Critical care

A nurse shares who she really is

A nurse shares who she really is

Debbie Moore-Black, RN

October 4, 2017Oct 4, 2017

How do I tell you who I am in a couple of paragraphs? Well, I was born in 1955, so that makes me 61 years old. My namesake is probably movie star and America's sweetheart Debbie Reynolds. My maternal grandfather…

How do I tell you who I am in a couple of paragraphs?

Well, I was born in 1955, so that makes me 61 years old. My namesake is probably movie star and America’s sweetheart Debbie Reynolds.

My maternal grandfather was straight from Italy; my paternal grandfather was straight from Ireland. Both crossed the Atlantic and landed on Ellis Island in New York Harbor. It was the promised land.

So, that means I …

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What does it mean to say, “We want to live?”

September 28, 2017Sep 28, 2017

How often have I heard those words or some version of them? The location of the conversations varies. I might be standing outside the curtain of an emergency room bay or sitting on a worn chair inside a cramped waiting room adjacent to the ICU. Possibly on the phone in the dark of my bedroom at some pre-dawn hour. Those words, coming from the mouth of a spouse, a child, …

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Medical education

Caring for your own wounds: Lessons from the burn unit

Emily Gorell

September 20, 2017Sep 20, 2017

“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,…

“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 …

It’s time to stop it with the “routine” labs

Fred N. Pelzman, MD

September 18, 2017Sep 18, 20173

"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…

“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 …

A nurse returns from vacation. And she’s thankful to the ICU she came back to.

Debbie Moore-Black, RN

September 14, 2017Sep 14, 20174

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…

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 …

Medical education

Gamification of medical education: Choose Your Own Medventure

Chris Carroll, MD

September 5, 2017Sep 5, 2017

More and more health care practitioners are turning to social media for their medical education. Fellows are learning ultrasound from Snapchat, nurses are learning how to insert NG tubes from watching YouTube, and learners are learning pathophysiology from blogs and podcasts. To reach this audience with credible and reliable content, it is important for medical educators to be present where the learners are, and that means social media.

Users are also …

A reminder of how important bedside manner is

Rakhi Dimino, MD

August 29, 2017Aug 29, 2017

Being a physician is hard. Really hard. Four years of medical school, multiple years of residency and perhaps fellowship training add up to years of working endless days in a row and powering through exhausting nights. For many of us,…

But being a patient is harder. Being the daughter or son or husband …

Planning for the end of life: What baby Charlie can teach us

Mark Kelley, MD

August 20, 2017Aug 20, 2017

Charlie Gard was a one-year-old boy who had a rare genetic disease leaving him blind, comatose, and unable to breathe on his own. This metabolic disorder can be fatal and has no known cure. Charlie’s parents wanted him treated with…

Charlie Gard was a one-year-old boy who had a rare genetic disease leaving him blind, comatose, and unable to breathe on his own. This metabolic disorder can be fatal and has no known cure.

Charlie’s parents wanted him treated with experimental drugs in the hope that a miracle would happen. As reported in the press, the British medical and legal community considered this care futile and blocked …

Physicians put up walls. But they feel everything.

Caitlin Smith, MD

August 19, 2017Aug 19, 2017

We sat in the office of the intensive care unit under fluorescent lights, both staring at computer screens covered in vital signs and labs. It was the summer of my second year of residency, and I spent it entirely in the intensive care unit. There were two of us on call at night. Half the nights we would spend shooting the shit about life, and the other half we spent …

Physicians should not tolerate racism from patients

Farshad Farnejad, MD

August 15, 2017Aug 15, 201766

It’s 7 a.m. We sit down around a table in the physician's lounge to discuss and our patients. I am a general and critical care surgeon. Every fourth week I’m “on service” for the ICU. This is my week. I…

It’s 7 a.m. We sit down around a table in the physician’s lounge to discuss and our patients. I am a general and critical care surgeon. Every fourth week I’m “on service” for the ICU. This is my week. I was off over the weekend. I’m refreshed and ready to go. I’m excited. I enjoy the challenge of taking care of critically ill patients.

I get sign out from my partner. …

A code in the cath lab that was unlike anything I had ever seen

Daniel Mishkin, MD

August 14, 2017Aug 14, 2017

An excerpt from The Other Side of the Bed: What Patients Go Through and What Doctors Can Learn. As soon as I’d opened my mouth, I regretted it. In the hospital, it’s bad luck to say “It looks quiet,” or…

An excerpt from The Other Side of the Bed: What Patients Go Through and What Doctors Can Learn.

As soon as I’d opened my mouth, I regretted it. In the hospital, it’s bad luck to say “It looks quiet,” or anything to that effect. At the sound of those words, alarms begin to ring. In the hospital, crises always seem to come in waves. There are spurts of relative …

A physician’s mixed feelings about clinical pathways

Christopher Johnson, MD

August 2, 2017Aug 2, 20172

As the kids say, it’s complicated. Practicing physicians are seeing an ever increasing list of protocols and pathways coming their way. These arrive in several forms -- order sets for medications, guidelines in how to proceed for various conditions, when…

As the kids say, it’s complicated. Practicing physicians are seeing an ever increasing list of protocols and pathways coming their way. These arrive in several forms — order sets for medications, guidelines in how to proceed for various conditions, when to do this, when to do that, and when not to do either one. They generally are the product of various committees trying to synthesize what these days we call …

A biker’s heartbreaking story

A biker’s heartbreaking story

Ben Gold, MD

July 20, 2017Jul 20, 2017

A lone figure stood at the entrance to bed 14, intensive care unit 2, floor 15-North. Though it was 2:30 a.m., he stood with rapt attention. He looked out over the hallway, eyes scanning. He looked like a gargoyle brooding…

He looked unlike anyone I’d ever seen in an ICU. He was a slightly pudgy yet wholly muscular 5′ 10” or so, with a few days …

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My patient is dying, and I don’t know what to do

July 5, 2017Jul 5, 20172

The patient in front of me is trying to die. Elderly and frail, he is lying in bed. His ribs outlined under the skin that should be smooth. His temples are concave where they should be flat. Both are an outward display of internal damage from his lung cancer. More striking than his cachexia are the strained muscles in his neck and his pursed-lip breathing. He is working hard for …

I want to help him, but I need to know more about him

May 22, 2017May 22, 2017

I pause in front of the door. On the other side, you all wait. A spouse, sons and daughters, sometimes with their own small children in tow. Today, it’s your husband and father you have come for. Yesterday it was someone else’s mother. You have come from near and far, across the street and the country. Your weary eyes are unable to mask your sadness. Over the past week, you …

What do you do when you know someone is going to die?

April 7, 2017Apr 7, 20176

What do you do when you know someone is going to die? I’m not talking about death when it comes at the end of a long protracted illness or a terminal diagnosis. Or the final act at the end of…

What do you do when you know someone is going to die? I’m not talking about death when it comes at the end of a long protracted illness or a terminal diagnosis. Or the final act at the end of a “good” life, when the body and mind have ultimately given way. I’m talking about when you realize the twenty-five-year-old woman in front of you, who you met five minutes ago, …

This is what heroin addiction looks like

Debbie Moore-Black, RN

April 6, 2017Apr 6, 20174

What can I tell you? It started out innocently. College exams were over. And that meant one thing — party time! Bubbly, shots, beer, cocaine and Percocet. Everyone was happy. It was a celebration. Pam came from a pretty strict…

What can I tell you? It started out innocently. College exams were over. And that meant one thing — party time! Bubbly, shots, beer, cocaine and Percocet. Everyone was happy. It was a celebration.

Pam came from a pretty strict religious family: no alcohol, no premarital sex and no crazy music in her house growing up. It was church every Wednesday and Sunday. And if you missed a Sunday, you were …

This doctor beat burnout by doing these 5 things

Roozehra Khan, DO

March 28, 2017Mar 28, 20172

Burnout syndrome is a state of emotional, mental and physical exhaustion caused by excessive and prolonged stress. I burned out early. Right out of fellowship, I no longer wanted to be a doctor. The grueling hours, my grumpy co-workers, and distant patient engagements left me totally exhausted. However, over the course of a year, I was able to rediscover my passion for medicine.

Some tactics were deliberate, mindful behaviors, some occurred by accident, …