My career is based on communication and empowerment within the medical world. I educate on the patient/family side and the medical professional side. It takes understanding and empathy from both sides of the stethoscope to optimize communication. It takes communication between both sides to bridge perceived power differentials. It takes work on both sides to change a culture of uneven power dynamics.
I read two Facebook posts within the past few days dealing with a …
The nightmare sickens me. A small child trusts a man to protect her, take care of her, and shield her from harm. The man, for incomprehensible and useless reasons, neglects her unto death. For me, when I think of Germanwings flight 9525, I am haunted by the photo of a single tiny girl, taken in the last days of life; the obliteration of that perfect life’s potential. Waste, tragedy, evil.
She was lying there stretched out, her mouth open, her eyelids sealed, her fingers straight, immobile, and paler than an image made of wax. From out of her eyes came two streams of tears flowing slowly down onto the pillow …
For forty-three days, Charles did not leave her. He neglected his patients; he sat up every night, he was constantly taking her pulse, applying sinapisms, cold-water compresses. He sent Justin to …
I recently attended the David Stroud Adolescent and Young Adult [AYA] Symposium at Keck Medicine of University of Southern California. It was a very interesting symposium with experts in adolescent and young adult cancer presenting on many different topics important for this population. There was also a panel of young adult …
New York officials are doing an “experiment” that should strike fear, anger, and outrage in the hearts of doctors who take care of Medicare patients. (New York has the highest Medicaid budget of any state.)
As any doctor who has a high volume of Medicaid patients knows, Medicaid pays practically nothing. Doctors who take Medicaid usually have to carry a bigger patient load to survive. Medicaid patients are often sicker than …
Popular TV doctor, Gregory House’s favorite adage about patients is: “Everybody lies.” I used to believe that this was a cynical and inaccurate statement, but I had to revisit it recently when faced with a patient whose signs and symptoms were consistent with a diagnosis that she vehemently denied.
A young woman was admitted to my rehab unit with brain damage of …
I practice gastroenterology in Cleveland in the dark shadow of a large medical institution whose name contains the name of our city. They are a world class medical institution whose reputation is largely derived from its cardiovascular department. Presumably, these practitioners, like all doctors, advise patients who smoke that cigarettes have deleterious health effects. The entire campus is smoke-free, as …
Medicine is filled with intricacies and subtleties about the human condition. Within these nuances, and embalmed with the science of the profession, lies the true art of medicine, a concept not hastily understood, nor easily defined. Although the practice of medicine continually changes in response to new biological understandings, novel technologies, and evolving cultural contexts, the ethical foundations of the clinical relationship between patients and physicians paradoxically remain constant. …
I recently sat down with a well-known physician within the orthopedic community as well as among the medical socialites of social media. When I walked into his office, the first words out of his mouth were about my attire. As I was concerned about first impressions, I broke out the fancy suit, custom tailored, of course, a matching shoe and belt …
I remember being more confident that most of my peers. The look of dread on my fellow interns face pre-call, and the fatigue post-call always seemed unnatural to me. Maybe it was on account of my lifelong pursuit of medicine. I felt nothing but elation at the newly branded “M” and “D” that came after my name on the hospital badge. I was no longer a volunteer, no longer a …
A couple of weeks ago I was on-call and had to go down to the emergency room to see a patient. Before I entered the room, I was told that the patient was accompanied by her long-time physician who was a bit “crazy and old school.”
“Hmm … that’s strange … why would her physician be in the room with her?” I …
As the rugged beauty of the Pacific Coast unfolded in all of its splendor, I was in awe of the entirely different experience: the one created by our Uber driver, Calvin (name changed to protect anonymity).
My friend and I, attending our annual cardiology meeting in sunny San Diego, carved out a few hours of rest and relaxation. We were heading to La Jolla, a scenic seaside community about 20 minutes …
“Doctor, I have trouble breathing when I walk up stairs, and I cannot lie flat in bed, so I have to sleep sitting in a chair. I feel much worse than before I got pregnant.” I recognized the diagnosis at that point, but I continued the appointment to confirm my suspicions and to revel in the art of medicine.
I listened to the young woman’s lungs, full of crackles from fluid backup, …
I’m walking very slowly with my dad down the produce aisle at the local supermarket, past the colorful waxed apples, Mexican mangoes and Rainier cherries, and imagining my life’s blood trickling onto the floor from an invisible wound.
As I pass by the misting system spraying the bins of green, red, yellow and orange peppers, past the lady reaching for carrots, past the stock guy balancing the heirloom tomatoes into a …
Spring is here. The days are getting longer. The temperature is slowly getting warmer. Green stuff will start poking through the ground and popping out on trees. We’ll see more of our neighbors, since they won’t be trying to get from their cars into their houses (and vice versa) as quickly as possible before they freeze.
Pollen allergies will start up again. And grass allergies.
So many people suffer from the watery, itchy eyes, itchy, …
I’ve just finished sitting through a wonderfully aptly named lecture: Probability and Statistics, in which, among other things, we learned (again) that the utility of various clinical tests depends at least as much and generally more on the patient and condition involved than on the specific test itself. From stress tests to mammograms to PSAs, the relationships of true and false positive and negatives, positive and negative predictive values all …
Sometimes, after crafting an important or complex plan of care with a patient, I say: “Let me type all this into the computer so that, in case I run into that big bull moose up on Vaillancourt Hill on my way home tonight, the next doctor who sees you will know what we were thinking today.”
Patients sometimes squirm or laugh nervously at that, but then they usually indicate understanding and …
I respect your First Amendment right to exercise free speech. In regards to your recent comments on doctors, however, your words don’t matter. Here’s why.
There is a concept known as the beauty of medicine; I attempt to capture it in the following paragraphs.
If you present to the emergency department with acute chest pain, we will work you up for …
As a traveling physician, I’m often asked if I have a favorite place to work. Since I have licenses in 14 states, I have an unusual vantage point from which to compare hospitals. I know that people who ask this question presume that my answer will be heavily influenced by the town where the job is located, and all the associated extra-curriculars, environmental peculiarities (ocean, mountains, desert), and potential amenities. …
As with the beginning of each new year, the word “improved” gets bandied about: improved patient care, improved patient satisfaction, improved efficiency. Physicians are constantly being told to push past their burnout and embrace multitasking for the sake of improved health care delivery. Patients are told to “hurry up and wait” as they line up for health care like lemmings on the top of a cliff.
