“Peace is your home, integrity is the way to it, and everything you long for will meet you there.”
– Martha Beck
In 2017, the blueprint I had crafted for my life evaporated before my eyes.
Up until that point, I had systematically checked off the steps to becoming an Air Force oral and maxillofacial surgeon. I was in the Air Force, and I was in oral and maxillofacial surgery (OMFS) residency. I …
2 insight-provoking questions when starting over
I don’t think I became a whole person until my mid-30s. When you spend the majority of your life in school, training, and building a practice, everything else goes on hold, or autopilot. There are very few things that I made conscious decisions about. Becoming a doctor was something I decided in childhood, and then it was a mission that I felt I needed to achieve. Every action in my …
A physician was bullied and fired by the bully
I’ve been as guilty as anyone of leaving my patient out on a limb. As a practicing primary care physician, I’ve had patients with diabetes who observe Ramadan, but I had no idea how to support them during their fast. I’ve had transgender patients yet didn’t have the right language to talk about their health, and nothing in the electronic health record (EHR) seemed designed to support them. I’ve sent …
The center of gravity in health care and the role of primary care
In most professions, the pecking order is clear, even when there’s no formal designation.
Take pro football. Although nothing in the rulebook grants status or authority to certain players, everyone knows the starting quarterback is the most valuable person on the field. That’s because no other player can do more to win (or lose) a game.
You might assume the same type of logic applies to medicine. If saving …
Restoring the value of primary care
Throughout history, ancient tribes practiced cannibalism with the intent of bolstering their own courage or energy by consuming their defeated enemies. They wanted to be what they ate: full of courage and vigor. They would even eat their enemies to vanquish their energetic spirits before they ascended to the afterlife.
Christian Communion also practices the consumption of the figurative blood and body of Christ. It serves as a remembrance …
We are not defined by what we eat
I entered my Manhattan apartment around midnight, roughly an hour after observing a transplant team recover kidneys and a liver from a young patient newly pronounced dead. Still wearing scrubs, I sat down on my bed, and, like a ghostly twin or guardian angel, watched myself spill tears.
The scene I witnessed in the operating room that evening as a second-year medical student was at once grotesque and hallowed, shocking and …
A photographic exploration of the physician’s inner life
To spend an entire college year (two semesters) studying epistemology seemed like a colossal waste of time when I was 19. We had no choice; we had to take it, and I got a pretty good mark, as I recall. It took a half year to find out what it was about, but it seemed to concern itself with how we obtain knowledge. There is inductive reasoning and deductive reasoning …
A primary care physician’s gut feelings
Oh no, it’s a doctor hopper. You know who I’m talking about: the patients with twenty previous doctors documented in their chart. The ones who took years to be diagnosed. The ones who still have not been diagnosed, but insist something is wrong. They’re just jumping around until they get their way, you seethe.
Really?
Every doctor’s appointment is a commitment of time and money for a patient. I think I speak …
How about those doctor hoppers?
For many of us, the term self-care is synonymous with self-indulgence. I used to think so too. Our thoughts immediately race towards behavior requiring us to take time away from our loved ones or shortchange them of our responsibilities.
As a child, I looked to my parents as prime role models. They were first-generation immigrants from Iran who were trying to uphold their …
How this physician’s self-care awakening helped her lose weight and take control of her health
We all need hope. It is powerful and its absence is devastating. Hope allows us to move forward and to dream. Over decades of practice, I have found it to be the most powerful medication I can give a patient.
When we dispense hope, we must be as honest as we are with any treatment. False hope must be vigorously avoided. It is lying. In giving false hope, we might deprive …
Since the beginning of COVID-19, we have recognized the truth of philosopher George Santayana’s oft-quoted 1905 writing — “Those who cannot remember the past are condemned to repeat it” — and looked for lessons from the 1918 Spanish flu, the deadliest pandemic of the 20th century. Much was different, yet so much the same. There was no testing, treatments, or ability to prevent the virus then beyond shutdowns, masking, distancing, …
Looking back on 2 years of uncertainty, adversity and more than a few silver linings
In health care circles these days, you hear about the social determinants of health (SDOH) almost as often as you hear: “You’re on mute!” SDOH are the conditions in the places where people are born, live, learn, work, play, worship, and age that affect health outcomes. These non-medical factors like income, socioeconomic status and access to health care, safe housing, and reliable transportation drive …
Coding for social determinants of health and unmet social needs
Very few are talking about workplace bullying, yet many are benefitting from it. It acts contrary to the principles of care at the heart of medicine — and we need to do something about it.
How many physicians have wanted to leave medicine because they were subject to horizontal violence or bullying in the workplace? Who has felt undermined, belittled or humiliated when showing up to work on a daily or …
Let’s talk about bullying in medicine
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I have deep roots in the Benedictine tradition at St. John’s University, MN. I took my first steps in Guild Hall, graduated from St. John’s Prep School and University, and later married my wife Ashley at The Abbey church. My understanding of the biopsychosocial and spiritual aspects of the human condition grew from these formative years at St. John’s and inspired me to become a physician and leader. I’m grateful …
From the ground up: an invitation for self-care for physicians and health care professionals
Over the past few decades, we have seen a huge swing in our patients’ perceived quality of health care. In the case of the COVID-19 pandemic, individualism in health care has been taken to an extreme. Because of misinformation from non-medical sources, autonomy, which was expected to lead to a more medically educated public, has instead resulted in widespread mistrust of the medical establishment. With that, many if not all …
Ubuntu philosophy in health care
Many of us in health care tend to have qualities that brought us to our professions, which hinder our self-care. We tend to be self-sufficient to a fault, at times lacking the humility to acknowledge or accept we need help. We may also think we are invisible and that we can endure all suffering we witness or experience without any need to process what we experienced emotionally. Additionally, we have …
You take care of others all day. Here are 11 ways to care for yourself.
U.S. health care is going to hell in a handbasket, but only as patients can we alter this. Centers for Medicare & Medicaid Services (CMS), hospital administrators and we patients are all guilty of worshiping at the altar of “patient satisfaction.”
It’s not that patient satisfaction is necessarily a bad thing. As a patient myself, I certainly seek out convenience and satisfaction. A UC Davis study in 2012, …
Only patients can save U.S. health care
Glowing and beaming.
Applying these terms to people has become somewhat dated, but to students of human nature, and especially doctors who meet people under all sorts of unusual circumstances, they still apply.
A former colleague of mine, who worked in general practice in Kansas in his early medical years, went on to an OB/GYN residency and practiced obstetrics until his retirement. He swore that he could tell when a woman was …
Glowing and beaming represent physical evidence of joy in life
For the better part of two decades in medicine, I considered printed journals an old friend. Getting my latest medical journal in the mail, opening it, enjoying the feel, look, and even the smell of the journal was almost like getting a monthly present. During training, Journal club was the substitute I needed for the Book of the Month clubs I could not attend with other friends. To this day, …
The case for ending printed medical journals
There is a particular pang of regret I get when I think about the patients who I have failed to say goodbye to.
By this, I mean when a physician leaves a group or practice, they are often prevented from sharing their next destination. Like most young physicians, I had left my first employer within five years and was barred from sharing my next job details. I had learned in training …
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