“Medicine is not for boys.”
That’s what my 7 year old recently very emphatically told me. My son is not interested in becoming a doctor because it is for girls. He then suggested I discuss medicine with my 3-year-old daughter because she’s a girl.
My son instead prefers to be a fire fighter, soccer player, or superhero, or maybe a dentist because some boys still actually do that — but definitely not a …
Are we losing our boys in medicine?
“You must respect the body you are trying to heal.”
I heard this said twice into my headphones, the second time more slowly and firmly than the first, while I sat on the runway about to take off. It continued to echo in my head over the course of the flight. As a physician, the reference to healing a body has obvious resonance. However, as I embarked on yet another gathering …
Use generous orthodoxy to drive health care change
Sometimes an interesting thing happens on patient rounds. Rounds are a traditional exercise in hospitals going back at least a century. In the old days, this meant the physician going from patient to patient. He (it was nearly always he back then) went over the patient’s progress with the bedside nurse, examined the patient, reviewed pertinent test results, made an assessment, decided on a plan for the day, and gave …
A game of broken telephone in the hospital
Several years ago, I was sitting at the gate in a Washington, DC, airport when I got a call on my cell. A close friend of one of my patients wanted to let me know that Lara (not her real name) had died after a long and difficult course of throat cancer.
Lara was relatively young, a kind, brilliant and incredibly thoughtful woman, and I’d had a deep patient-physician relationship with her, given all that she’d been through …
In medical training, each morning begins with pre-rounds, a sort of prologue to the work day that gives us a preview of our patients’ conditions. Like a daily ritual, we arrive in the hospital as the sun begins to peek over the horizon and proceed to visit each of their rooms. Some of them are still sleeping, but we wake them up anyway to needle them with questions. Any pain? …
How do you talk to a dying patient?
What is one of the rules that medical people comply with the least?
My vote goes to “translation.” The rule is that you must use a qualified medical interpreter for any interview or discussion with a patient who does not understand English.
How is “lack of understanding” defined? It is usually fairly obvious. If you aren’t sure whether the patient gets it, he probably doesn’t.
Why can’t family members act as translators?
There is …
What’s the big rule that medical professionals don’t follow?
A few months ago I wrote an article about a 28-year-old MBA who attempted to tell an experienced physician where to round first. The article was widely circulated and went a bit viral. Clearly, the scenario resonated with thousands of physicians across the country.
It was interesting that afterward, I received many messages from various people who had read it. The majority of these were messages of support …
The day when MBAs no longer have to answer to physicians
It turns out that South Carolina is having a busy hurricane season. Recently, Charleston County was under a mandatory evacuation in anticipation of Hurricane Matthew. All I-26 lanes were converted into westbound traffic, gas stations were running low on fuel, and the local Wal-Mart was out of bottled water. It was T-minus 3 days to the landfall of Hurricane Matthew, with very variable predictions on the trajectory, speed, and strength. …
How a hurricane brought a hospital team closer together
I stood at Jack’s bedside along with his wife and two friends as life support was withdrawn. He was 52 years old and had married his wife just seven months earlier. After years of living on the street, struggling with drug and alcohol addiction, he had managed to stay clean for almost a year. Then he experienced a heart attack, and his brain went without oxygen for at least 30 …
The final vestiges of life evaporating
As physicians, we generally attempt to separate our personal lives from our work. Some of this comes from modeling behavior of others during training, some comes with further experiences in coping with the patients we encounter.
I recently had the pleasure of caring for an elderly gentleman who was brought into the hospital by his loving wife and son. He had Parkinson disease, as well as dementia, and his family reported …
A dying patient stirs up personal memories for this doctor
There are few worse ways to wake a person than with a needle stick in the arm to draw blood. If you have ever spent the night in a hospital, chances are the first thing that happened in the morning was a vampiric nurse or lab technician, following doctor’s orders, standing over your bed and greeting you with a needle and a set of vials.
Most of us just grit our …
Can you cut lab costs and make your patients happier? Here’s how.
“Nursing students needed to work in the University Hospital. Good pay. Orientation.”
As a rising nursing school senior in the 1970s, I naïvely applied for the job above without getting the full details. No one mentioned that I’d be working in a psychiatric unit housing twenty-five aggressive, catatonic or schizophrenic patients, many of whom had been locked away for years.
The entrance sign, which should have read “Locked Psych/Med/Surg Unit,” said simply, …
A new nurse gets a crash course in compassion
I walked into a patient’s room and noticed the hospital has supplied a fold up stool hung on the wall labeled “For Physicians.”
I shrug. I take it down the stool and open it up and seat it next to the patient’s bed. I greet the patient, and we discuss how he feels and what all is transpiring and planned for the day. He feels cold, nervous, pain in his back, …
Physicians provide a value to society that cannot be cheapened
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By now you’ve probably heard about the hospital that charged $39.35 for a woman who just had a cesarean section to hold her baby.
The baby’s father posted a copy of the bill on Reddit, and it drew over 11,800 comments. The story was also widely circulated on Twitter.
At least one labor and delivery nurse on Reddit and a spokesperson for Utah Valley Hospital where the baby was born stated that …
How much should it cost to hold your newborn? $39.35?
Whenever he meets with a new patient, Harvey Chochinov likes to ask one important question: “What should I know about you as a person to help me take the best care of you that I can?”
It’s a question every doctor should ask, says Chochinov, author of Dignity Therapy and director of the Manitoba Palliative Care Research Unit; a question he has found helps patient and doctor alike dial …
The value of a spiritually competent doctor
I recently watched the movie Sully. It was the first time I’d ever watched a movie on its actual release date. Knowing what a legendary actor Tom Hanks is, and what a fascinating and near-tragic story unfolded on January 15, 2009, I felt confident that my choice to venture out to the cinema on a beautiful Boston September evening, would be a good one.
The movie sure didn’t disappoint. Brilliantly directed …
Captain Sully and the human factor in health care
Jim Morrison of the Doors once sang, “Petition the Lord with prayer … You cannot petition the Lord with prayer.”
But we did that. We petitioned.
On one side of the ICU, we had an 18-year-old girl, upper middle-class family, had everything. Beauty, brains, money, supportive parents, and she was off into this new bright world, choosing her college of choice. A simple surgery led to sepsis, severe sepsis that raged through …
We have no answers to these unbearable algorithms in life
OK, I’ll admit it. I’m a doctor
“I work at a hospital.”
Those words had left my mouth a hundred times before, and yet on this late summer day, I paused to actually think about them. Why I was saying them, what I really meant, and what I should have said instead.
I was making conversation with someone I had just met. The inevitable question, “So, what do you do?” was asked, and …
I’m a doctor. And I love what I do.
We have all heard the grumblings regarding the 80-hour resident workweek. This is due to the opinion that jobs after residency typically require hours that surpass 80 hours a week.
But, why? Why does medicine have to be this way?
I have worked 100 plus hour weeks for over 20 years, and I am exhausted. I am burned out and I can not catch up because of the sleep deprivation.
This …
To whom it may concern:
I am writing to you with great sadness, but with relentless determination to ignite change. I am a doctor with a disability. Two years ago I began residency training in pediatrics. The privilege was overwhelming as I stood a doctor in the very halls where I had been wheeled in as a patient with a brain tumor. I couldn’t believe that I had actually made it, …
A hospital bullies a physician and threatens termination for her disability
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