I ring the doorbell, waiting patiently outside. I hear a weak “coming” and some shuffling. Who greets me is a mother in her robe, hunched over at the waist, supporting her protruding postpartum belly. Her hair is disheveled. Her mask is revealing exhausted eyes with attempted mascara to look a “little freshened up,” she confesses a little later.
“My husband is just getting the baby; please come in.”
I …
Now is the time for postpartum home visits
One thing, which is constant in health care, is that it is continuously evolving. The challenges health care leaders are facing are not simple. They are often multifaceted, which require strategic, creative, and inclusive solutions. There are competing priorities and goals. Critical thinking has become an essential skill for all healthcare leaders.
Here are five simple tips to help you practice your critical thinking skills.
1. Ponder on the challenge. Spend as …
5 power tips to refine your critical thinking skills
Today at work, a mother asked me what I would do if it was my son in the isolette and not hers.
It’s not the first time I have been asked this. I understand where the question comes from, and yet I’m at a loss of what to say every time. Not because I haven’t pondered it before. No. It’s because I have asked myself the question far too many times: …
Being a neonatologist and a mother
Growing up in Puerto Rico, “babas” (bottles: biberón/botellas) and “bobos” (pacifiers: chupetes/chupón) were very common among the families and children of the island. I still remember our Abuelita giving us milk in our “babas,” so my younger sister and I were sure to fall asleep better. From the time of our births, to when my sister was three years old, the “bobo” was also consistently being used in our home.
Now, …
Bottles and pacifiers: advice from a Latinx pediatrician
It’s that wonderful time of year when new interns take their first steps into hospitals as practicing physicians One of us has just completed her intern year and the other quite a while back (but recently enough to still remember some of it), so we wanted to share some tips for the pediatric interns about to start this wonderful adventure.
1. Don’t be overly anxious (as a little anxiety is expected). …
9 tips for new pediatric residents
Many people looking in on the world of research have perceptions of brilliant minds at work, rapidly putting forth groundbreaking ideas. While they’re not entirely wrong, I discovered that this arena of fascinating new discoveries is not always so rapid and not glamorous at all.
As a clinical trials research associate, I learned that research is hard. I found that testing and implementing theories and postulations takes time and dedication. I …
The truth about research: Lessons learned by an aspiring physician-researcher
As I write this, hand sanitizers, disinfecting wipes, gloves, and masks are sold out everywhere in the panic over COVID-19. People are writing about increased anxiety, and mental health professionals cite a massive surge in requests for help. Go anywhere, and it is not unusual to see people wearing personal protective equipment. Welcome to my world 16 years ago when my daughter was born prematurely at 30 weeks’ gestation …
COVID-19 is rattling the nerves of preemie parents everywhere
Strange times right now, huh?
The spread of COVID-19 is expected to be massive because the virus is sneaky
I live in Maryland, and our schools are shut down statewide due to coronavirus (COVID-19).
That means that since I’m a pediatrician, I’ve been peppered with questions from patients, family, and friends wondering what they’re going to do with the kids for at least two weeks (and, realistically, probably four or more).
They’re all asking …
This pediatrician says no coronavirus break playdates
I remember lying in my bed after my second delivery in severe pain. With my first delivery, I had already endured a C-section. Four years later, I wanted to experience a “natural” delivery. I opted for a vaginal delivery after C-section (VBAC).
The VBAC quickly turned into an emergency where the maternal-fetal medicine (MFM) physician gave me two options: Get this baby out now or emergent C-section.
My mind flashed back to …
Confessions of a bed-sharing pediatrician mom
Let’s talk about the doctor who is excessively defensive.
I divide this kind of communication blocker into two varieties: physician personality and physician mode of practice. The physician with a defensive personality is one who interprets questions from parents as questioning of her medical judgment. Unlike the supremely egotistical doctor, who is often sufficiently secure in her image of herself that she is magnanimous toward parents who ask questions, the overly …
What to do with the extremely defensive doctor
Every day, children are cared for in clinics and hospitals. And every day, some of them are unhappy about it; some of them deeply unhappy about it.
The contemporary practice of nursing and medical care includes health care providers having to touch their patients. This may include an abdominal exam, listening to their lungs with a stethoscope, or even slightly invasive maneuvers, such as having to put an otoscope into their …
Reconciling consent culture and bodily autonomy with pediatric care
Most of us are, to some degree, procrastinators. We avoid or postpone doing unpleasant things. In this sense, physicians who are avoiders are no different from anyone else. For a doctor, however, avoiding things often leads to poor, or at least less than frank, communication with parents.
One kind of avoidance behavior is when the doctor avoids answering your questions. These doctors do not behave this way because they are poor …
The doctor who avoids answering your questions
An excerpt from Stay Away From My ER, and other fun bits of wisdom.
1. You don’t like to be told what to do. Especially not by arrogant doctors, who act as if they know better, just because they’ve been through a few decades of training!
2. Your …
24 reasons to not vaccinate your kid
Egotism is a common trait among doctors, although most of us keep it under adequate control when dealing with patients. The ideal doctor-parent encounter has been described as a collaboration among equals, each of which brings expertise to the exchange; the doctor knows medicine, the parent knows the child. This is the ideal, although sometimes the reality falls short of it. The way our medical system is now structured gives …
What to do if your doctor is excessively egotistical
The recent pardon of a convicted child rapist by the ex-Kentucky Governor has sparked a lot of controversies. The basis of the pardon was- “the victim’s hymen was noted to be physically intact.” Evolving studies have continuously shown that the hymen is not a reliable or accurate means to conclude sexual assault.
But if physical damage is the only criterion used to assess …
After child sexual abuse, being “physically intact” doesn’t tell the whole story
I’m a pediatric hospitalist, and I know that most days in the hospital are routine. But every once in a while, a patient pierces through your armor, and touches your heart in totally unexpected ways. Willow did that to me.
Willow was five days old and had been admitted because her breathing was not quite right. I first met her in her hospital room, with her dad hovering over her bassinet, …
A patient who touches your heart in unexpected ways
It’s Monday, I recall as I step into work;
“Preparing for battle,” I say with a smirk.
Surviving all weekend with a sick kid in tow,
the parents’ relief as they waited to show
you their child with fever, diarrhea and sneezing,
the one who is too hot, too cold or is freezing,
the one who forgot that a helmet is needed,
the one who is eating too much, they conceded.
The one who still haunts you when …
A poem for the pediatrician on a Monday
No one I knew had food allergy, let alone peanut allergy, when I was a child. I grew up at a time when peanuts were given freely on airplanes, and there was no such thing as a peanut-free table at school. Fast forward to today and the world has changed, with food allergies taking on almost epidemic-like proportions.
I am an allergist and became interested in food allergies …
A father-physician tests if a little peanut a day keeps allergy away
My first transgender patient was a teenager who said although he was born female, he’d protested his gender from the time he could talk. He told a story of being asked, “Well, if you are a boy, where is your penis?” and he pointed to his umbilicus (which was an “outie”). OK, no problem, we have a gender clinic I can refer you to.
When he came back and asked for …
A physician is worried about gender transition in pediatrics
In his article, “Medical education needs to stop burning out students — now,” Augustine Choi suggests the culture of medical education is responsible for increasing numbers of depression and burnout among medical students, and suggests that more programs are needed to address self-care and wellness in order to build resilience.
While I agree that mental health treatment should be readily available and easily accessible to those in …
To extinguish burnout, bring back physician autonomy
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