain cancer on January 1, 2014, her cancer also returned in April 2014, where her diagnosis was elevated to grade 4 astrocytoma, also known as glioblastoma, with a prognosis of just six months to live. She decided to take lethal drugs prescribed by her physician to end her life on November 1, 2014, at her home in Portland, Oregon. Under Oregon’s “Death …
The growing role of end-of-life activists
Our team is nearing the end of our call day when the ER pages us with one last admission. The ER attending starts with an apology — “I’m sorry,” she sighs, “this patient is a handful. He is homeless, belligerent, has a significant psychiatric history. He came in with ocular trauma. The ophthalmology resident thinks he may need surgery.” One of the interns on the team is busy with a …
What should physicians do when patients are racist?
Eye contact is one of the most basic mammalian traits that signals an interaction. Anybody who has a dog or cat at home sees on a daily basis how much animals value eye contact (and with dogs, it signals you’ve lost the battle!). In the case of health care, during frequent emotional exchanges between two human beings, it naturally follows then that simple eye contact has to be at the …
Doctors: Never forget the importance of eye contact
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By now, I’m sure most of you probably have heard about the Cleveland Clinic first-year resident who was fired last September when it became known that in 2012 she had tweeted she would “purposely give all the yahood [Jews] the wrong meds …”
The website Canary Mission documented numerous tweets expressing similar thoughts. She has apologized but will likely have great difficulty finding another job as a physician.
This …
Should residency programs review their applicants’ social media history?
Obesity is a global epidemic, and its prevalence is increasing in every part of the world. While we have new medications and complex surgical techniques that promote weight loss, the awareness of healthy eating habits and dietary education are still the most important factors in helping control body weight.
Unfortunately, nutrition knowledge appears confined largely to books and exams; as the doctors barely engage in nutrition counseling with patients. In teaching …
Why doctors-in-training need better nutritional education
Before I could see her, I could hear her. My patient, a young woman with messy braided hair, was grunting with every effort to breathe. The noises quieted slightly when I reached her bedside, but her tears continued to fall between gasps. Her body movements were exaggerated, rooted in the rhythm of her labored breathing — several violent shudders with every expansive inhale, and a wave of quivers with every …
In medicine, what’s in a name?
It’s Monday morning, and I’m the attending physician starting a week of inpatient service in the hospital. On my patient list is a man named Earl, age ninety-one. He’s outlived his siblings, his first and second wives and all of his peers. After seven decades of smoking, his lungs are failing; he carries a diagnosis that reads “severe emphysema.”
The sign-out note from Earl’s previous doctor reads: “Daughter and son-in-law met …
Another chance to practice self-compassion
As a hospitalist, like most in health care, I am afflicted by the slow march of thousands of mouse clicks on the electronic health record (EHR) every day I work. But after starting a new job and learning a new EHR, I have become painfully aware of the volume of alerts that pop up when I place orders. Don’t get me wrong: I appreciate being informed that a patient has …
How EMR alert fatigue overwhelms physicians
When you enter the doors of an emergency department, what you are entering is the realm of the unknown. Needles, blood, blaring alarms and all-nighters with nurses are about to become your new norm. For your whole life, you thought good food, sleep, and TV reruns could fix anything. But those are in short supply in a place you need it the most. Oh, and when else in your adult …
10 things patients should know about hospitals
Stepping into a hospital for the first time as a clinical medical student is a strange dichotomy. There is still so much you have to learn before you will become a physician, but you are quickly thrust into life-and-death situations. One of my early rotations was in the emergency room. As a student, you have no actual authority and must be closely monitored at all times. Many times you will …
I had just witnessed my first patient die
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