I am naturally a problem solver, and I share this characteristic with most of my fellow physicians. When I felt burned out at one point in my career, I was certain that a literature search would help me solve the problem by giving me answers I could use to make my burnout a thing of the past.
My research, within the academic literature and information on the web, led to some …
An excerpt from Twenty-Six.
5 a.m.
“Reminder to everyone, morning round at 6, lots of new patients,” flashes a message from Puta on the residents’ WhatsApp group.
It’s dawn, and the first rays of sunlight illuminate the corner of the bedroom. I roll over, but the alarm clock on my phone keeps ringing. …
I saw a patient recently with a new brain tumor. She came with an internet search that suggested she had five years to live. I cannot beat that predictive confidence. The best I could do was to poke holes in the assumptions that servers and algorithms had made, to question the arc of the future, and finally to tell her that the tumor was small, likely benign, with minimal effect …
At one point, many of us will ask the questions, “Am I going to die? Am I safe? Who can I count on? It could be as you face your mortality or find yourself in a dangerous situation. Or, as it has been for many frontline health care professionals while facing a job-related risk like contracting COVID-19. Medical professionals are not the only ones who have experienced high levels of …
Every day, in my job as an anesthesiologist, I am called upon to manage conflict. Sometimes, it’s between two members of my team, sometimes it’s between coworkers, and many times it is a conflict I may have with my own co-worker or peer.
Whether it’s because someone I supervise is chronically late or underprepared, I have to go …
An excerpt from The Heart of Fear: A Surgeon’s Collection of Stories on Adversity, Passion and Perseverance.
Each step is calculated.
Each step is deliberate.
Each step is taken with the goal of saving a life.
Everyone needs a hobby, but skydiving can predispose you to precarious scenarios. When you’re in a high-stress situation, your training kicks in. You do what you need to do to regain control, deploy your reserve, and fly your …
An excerpt from All Bleeding Stops.
Megan continues to take his blood pressure every few minutes. With growing tenderness Denis watches her fidgeting with the IV, biting her lip, eyes flitting from one machine to the next, desperately seeking the reassurance she knows will never come.
She thinks she’s not a good doctor because she hasn’t memorized enough textbooks or performed enough …
Advancements in health IT have created ease and efficiency in delivering health care that has never been seen before. Electronic ordering and prescribing have reduced medication errors from misinterpreting handwritten information. The interoperable transmission of critical patient history, lab work, and digital imaging from one hospital to another has reduced costs and unnecessary extraneous tests. Virtual care and telehealth utilization during the COVID-19 pandemic has revolutionized how patient encounters are …
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In this episode, we’re joined by Emmanuel K. Konstantakos, an orthopedic surgeon, and Jeff Morris, an attorney and CEO of the American Board of Physician Specialties. They discuss the ongoing debate about physician board certifications and the …
Working with and supervising residents takes a certain degree of trust. Empowering residents with trust can be a difficult proposition for educators. There’s a moment early in the career and education of an anesthesia resident where they earn the trust of their faculty and supervising attendings. This moment is not contingent upon the memorization of a textbook or the demonstration of intubation skills. It doesn’t depend on the recitation of …
An excerpt from The Medical Jungle: A Pioneering Surgeon’s Battle to Revolutionize Vascular Care and Challenge the Medical Mafia.
Still no matter what anyone said, I knew in my heart that endovascular grafts and endovascular aneurysm repair were going to be a game-changer and that vascular surgeons had to get involved …
“Musta been the ham sandwich,” he said as he leaned onto the operating table and belched a couple of times. We were halfway through an operation, and Doug, my partner, didn’t look all that good. I’d been in practice for all of a year, still greenish, and he, ten years my senior, was my guardian angel, my guide through the vagaries of the world of private practice, and the best …
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I ran across one of those bordering-on-sappy Facebook posts that always pull me in, asking people to describe their job poorly and make it comically accurate. The photographer admitted she would flash clients, shoot someone, and then frame someone else. The bartender alluded to being a psychiatrist, marriage counselor, babysitter, and thirst quencher. You get the picture.
I am sure that each specialty in medicine has its own pithy, confuscating …
The skill
Patient safety, patient experience, workforce health, and cost-effectiveness are critical outcomes with an important common root. They’re all impacted by our ability to communicate effectively and respectfully. Additional terms to describe these skills include people, interaction, interprofessional, relationship, and social skills. They can even be used to describe behaviors inherent in many properties of complex adaptive systems, such as the butterfly effect, flexibility, and adaptability. The more we understand …
An excerpt from Doctor Zhulik.
Christmas Eve
“You know, you’re the worst f*cking intern I have ever seen.”
“I don’t know why the hell you’re even trying to become a surgeon, Appleby. You have the manual dexterity of a chimpanzee.” A heavy man, Bernstein’s belly burst out of the gown, threatening to push …
The senior medical student is hours into her on-call shift on her surgical rotation. She’s been up since four, exhausted, and can’t remember if she had eaten anything since breakfast. The staff surgeon on call “pimps” her on surgical anatomy, pointing at the various arteries and veins in the patient lying in front of them on the operating table. The student has difficulty remembering the various arteries and nerves while …
Surgical training has long been confined to traditional models of Halstedian apprenticeship, where trainees are guided—but also potentially limited—by their superiors. Within this dynamic, the transfer of knowledge from expert to learner is dependent on individual educators, which can then be easily affected by personal circumstances and potential unconscious biases.
Physicians are often busy and rightly focused on patient care, but this can lead to uncaptured and delayed feedback for …
When the COVID-19 pandemic began to dominate all aspects of health care, many of our colleagues opted to wear scrubs instead of their routine work attire and white coats. They cited concerns about personal infectious risk and not wanting to bring the virus home to their loved ones on their clothes. This reluctance aligned with research on the white coat as a nidus for infection, but it conflicted with the …
Historically, the Canadian health care system has decided what should be done for the care of the population.
Who gets care, when and where, what is a priority, what delays are tolerable, and what degree of saturation is acceptable in a Quebec emergency room? This paternalistic approach is obsolete.
A modern service company must be interested in the needs and desires of its clientele.
Other than in the health …
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