We tend to like threes.
Hendriasis, in Greek — one through three, is a figure of speech used for emphasis in which three words are used to express one idea. For example: Veni vidi, vici. Location, location, location. Or one of the anthems of my youth — sex drugs and rock n’ roll. Monty Hall had three doors on “Let’s Make a Deal.” Even Uncle Junior, the patriarch in the “Sopranos,” …
“Someone call for a body bag.”
These were words that I didn’t expect to hear on my final day of burn surgery at large metropolitan hospital. We had just planned on a routine burn excision and skin grafting. Our patient, Faith, was a seven-year-old girl with third-degree burns to 85 percent of her body from a house fire. We had been caring for her in the ICU for the past three …
Caring for your own wounds: Lessons from the burn unit
That first paycheck as a new attending means so much more than what is direct-deposited into the bank account. The emotions of finishing medical school and training to finally seeing the fruits of your labor positively affect the bank account is something to be proud of. As a medical student (like myself) and resident, it is the light at the end of the tunnel. You’re probably asking yourself, “Why should …
The key to financial freedom: Live and work like a resident
I find myself spending close to an hour on the computer each morning at the hospital. I spend this time dutifully looking up vital signs, labs, recent radiology or pathology results as well as many other valuable pieces of information about each of my patients. I watch as my colleagues frantically record values, while making sure to point out important trends and gross abnormalities.
When we round, there is always a …
This doctor spends more time at a computer than with patients
“So, I’m getting routine labs on her.”
Wait, what?
Statements like these often make the hair on the back of my neck stand up. One of our residents was seeing a healthy young woman for her “annual physical,” seen just a few days after a routine postpartum visit with her OB/GYN after the uneventful birth of her third child two months ago.
The resident was coming for his afternoon continuity clinic from an …
It’s time to stop it with the “routine” labs
My intern gazed blankly at her notes from the day.
“You OK?” I asked.
Her face was quivering with restrained tears as she turned to me, “I don’t think I helped anyone today.” This was not the first time, nor would it be the last time, that I had heard those words from a resident physician.
Medical training is no joy ride. How could it be? First, there is the intellectual challenge of …
How to find joy in practicing medicine
I have a very interesting job: I travel around the country providing neuromonitoring to surgeons in the operating room. I’m also an anesthesiologist assistant, certified and licensed to provide anesthesia. Throughout my ten-year career in the OR, I’ve been the guest of nearly a hundred hospitals in the U.S. and the UK. No two hospitals are the same. My career has allowed me to meet hundreds of incredibly caring doctors, …
Here’s how your attitude affects patients
Two months into my pediatric residency, while working on an overnight call, I encountered my first medical mistake. We, fortunately, had had a very good night, and all patients had remained stable. It was an hour before sign-out to the morning team, that I received a page. I quickly held my pager and dialed the 4-digit number, only to find a busy dial tone. I was a little surprised and …
A safe space is needed to talk about medical errors
As an attending and educator, I give a lecture to the residents each year about stroke syndromes. In the lecture, I use mnemonics, pictures, and associations, so that the trainees can retain the information in non-traditional ways and have fun learning what could be otherwise dull material. When I talk about the internal carotid artery stroke syndromes, I bring up the possibility of “the good, the bad and the ugly” …
What it’s like to be on call during a hurricane
I’m in the ICU and was just back from an incredible tropical vacation. Nine days of vegging out on the beach. The glistening ocean was just steps away from the five-star hotel I was staying in, where doormen greeted me with fruity daiquiris and a staff that couldn’t wait to serve my every whim.
I was in paradise, and far, far away from the reality of my day-to-day existence as an …
A nurse returns from vacation. And she’s thankful to the ICU she came back to.
As a second-year family medicine resident, wife of a nurse and mother of an almost-two-year-old, the feeling of just not being enough has a suffocating hold on me some days. Non satis. Sounds like a pretty good gig when I talk with others outside the medical profession and friends from home. Training to be a doctor? Great. Happily married to an amazing man who’s taking time off work to raise …
A resident deals with being a wife, mother, and doctor
Approximately 300-400 physicians commit suicide annually. Given that a typical doctor has about 2,300 patients under his or her care, that means more than a million Americans will lose a physician to suicide this year.
In a study of six medical schools, almost seven percent of students said they had thought of ending their lives in the last two weeks. In another recent study, 29 percent of residents …
Stop exploiting medical students and residents
“Apocalyptic” was the word used by my fellow volunteers at the local church, a temporary shelter for displaced families on post-hurricane-landfall day 3. Although the flooded roads harboring similarly displaced alligators, fire ants, and snakes and the black flecks in the sky representing rescue helicopters were grossly removed from the many-eyed beasts of Revelations, I agreed with their assessment. In fact, the thousands of flooding victims stranded on roofs in …
What Hurricane Harvey taught this medical student about patient care
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This is by no means a scientific study, just some thoughts on what I have seen in my 22 years as a nurse and the loss of bedside nurses who hate it. I think the advent of nurses leaving the bedside will cause a greater crisis for the nursing profession.
I obtained my ADN in 1995 after having worked as a computer operator for 16 or so years in the defense …
Here’s why this nurse really retired
As a pediatrician, I have always known the value of my presence. At least, that is how I remember feeling during long nights in the hospital taking care of sick children, in the clinic or in any situation that required pediatric expertise. “How can I help?” I would always ask as I entered an exam room. Answering questions from wide-eyed parents about their foreign and frightening new bundle of joy, …
Being a CEO isn’t that different from being a clinician
Which arrow causes you more pain, the first or the second?
Fellow blogger Michelle at The Green Study recently posted a piece in which she distinguished between pain and suffering. It reminded me of a Buddhist teaching that inspires and humbles me. Blogger and curator extraordinaire
Maria Popova quotes it in an article she wrote last year on a book by Tara …
How mindfulness may ease your suffering
This is a letter to everyone who has ever smiled, shrugged their shoulders, or nodded while either hesitantly or enthusiastically uttering the words, “Yes,” “Sure,” “OK,” “I guess so,” or, “Of course,” when a medical student has asked if he or she can talk to and examine you before your doctor comes in. We know that you are busy and that your time has value. We know that you have …
I am not a doctor. (Yet.) I am a novice third-year medical student, somewhat able to perform and document a physical exam on a sleeping child, to dial the correct number to call a consult and to make wild guesses about chest X-rays (“I see a consolidation?”). I write about medicine not from a position of experience, but of malleability. I want to become like the best doctors I see.
Towards …
I vow not to call my patients “difficult.” Here’s why.
In a terrible twist of fate, the very day that the Centers for Medicare & Medicaid Services (CMS) Hospice Compare website went live, I found myself in a pulmonologist’s office with my parents, taking in the news of my mother’s advanced cancer and malignant pleural effusion. The shock of it, and the uncanny timing are beyond comprehension. You see, I’ve been leading research at RTI International and …
Am I the first user of the Hospice Compare website?
Imagine driving through an unfamiliar area, and there are no street signs. How would you feel? Frustrated? Scared? Angry? You would feel these emotions because you had no direction or guidance. Patients need direction when they enter the health care system. Signposting is a tool to provide direction.
On the streets, there are posts that have signs. They provide direction; they tell us where we are going. Hence, the name, “signposting.” …
3 ways to better communicate with patients via signposting
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