A friend delivered twins early. One is in the NICU, one died. What can I say or do?
This question was sent to me via Twitter. The person who added my name to the tweet knew that I might have something to offer because 10 years ago I was that friend. I entered the hospital with ruptured membranes at 22 1/2 weeks, pregnant with triplets. My son Aidan died at birth …
I used to think medicine would get easier over time. It makes sense, right? You see patterns, you learn how treatments work, and you just get to know stuff. Experience should make it easier to diagnose and treat.
That’s not been the case for me. In fact, it’s closer to the opposite. In the exam room, as I look up to the patient from my stool, and before I stand at …
Emily Oster has a book coming out entitled Take Back Your Pregnancy. In preparation for the book launch, as most authors do, she wrote a nice piece in the Wall Street Journal about decision-making, risks, and how some of what OB/GYNs recommend during pregnancy isn’t always evidence based.
In particular, she mentions listeria, a bacteria that is a food borne illness with potentially devastating outcomes during pregnancy. Osher quotes the risk …
Last week a woman told me that she had a miscarriage in her bathroom. She was terrified. She didn’t know what to do. So she flushed it down the toilet.
A miscarriage is the spontaneous expulsion of a fetus from the womb before it is able to survive on its own. One in five pregnancies ends in miscarriage. Many women don’t know they are miscarrying. Those who know usually suffer grief …
On June 10, 2013 a 32-year-old pregnant woman was reported to have died after having an ovary removed instead of her inflamed appendix. As the infected appendix festered, she became septic and succumbed to multiple organ failure. This tragedy occurred in the UK in late 2011, but has just come to light.
How could this have happened?
Let me count the ways.
The surgery was performed by two trainee surgeons. Their …
Typically, teen girls do not need a pelvic exam until they are 21. Most parents are surprised to hear this, especially if they know their teen is sexually active.
About 1/2 of teen girls are sexually active during high school which puts them at risk for sexually transmitted infections (STI) and unwanted pregnancy. However, for routine prevention and care, girls rarely need an internal pelvic or speculum exam during high school. …
The use of ultrasound has had a large impact on health care in resource poor countries. This article details some of the research that has been done overseas to look at the impact on bedside ultrasound by caregivers to deliver more appropriate care for injured and ill patients in Africa, Asia and Mexico.
Using an ultrasound to determine how dehydrated a child …
A divorced friend of mine who recently started dating was shocked to find that the complete absence of female pubic hair seemed to be an expectation among her potential partners. I’m not surprised, when I was in the dating pool a couple of years back there were men who actually listed full clamscaping required among the personal attributes they were seeking in a girlfriend (and here I was looking for …
With all due respect to the many caring, compassionate, and skilled male OB/GYN physicians out there, we’d be amiss in ignoring the research showing a near majority of younger women preferring a female gynecologist. Some call this reverse discrimination in gynecology. I’d more simply call it patient preference. The bigger question is, “Where does this leave the male gynecologist?”, especially in a current marketing climate promoting the “female only” OB/GYN …
Somewhere near where you live, a couple will discover this week that they are infertile and that if they want biological children of their own, they are going to need in vitro fertilization (or IVF). According to treatment protocol, the woman will need to take powerful medicines to ramp up her production of fertilizable eggs. One monthly cycle of this treatment will run …
I’ve been thinking lately about all the great advances in medicine over the years. There have been lots of them. And despite everything you’ve heard about looming cuts in healthcare, I have no doubt that the hits will keep on coming. Since I seem to be on this Top 5 thing lately, I figured I would continue this ride and rank my top 10 medical advances over the years. There …
Viewpoint #1. Training programs might say: we are headed for a major league collision in the training of women physicians. Soon 50% of all trainees will be women, and in some specialties, such as OB/GYN, they will be 80-90% of the residents in any particular program. Training years coincide with prime child bearing years. Imagine if even only half the residents in a program were pregnant at once. What would happen …
In a word, yes.
And this is a difficult concept for many doctors to get because we have long been taught that the gold standard is culture.
Let’s back up a little. These are the symptoms of a bladder infection: needing to empty your bladder a lot (urinary frequency), when you gotta go, you gotta go (urgency), pain just over the pubic bone, blood in the urine, burning when you empty your …
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As a doctor, I appreciate that I am at an advantage when I seek medical care. Knowing terminology and basic medical principles helps a lot. In addition, when you’ve been practicing medicine for a while you get a feeling from how a doctor discusses options if the care seems valid or if a second opinion is in order. Other things I look for are board certification and a doctor …
Full disclosure. I have 4 board certifications and dutifully do all of the required reading, continuing medical education (CME) and recertification exams to maintain my status (I am board certified in OB/GYN in both the US and Canada as well as board certified in pain medicine by both the American Board of Pain Medicine, ABPM, and the American Board of Physical Medicine and Rehabilitation).
I would never go to a non-board …
As my husband and I try and make a long term financial plan for paying off my almost $200,000 in loans from medical school, I sit here wondering, why did I pay 200 grand so that I can get peed on, pooped on, bled on, screamed at and sworn at? I’ve delivered a baby without gloves on (it was an emergency). I’ve been kicked so hard I almost fell off …
Labor and deliveries are slowly closing across the United States: California, Pennsylvania, and Ohio. In regional areas where there have been no closures, conversations in hospital boardrooms are probably questioning whether they should be. But why? Because of health care reform, increasing medical expenditures, hospitals are making less money due to reduced reimbursement, and because of the financial margin of obstetrics. To explain the complex answer further, we need to …
Celebrity is an interesting phenomenon.
On a hot summer night in 1990, my chief resident and I were on call at Harlem Hospital. We were informed that a “guest” was coming to interview us. Hot, sweaty and looking haggard rather than glamorous, we wanted to choke our director when Spike Lee walked through the door with film crew in tow. Lee was there to film the infamous movie, Mo’ Better Blues. …
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