Hospital medicine

5,188 articles · Since 2004

Articles, page 60

A doctor to a patient: Please call me when you get home

February 21, 2018Feb 21, 2018

It is 3:30 p.m. on a Wednesday, and I am bringing my last patient out of the operating room. Everyone is in great spirits: a smooth case and an early finish at our surgical center. The patient has already awakened,…

“Everything went alright, doc?”

I smile, knowing that I will be repeating what I am about to say a few more times as the anesthesia wears …

Physician voices

Medicine needs its soul back

Robert Baker, MD

February 21, 2018Feb 21, 2018

In a recent issue of the Annals of Internal Medicine, Terwiesch and colleagues propose “reimagining provider visits as the new tertiary care.” Initially, their arguments seem sound, even reasonable. Then, they conclude with this: The conceptual change is to see…

The conceptual change is to see every engagement with a clinician not as something to be celebrated but as a kind of failure — an inability to accommodate patient needs by any of

…

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Medicine needs its soul back

Physician voices

Are all of those morning labs really necessary?

Kunal Sindhu, MD

February 18, 2018Feb 18, 20185

After a complicated stay in the hospital, my patient was finally ready to be discharged. After all he had been through, I was excited to tell him the good news. “You will be leaving this afternoon,” I said, heartened by…

After a complicated stay in the hospital, my patient was finally ready to be discharged. After all he had been through, I was excited to tell him the good news.

“You will be leaving this afternoon,” I said, heartened by the smile I saw spreading across his face. He thanked me, and then said something that made me cringe.

“Finally! I thought you guys were going to keep sticking me with needles …

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Physician voices

How to get back into the medical workforce if you’re a mom

Virginia Thornley, MD

February 16, 2018Feb 16, 2018

As women in the medical workforce increase, women physicians are faced with the unique position of training the hardest they ever had in their lifetime cutting into precious childbearing years. Many women physicians seek time off or engage in part-time jobs to address the dilemma of fulfilling the obligations of their careers while enjoying the tender years of their babies. Others pursue non-clinical routes such as medical chart reviews or …

Health policy

Why are there vending machines in hospitals?

Jered Haynor, DO

February 16, 2018Feb 16, 201813

Why are there vending machines in hospitals? This seems like an odd question to ponder, and it certainly would seem to have nothing to do with the current state of medicine and health care in our country. But it is a question that I am having a hard time wrapping my brain around. Certainly, most hospitals do have vending machines that sell snacks and soda, and they are by no …

Physician voices

You don’t know what your patient’s end-of-life wishes are

Lauge Sokol-Hessner, MD

February 16, 2018Feb 16, 20182

As I walked in the room, I noticed it immediately: Norman was worse. The recurrent invasive cancer in his neck was impairing the drainage of fluid from his face making it difficult for him to turn his head, and it…

There were no more cancer-specific treatment options: the surgeons had declined to operate again; he had received maximum dose radiation; and …

Medical education

The dark side of negativity bias in medical school

Jay Thetford

February 15, 2018Feb 15, 2018

As a third-year medical student, fresh and green on my clerkship rotations, I was determined to stand out on my general surgery team. I knew this was not going to be easy; I was often the last item on many surgeons’ minds as they rush through morning pre-rounds at the hospital, flying around corners, their Nike sneakers squeaking on the polished white floors.

In the OR, I observed from the corner, …

Physician voices

Don’t let burnout impact our ability to provide selfless love

Pooja N. Gidwani, MD

February 15, 2018Feb 15, 2018

The ancient Greeks were one of the first groups of philosophers to recognize and describe the complexity of love. Eros: an intense, passionate form of love. Philia: a deep friendship or affection. Philautia: love for one’s self. Agape: an unconditional…

These same complexities in love forms described by the Greeks play an important role in how we treat our patients in medicine.

Eros allows us to have the passion …

Physician voices

Farewell pager, I’ll always cherish the memories

Rohini Harvey, MD

February 15, 2018Feb 15, 2018

This was a momentous week for me. After 14 years of carrying a hospital-grade old-school text pager to receive messages at work, I finally traded it in for a cell phone app. It should have been easy to get rid of my beeper. But instead, I felt waves of nostalgia when I turned it off for the last time. Those 240-character, pre-Twitter, low-resolution LCD messages follow the arc of my …

Physician voices

What’s love got to do with it: lessons from a dying physician

Charles A. Odonkor, MD

February 14, 2018Feb 14, 2018

They came from all corners of the globe to bid him farewell. He looked cachectic, his frail form interrupted by swelling in his abdomen and legs, a result of end-stage pancreatic cancer. It was Dr. Yeat’s last week in the hospital before being transferred to a nearby hospice. He was now on morphine, and despite severe fatigue and difficulty breathing, he always managed a smile.

Some of his visitors were former …

Physician voices

In defense of FOX’s The Resident

Rohin Francis, MD

February 13, 2018Feb 13, 20183

The public’s apparently insatiable appetite for medical drama continues unabated as yet another prime-time TV show set in a hospital has hit our screens. FOX’s The Resident has generated discussion like no other. This may simply be due to the fact it’s the first major launch in the era of widespread social media, but it seems to have enraged a vast swathe of our ranks. Has The Resident crossed a …

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In defense of FOX’s The Resident

Physician voices

A system to identify doctors who’ve been working too many hours

Valerie A. Jones, MD

February 12, 2018Feb 12, 201812

My shift had finally ended. As a second-year resident, I was driving home after 30 hours awake straight. The busy call included delivering several babies, two Cesarean sections, circumcisions, rounding, triaging new patients, and teaching medical students. Never during that…

I couldn’t wait to get home at the end of the shift as I was completely exhausted. So, …

Physician voices

Is residency an exercise in futility?

Brian Radvansky, MD

February 12, 2018Feb 12, 201811

It was Saturday. My first day off in the last 14, which included three 26-hour calls. My wife was left home alone for these stretches to care for our 2-week-old son. I’m sitting on the couch, reading a book to my little man, enjoying a much-needed breather, and making up for lost time in seeing him grow into a person.

And the phone rings. Concurrent emergent cardiac surgeries: the only way that …

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Is residency an exercise in futility?

Health policy

The way we treat young doctors is barbaric

David Penner

February 12, 2018Feb 12, 20182

The exploitation and bullying of medical students and residents can only be meaningfully understood in the broader historical context of the New Deal’s dismantling and the destruction of the middle class that has followed in its wake. Moreover, it is fallacious to look at this inhumane treatment as something that happens only within the confines of the medical profession. For these exploitative working conditions have in fact become the norm …

Physician voices

The huge impact a dying infant had on this physician

Brian Han, MD

February 11, 2018Feb 11, 20182

Lines are slowly being taken out of the small infant, his bruised and discolored arms continuing to ooze. Machines and circuits, one by one, are being shut up and turned off. Leads and wires are carefully taken off of the lifeless chest of the once critically ill, but alive infant. Just hours ago, physicians, nurses, and other providers were rushing in and out of the room, desperately doing everything they …

Conditions and diseases

Think twice before you give a hug

Rabbi Chaya Gusfield, BCC

February 10, 2018Feb 10, 2018

I’m usually a hugger. When I see people I haven’t seen for a while or want to acknowledge someone in an open-hearted way, I often will automatically reach for a hug. Physical acknowledgment is usually perceived as a sign of warmth. But not always. In the last few years, I have noticed that this automatic hug can actually cause harm or insult even though my intent is not to.

I learned …

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Think twice before you give a hug

Medical education

Lifelong lessons from a medical student’s first rotation

Ezinwanneamaka Morayo Ejiofor

February 10, 2018Feb 10, 2018

"How long have you been doing this?" he asked, eyes gleaming with admiration. I was unsure whether he was asking how long I had been conducting patient interviews or how long I had been a medical student. I decided on…

“How long have you been doing this?” he asked, eyes gleaming with admiration. I was unsure whether he was asking how long I had been conducting patient interviews or how long I had been a medical student. I decided on the latter.

“2 years,” I replied with a confident smile across my chin.

“Well, you’re very good!”

“Thank you,” I replied, almost a whisper. It was a compliment that I was definitely not …

Physician voices

Learn to see beauty in death

Jo Ann Gates, MD

February 9, 2018Feb 9, 2018

We physicians stand witness to countless tragedies in our careers. At some point, as we stand by the bedside of a dying patient, comfort a heartbroken relative or officially call a death. We learn that love and loss, sorrow and…

We physicians stand witness to countless tragedies in our careers.

At some point, as we stand by the bedside of a dying patient, comfort a heartbroken relative or officially call a death. We learn that love and loss, sorrow and joy are intertwined. They depend upon each other. They are two sides of the same coin. Dealing with loss after loss, we learn to look for the beauty in all of …

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Learn to see beauty in death

Medical education

All’s fair in love and medical school

Jennifer Udom

February 8, 2018Feb 8, 20187

The third and fourth year of medical school are ridiculously difficult, but not for the reasons you think. Culture matters. Everyone and every specialty is distinct and it's on you to effortlessly navigate all of the people and their respective…

The third and fourth year of medical school are ridiculously difficult, but not for the reasons you think. Culture matters. Everyone and every specialty is distinct and it’s on you to effortlessly navigate all of the people and their respective idiosyncrasies. Although people are all individuals, each specialty seems to have their own overarching spirit.

For example: surgery.

Surgeons do not respond well to the bleeding heart types. Instead of complaining on …

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All’s fair in love and medical school

Physician voices

Is “doing everything we can” at the end of life doing too much?

Jason J. Han, MD

February 8, 2018Feb 8, 20186

In his soulful book, How We Die: Reflections on Life's Final Chapter, the late surgeon and author Sherwin Nuland describes one of his patient encounters as a medical student. The patient, a 50-year-old man, presented to the hospital after a…

In his soulful book, How We Die: Reflections on Life’s Final Chapter, the late surgeon and author Sherwin Nuland describes one of his patient encounters as a medical student. The patient, a 50-year-old man, presented to the hospital after a heart attack.

A few hours later, the patient suddenly collapsed pulseless and unconscious.

Training in an era when there was no defibrillator or CPR, the author notes:

For reasons I cannot explain to

…

Hospital medicine

Articles, page 60

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