An adapted excerpt from Decisions: Practical Advice from 23 Men and Women Who Shaped the World. Reprinted with permission from Kensington Books. Copyright © 2020 Robert L. Dilenschneider.
Count me among those who apparently didn’t get the “science gene.” In my case, the Bunsen burner in my high school lab did me in. I know …
Ignaz Semmelweis and why we wash our hands
I often hear professionals talking about “working at the top of their license” – contributing their highest skills according to their training. To overcome this pandemic, now more than ever, every single one of us will need to work and live at the top of our humanity. Patients, families, nurses, doctors, front desk staff, administrators, lab techs, health plan executives – everyone – must find even small ways to create …
Living at the top of our humanity: a patient’s plea
I’m a proud member of our hospital’s Jewish All-Star team, which means I work every Christmas. One great thing about working Christmas is the hospital is never full. No one wants to be hospitalized on Christmas. If patients can go home, they do, sometimes even against medical advice. On top of that, there are no elective surgeries, chemotherapy admissions, or surprise calls from clinic. All is calm, if not bright.
Of …
The hospital census calm before the COVID-19 storm
Health care workers’ lives are not expendable. Yet, we are being asked to battle a microscopic enemy with disgracefully inadequate personal protective equipment (PPE).
We know that using PAPRs (powered air-purifying respirators) would be the best practice when working with highly infectious air-borne diseases. But, PAPRs are uncommon in our institutions, so the guidelines were relaxed. An N95 disposable mask was suggested as the next line of defense even though we …
We are not expendable. We are not replaceable.
I hope we eventually study the COVID-19 event after a sober period of analysis and reflection as an example of a societal panic attack. This is not Ebola, with a mortality rate of over 50%, or even SARS, with a 10% death rate. We’ve seen this movie before, figuratively and literally.
A new viral disease appears (like the swine flu in 2009), people die, the fear and misinformation spread like wildfire. …
Our collective struggle to fight COVID-19 coronavirus
In February, I had my first patient ask about my thoughts on the coronavirus. At that time, I was aware of the coronavirus and cautiously optimistic about the situation. My advice to the patient was to have a healthy level of concern about the virus, given the medical communities limited data on the virus. I instructed the patient on proper handwashing techniques since this is an issue, even for many …
COVID-19: 5 tips for psychiatrists
One week ago, a mere glance at my phone between patients would have sufficiently caught me up on 30 minutes of disconnect from both social and mainstream media. Today, as I closed one virtual appointment and waited for my 9 o’clock follow-up to join me on-line, I was met with 16 texts, 148 WhatsApp messages, and four breaking news alerts from a variety of apps. Yes, I was thinking about …
A guide for mental wellness while distancing: a psychiatrist’s perspective
In 2009, when more than $35 billion was invested in expanding national electronic health record (EHR) uptake, one of many advantages touted was its value as a tool for managing population health. This promise has failed to materialize due to a chaotic rollout of non-communicating systems. Today, as we confront COVID-19, the coronavirus wreaking international havoc, the need for such a tool is exquisitely evident.
How could …
Would Medicare for all help us combat COVID-19?
I am a physician, and I am not isolating. Like the Vietnam War defined my parents’ generation and World War 2 defined the generation before that, the COVID-19 pandemic will likely define mine. My father and grandfathers went to battle – I am now called to be a soldier. My small group of orthopaedic trauma surgeons agreed this morning to rotate in and out of hospital shifts every two weeks. …
I am a physician and I am not isolating emotionally
A few days ago, a good friend revived an email thread that routinely circulated among our social cohort of 17 aspiring doctors during our final two years of medical school. The subject line read: qThurs HH. Translation: happy hour every Thursday.
Back then, the goal of the email was to establish a standing opportunity for any available recipients to vent about 5 am rounds and difficult attendings or to share stories of fascinating cases and …
Residency training in the time of COVID-19
The summer of 1979 is permanently etched into my memory. I walked into the intensive care unit as a newly minted intern. I walked over to ICU-Bed 1 to be introduced to my first patient, a frail teenaged boy who was tethered to a ventilator.
“He is day 30 with respiratory failure from disseminated coccidioidomycosis,” my internal medicine resident informed me. “He is your responsibility now, and don’t f*** it up.”
An …
Coronavirus: the human factor in intensive care
As the United States faces enormous issues regarding the COVID-19 outbreak which has now impacted all 50 states, I would like to refer to a quote from Franklin D. Roosevelt: “Let me assert my firm belief that the only thing we have to fear is fear itself — nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance.” This quote epitomizes a message that should also hold true today both …
Fear paralysis in the world of COVID-19
Physician burnout. Physician suicide awareness. Buzzwords. Words that get tossed around. People in leadership seem to be concerned about. Institutions say they care. “Solutions” get created.
Solutions that look great on paper. Sometimes under the guise of the employee assistance program. The brochure says we care about your mental and emotional health. We get that life is hard. So we’re here to help. We’ll set you up …
Raw thoughts from a critical care physician
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I, like many of my physician colleagues, nurses, and healthcare workers, have spent my entire adult life sacrificing everything to help others, trying to serve the sickest of the sick. However, for every patient I have saved, you have seemingly multiplied by thousands your vast net of suffering. It takes me just seconds to visualize my weakest, immunosuppressed, heart transplant patients, who have already given everything to survive, to realize …
God bless us all and help us to destroy you, COVID-19
As we have literally overnight plunged into the world of telemedicine, I wanted to caution everyone to stop and think about something.
As an avid telemedicine provider, I truly believe in helping support our patients and the public. However, if anyone is an employed physician or medical provider, please keep reading.
If your practice did include telemedicine before, this may be a non-issue. But if it didn’t, you need to ask these …
Advice to employed physicians plunging into telemedicine
I want to make this simple so that politicians can understand. Our country will never survive this pandemic without centralized quarantine and widespread testing. This is not the flu, and our current policies and lack thereof will result in millions dead and economic disaster.
What is centralized quarantine? Every person who is tested positive must go to a government-designated housing location and not leave until they are no longer infectious. They …
Is centralized quarantine in our near future?
We are in a bizarre state of limbo within the crisis. We feel hopelessly behind, yet still attempt courageous efforts to be preemptive. My residency program, for example, had a fantasy of identifying which services were essential and which were not, staffing physicians appropriately, and staggering work hours to minimize exposure and allow others to be available for back-up when some inevitably fall victim to either quarantine or the virus …
I am a middle-aged gastroenterologist almost 15 years out of training. I have a chronic medical disease and had a bout with lymphoma two years ago, both of which require me to stay indefinitely on immunosuppressive drugs.
I am certainly not the only health care worker who is scared. Most winters that I will contract the flu or another illness from patients who want their screening colonoscopies performed while sick, from …
Why this immunocompromised doctor wants you to stay home
The coronavirus (COVID-19) is the single-most important topic on the minds of Americans, and it remains the subject of regular updates from health officials. And yet, despite the abundance of scientific facts and guidance surrounding the disease, misinformation abounds as confusion persists.
Avoiding many of the worst consequences and doomsday predictions will depend, in part, …
7 dangerous myths about the COVID-19 coronavirus pandemic
Early data from China and Italy shows that the outbreak disproportionately kills older adults. The rapid spread of these infections in the United States has triggered informal and formal efforts to protect frail and vulnerable populations like those in nursing homes.
Informal recommendations like social distancing have greatly changed the day-to-day lives of most Americans but have played a lesser role for those living in long-term care. …
COVID-19 policy amendments put nursing home residents at risk
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