I was sitting in the tea room out the back of the country hospital where I occasionally work as an emergency doctor, and we started to discuss the case of Dr. Hadiza Bawa Garba. Dr. Garba is a pediatric registrar from the UK who has been all over the news after being struck from the medical register for doing almost exactly what any one of us would …
The case of Dr. Hadiza Bawa Garba is a tragedy
It’s always a coup when an anti-vaccination organization can convince a physician to join their ranks. They act like it provides a thin veneer of legitimacy to their pseudoscientific cause. This was recently the case with an anti-vaccination organization in Ohio (my home state.) They recruited the former medical director of the Cleveland Clinic Wellness Institute. You may remember his infamous article in the Cleveland Plain Dealer in January 2017. …
When an anti-vaccination organization convinces a physician to join their ranks
This was a momentous week for me. After 14 years of carrying a hospital-grade old-school text pager to receive messages at work, I finally traded it in for a cell phone app. It should have been easy to get rid of my beeper. But instead, I felt waves of nostalgia when I turned it off for the last time. Those 240-character, pre-Twitter, low-resolution LCD messages follow the arc of my …
Farewell pager, I’ll always cherish the memories
I work as a pediatrician in a bustling metropolis, in an outpatient setting of a world-renowned academic center. One of those non-profit hospitals you see in television ads. For the last three years, our outpatient encounters have plummeted, and the mothership has put all efforts into recuperating financial losses. Meanwhile, our office phones are ringing off the hook, and we cannot seem to hire enough nursing staff to deal with …
Dear Mom and Dad: Are you calling your pediatrician’s office too often?
Lines are slowly being taken out of the small infant, his bruised and discolored arms continuing to ooze. Machines and circuits, one by one, are being shut up and turned off. Leads and wires are carefully taken off of the lifeless chest of the once critically ill, but alive infant. Just hours ago, physicians, nurses, and other providers were rushing in and out of the room, desperately doing everything they …
The huge impact a dying infant had on this physician
This week I had some particularly emotionally tough cases at work, and it got me thinking about life in general and how, in spite of having a tough job, I have learned so much from it.
When I think of childhood diseases, there are the ones that are chronic, the ones that let you process that your baby is sick and has a potential life-threatening condition. You have weeks and months to …
What I learned from the ICU (other than medicine)
I lightly knocked on the door of the next patient that I was set to obtain a history from. It was late in the morning in the middle of the week, and my mind was becoming increasingly preoccupied with deciding what to eat for lunch. My preceptor had allowed me to practice my history-taking skills with every patient that had an appointment with her that morning and had also given …
How a symbol influenced this patient encounter
There I was, an awkward 13 year old sitting in the doctor’s office. For the past two weeks, I had been complaining to my mom about rib pain, and she had scheduled a visit to the pediatrician. I was very active — I played softball constantly — and she wanted to be sure I hadn’t broken a rib.
“Where does it hurt?” the nurse asked me.
“Right here,” I said, pointing to …
A #MeToo moment with a pediatrician
I remember the moment I first saw a female chest X-ray. It was my own. My lecturers in the first months of medical school showed a few chest films, but I failed to recognize that the bodies all looked the same. I proudly showed my sister my clear lungs. She laughed and said, “I can see your boobs.” I looked again at mine with new eyes, taking in the dull, …
Medical education systematically ignores the diversity of medical practice
I am pediatrician who has been practicing for almost twenty years. During my career, I have been employed by two different free-standing children’s hospitals, a non-profit community-based health center, and now I own my own practice. In every setting, I have had to generate coding and billing for my work even when my salary was independent of that billing.
There is no other profession that would dutifully learn the “rules” of …
Insurance companies manipulate the doctor-patient relationship for financial gain
You’ve probably already seen the news: A 6 year old boy in Florida has died of rabies. He had handled a sick bat (some reports said he was trying to rescue the critter), and that was enough contact to transmit the virus. Once symptoms begin, rabies in almost always fatal — so the only way to prevent this from happening again is to avoid contact, and get rabies …
Your questions about rabies: answered
So you heard the flu shot is 10 percent effective.
With so many sources of information available, the primary care provider’s role increasingly becomes that of educator. It is important to me that the parents of my patients make informed decisions, so when I have a parent decline the influenza vaccine, I make an effort to ask why. The number one response I hear has been “What’s the point? The flu …
So the flu shot is only 10 percent effective. Here are 5 reasons to still get it.
Dear Boys,
I am so blessed to be your mom. You each have amazing personalities, unique talents, and special characteristics. I know someday you will grow up and be strong men. Kind men. Respectful men. Successful men. Men like your grandfathers. Men like your father.
Someday when you go out into the world, you will find yourself working with all different kinds of women. You will work for women, beside women, and …
A physician mother to her sons
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My pediatric practice is one which harkens back to days long ago when physicians knew their patients and pertinent medical histories by heart. My 81-year-old father and I were in practice together for the past 16 years; he still used the very sophisticated “hunt and peck” to compose emails. The task of transitioning to an electronic record system seemed insurmountable, so we remain on paper. Our medical record system has …
A 16-page note with little information to help physicians
We’ve known for some time the prevalence of obesity is growing among Americans — not just adults, but children, too. Obesity is associated with a long list of medical problems, including heart and other vascular diseases, diabetes, and joint problems. It is encouraging that recently the seemingly inexorable growth of pediatric obesity prevalence seems to have reached a plateau. But we still have a future problem looming for population health as …
Childhood obesity is a grave threat to our nation’s health
Pediatric physeal fractures have traditionally been described by the five-part Salter-Harris classification system.
Type I fractures occur through the growth plate. These injuries may present with normal radiographs, and the diagnosis is often made clinically when tenderness is palpated over the growth plate.
Type II fractures occur through the growth plate and metaphysis. Type II injuries are the most common physeal fractures.
Type III fractures occur through the …
Learn about Salter-Harris fractures with a Medcomic
In my off time, as a mom and a physician, I spend a decent amount of time lurking in a rather strange environment, even for the internet. A place so filled with anxiety, stories of ill-chosen spouses and little glimpses of unbridled joy, that you’d think you were somehow inside a taping of the Real Housewives of This-crying-baby-makes-me-hope-that-I-end-up-having-a-dissociative-fugue. You know, *that* place.
Online mommy groups on Facebook.
And, there I am, lurking …
A physician lurked on Facebook mom groups. Here’s what she found.
“This is a 17-year-old boy who came in as a category 1 trauma yesterday for a rollover MVC with bilateral uncal herniation, epidural hematoma and subdural hematoma currently intubated and sedated with propofol and fentanyl.”
As the overnight resident presented this patient on PICU, we could see everyone’s early morning smiles fading slowly and beginning to understand the grave consequences anticipated in this severe traumatic brain injury. We could see the …
Here’s what you learn when a young patient dies
I majored in history of religion in college and have always had an interest in the places various twists and turns of theology can lead people. One relatively recent wrinkle is what has been loosely termed “prosperity gospel” or “prosperity theology.” It’s built upon the basic notion good things happen to good people, and bad things happen to bad people. Of course, that’s a foundational viewpoint of much of Christianity in the …
How religion helped this physician in the PICU
At this place again.
Place: Neonatal ICU.
Time: 3 a.m.
Location: Bedside of a sick preterm female. She is intubated and on the ventilator. Antibiotics course through her veins. Blood transfusions, IV fluids and vasopressors support her in the fight of her life. Lab tests are checked, and adjustments are made to meet her needs.
Her parents sit beside her isolette. They watch the monitor, silently begging the numbers to give them some sign, …
Here’s how to take care of yourself in difficult times
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