I was quite young, but I could sense the unease in my mother when she first sent me off to elementary school amidst an uncertain risk of paralytic polio in the 1950’s era. She maintained her frightened countenance until 1960 when the Sabin vaccine miraculously appeared. Many years later, my wife, a pediatrician, had intubated a young patient with measles who needed ventilatory support. A few days later, she …
COVID-19: What can we learn from history?
I have been reading, thinking and consulting for a while about the occupational health syndrome commonly referred to as burnout. As initially defined back in the 1970s, burnout is a state of mental and physical exhaustion caused by one’s professional life. Extensive research shows that burnout (also called work “strain”) is the result of working conditions in which people have too much work, too little control, and too few resources.
Despite …
From physician to provider to health care worker: Names matter, even in a pandemic
The world is paused. But is it? Just because the world is experiencing a pandemic does not mean that the rest of the world’s ailments all of a sudden go away. Their priority may fall in ranking, but they persist. Health and disease continue.
I ate lunch and had severe abdominal pain shortly thereafter. Perhaps a bout of bad acid reflux, I thought, but the pain persisted into dinner, and when …
Undergoing an appendectomy in a pandemic
There have been increasing statements in the media to the effect that, for the COVID-19 pandemic, “the cure is worse than the disease,” and that the economic impact of the drastic and widespread quarantines will cause a severe recession that will result in excess deaths. This is very unlikely, as the overall U.S. mortality from unchecked COVID-19 would likely exceed the mortality from an economic recession resulting from the public …
COVID-19: Will the disease or the cure cause more death?
COVID-19 has given us many things, some of which we expected. Scarce resources, anxiety about keeping ourselves and our families safe, a sense of unparalleled vulnerability, and a solid helping of helplessness, knowing ultimately we may not be able to function as the doctors we strive to be when it matters most.
Personally, COVID-19 has given me an unexpected gift—one I really hadn’t seen coming. Psychologists call it the “dissociative state,” …
It has been a month since the first case of SARS-CoV-2 presented in my hospital in South Jersey. The virus has been causing devastation around the globe since December 2019, and before the United States – China, Italy, and Spain suffered the greatest casualties. Like many physicians, I continue to blog in order to spread awareness and also to ensure that we are well-prepared as a society to face an …
A physician’s predictions about COVID-19
As COVID-19 continues to spread throughout the country and leave lasting impacts on our economy, many of us are trying our best to cope with the changes. While this can take a huge toll on our mental health and leave us unsure of our next move, there’s one thing we need to do in the midst of the chaos: Buy long-term disability insurance. Here are six things you …
In the midst of coronavirus: Buy disability insurance
Lisa’s heart pauses every time her phone rings. She’s unsure if the call she is answering is going to be the final update she will ever receive from the intensive care doctor caring for her love, John. Her 55-year-old husband of 31 years was placed on the ventilator eight days ago for a lung infection due to coronavirus. He resides in the ICU of the local academic hospital, …
The unintended consequences of isolating our dying COVID-19 patients
As a health care provider, husband, father, and friend, I felt compelled to share my perspective with colleagues, loved ones, and the community as we continue to manage COVID-19. These are unprecedented times we are facing, and there is a myriad of information and guidance we are asked to review and assimilate. This is not more information or guidance. Instead, it’s a message of hope to reduce the hysteria, fear, …
A different perspective on PPE during the COVID-19 crisis
The CDC’s overseas epidemic prevention activities, a veritable gift from America to the world, were effectively eviscerated in early 2018 by Trump and the then Republican-controlled Congress in alignment with the White House’s “America First” ideology. This wholesale slaughter on global public health preparedness later left China unable to take advantage of the CDC’s expertise once the novel coronavirus had been detected, thereby propagating the crisis around the world. What …
The oath we took does not include compromising our own safety
As researchers and physicians race to investigate innovative therapeutics against the novel SARS-CoV-2 virus, unanswered questions remain regarding the ethics and design of clinical trials. Namely, what is the most ethically and scientifically rigorous approach to test unproven novel or repurposed therapeutic agents during a major public health emergency? Canonically, randomized controlled trials (RCTs) have represented the gold standard for evidence-based medicine. In this approach, the efficacy of an intervention …
An ethical approach for clinical trials during the COVID-19 pandemic
I have been a physician for almost twenty years. The AIDS pandemic has been the greatest public health calamity of my career. Global Health Observatory data estimates that approximately 32 million people have died from HIV-related illnesses since the disease was formally identified in the early 80s. AIDS had already gained a firm foothold in the United States before the administration of the time publicly mentioned the name. Now, the …
COVID-19 is a different world for our most vulnerable citizens
With COVID-19 well underway and impacting everything from the economy to everyday life, here are a few financial planning strategies during a crisis.
1. Understand your budget. During uncertain times, spending usually reverts to a survivalist mentality. This is a good time to prioritize what really matters most. As we’re all staying home during COVID-19, entertainment and food costs have greatly reduced. I know I’m cooking meals and finding …
Physician financial planning during uncertain times
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I am a physician. I have worked hard to get where I am in life. I went into medicine for many reasons. The intellectual challenges. Being in a field with lots of human interaction. And of course to help people. I went into emergency medicine because I ultimately couldn’t decide on a single specialty. I liked something about each one. When I rotated through the emergency department early in …
In the coronavirus crisis, for-profit health care kills doctors’ spirits
Coronavirus is sweeping across the world, cities are shutting down, hospitals overflowing, the economy crashing, and suddenly your cranial nerve mnemonic feels like the last thing you should be focusing on. But while the world screeches to a halt, medical students are finding themselves in an unexpected limbo, somewhere between the front lines of health care and the shuttered campuses of colleges and universities. For medical students, COVID-19 means virtual …
What COVID-19 means for all medical students
The front desk staff member who checks you in at your primary care physician’s office is 64 years old with a history of hypertension and coronary artery disease. She unexpectedly became a widower five years ago and is planning to work until the age of 68 to secure adequate retirement savings. She is worried about contracting SARS-CoV-2 from a patient as they check-in despite being vigilant about her personal hygiene …
Health care workers are here for you. Do your part to keep them safe.
On a sticky summer day four years ago, a class of eager medical students and I harmoniously chimed the Hippocratic oath, binding us to the highest standards and code of medical ethics.
As newly accepted and unassuming medical students, how could we understand the sacred nature of this rehearsed and recited ‘covenant?’
While pledging the words embedded in this sacred vow, we were completely unaware that the culmination of our medical education …
COVID-19 and the Hippocratic Oath
As the coronavirus pandemic spreads across the country, states are mandating “stay at home” orders; and with these orders comes further social isolation for domestic violence (DV) survivors and their families. Many recent articles highlight the potential risks for DV victims “stuck at home” with their abusers as their opportunities to seek help and support are dwindling. With only ‘Read more…
Domestic violence and social isolation during COVID-19
Since graduating from medical school in 2002, I have seen a disturbing trend in the lives of doctors. For years, physicians have been squeezed from every direction. Insurance companies and hospitals are constantly fighting to remove our autonomy. The amount of paperwork we are required to produce has skyrocketed over the past 20 years, combined with the use of electronic medical records, our face time with our patients has shrunk …
From a physician to our leaders
As doctors, we know how this disease progresses. We know the prognosis for patients who need to be on a ventilator. We know that if we have a cardiac arrest during the course of COVID infection, our prognosis gets much grimmer. Faced with this knowledge, how do you decide how far you are willing to go to try and survive?
If you had to be intubated on a ventilator, would you …
How far are you willing to go to survive COVID-19?
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