She was a stressed-out mother of six, working a grueling job as a kitchen manager that required her to wake up at 4am every day. She came to her doctor for her headaches: searing, throbbing pain that made her vomit. She slept fewer than five hours a night. She had tried every over-the-counter pain medication I had heard of, and she had maxed out all of those doses. I met …
I was 15-years-old the first time I went on a date. Like any rookie, I had no idea what to expect. As my date and I sat at the red-and-white-checkered table at TGI Fridays, I watched his expression slowly change from one of interest to trepidation; after drowning him with endless conversation, I was hardly surprised when he informed me that he would not be calling for a second date. …
Earlier this year, we launched the Teaching Value and Choosing Wisely Competition in conjunction with Costs of Care and the ABIM Foundation. Why a competition? Not surprisingly, traditional “literature review” yielded little by way of promising strategies for educators who wished to learn how to teach about value.
However, we had all learned of isolated stories of success, occasionally through attending professional meetings, sometimes via networking with colleagues, or more …
Over the last month I have received several comments from readers who have or who are trying to make the choice between nursing and medicine. And may I just say what a great problem we have now, to be able to choose. I’ve been thinking about this and I submit there are three considerations: philosophical, practical, and logistical.
1. Philosophical. Many of you have heard of the “medical model,” the idea …
Had I met her anywhere but the hospital, I would have gone to her side. I would have asked her what was wrong. I would have offered to help.
She was 99-years-old and about to undergo surgery. Pre-operative holding is generally a busy place. Patients lie in gurneys, spending some last moments with loved ones and fielding questions from various players of the surgical team as they come to the bedside. No, …
We have been training physicians the same way for a century, ever since the famous Flexner Report of 1910. That report was commissioned by the Carnegie Foundation in an attempt to improve medical education. Up until then many medical schools were simply terrible. Many were proprietary schools, owned by doctors and run for profit rather than education. Many doctors met their first actual patient after they graduated.
During the decade following Flexner report these proprietary …
Recently, a lot of my classmates have been passing around a New York Times article titled “Medicine’s Search for Meaning,” a piece detailing the high burnout rates of doctors-in-training and the inadequacies of medical education to address physician wellness. What I found to be of the most saddening paragraphs in the article goes as follows:
Nearly half of medical students become burned out during their training. Medical education has …
What’s all the fuss about extracurricular activities? Isn’t doing well in your coursework and on the MCAT enough to get into medical school? Nope. Extracurricular activities and employment are opportunities to explore your interests, become involved in your community, develop a project or earn money to support yourself. Saying you love to …
“Well, if medicine doesn’t work out, you can always fall back on waiting tables,” I joked with my waiter, who, like me, happens to be a medical student. We were bonding over completing our first year of medical school — he, in Detroit, and myself, in the Bronx. He liked waiting tables and decided to work during his last summer of …
In July, I began an exciting role at Einstein: assistant dean for educational informatics. One of my main objectives is to optimize the use of technology to advance and deepen learning. But as much as I welcome it, technology alone will not achieve our educational goals.
Recently, David J. Hefland, the president and vice chancellor of Canada’s Quest University, characterized the model of contemporary education as “students as empty vessels that must be …
In a large lecture hall of fellow clinicians-to-be, I was told that my job as a physician is not to be concerned with costs but rather to treat patients. My wrist, moving frantically left to right on my page taking notes, stopped. I looked up and my mind wandered: What an odd message to tell those who will be listening to ill people’s symptoms, prescribing medicine, ordering tests and orchestrating …
There is a saying that you enter medical school wanting to help people but exit it wanting to help yourself. It may be a cynical view, but a realistic one. The criteria for being a good medical student are far different from being a good doctor. Medical education may be breeding a legion of self-serving, grade-grubbing, SOAP-note spewing machines rather than …
The discourse on the problems of the modern healthcare system contains much vitriol and blame. There is a distinct flavor of adversarial combat in the discussion; pitting physicians, those in the trenches, with those politicians and lawmakers on the other side. With estimates of healthcare costs exceeding 15% of the gross domestic product of the United States, it is easy to understand the passion that the topic evokes. The complexity …
Medicine offers you a front-row seat on life. Meaning is all around you. When you can see it, it gives you a sense of gratitude for the opportunity to do this work.
-Rachel Naomi Remen
The first-year medical student cried openly during the session. Not hard, but enough to be embarrassed.
“I’m really sorry,” she said, “but this is one of the things that scares me most about going into medicine. I cry …
I don’t have time for this, I thought as I attempted to walk the twenty minutes from home to my Mind-Body Medicine class at a ten minute pace. I felt a sharp cramp in my abdomen, reminding me that I had just wolfed down dinner without taking a break for enjoyment or digestion. By the time I reached the medical school building the sky was dark, my face glistened with …
An op-ed piece this past summer by Verlyn Klinkenborg in the New York Times decried “The Decline and Fall of the English Major.” As I read it, I reflected on my own experience in medical school and beyond, and I think that Mr. Klinkenborg’s message is one that medical school admissions committees should be hearing loud and clear.
Despite the fact that doctors are faced with increasing mounds of paperwork …
It was a quarter past six in the evening. The day team had just completed their signout to us. As we sat quietly along the periphery of the trauma bay getting oriented to our list of patients, a small army of hospital personnel started trickling in. We were expecting company.
He was rolled into the first slot. From behind the desk, I tried assessing how serious the injuries were, but the …
Three years ago, in the midst of all that was happening with health care reform, I thought about if I’d ever recommend medicine to my daughter. I thought and thought about that issue and looked deep inside myself for reasons one might still choose this profession, then penned “The Top Ten Reasons to Be a Doctor.” It is, by far, the most popular post on my blog, having been …
The greatest good you can do for another is not just to share your riches but to reveal to him his own.
– Benjamin Disraeli
In 2009, when I was president-designate of the American College of Chest Physicians, a prominent physician, educator and outstanding mentor, who had recently died was honored by her colleagues. One of her junior colleagues, who had never met …
By no means is that very telling of my current life. On the contrary, I get glimpses of different times of the day when I go into patients’ rooms and look out the window or if by chance the anesthesiologist decides to open the curtains in the OR (yes, this hospital has windows in its ORs!).
So this topic of flowers and bees is very random. But it just …
