I was recently scrolling through my Facebook newsfeed when I came upon a long message chain started by one of my friends, an older woman from my hometown in New Jersey. She had seen a discussion given by a drug representative who was promoting administering Gardasil to early adolescents for the prevention of cervical cancer, and my friend wanted to know how other parents felt about allowing their children to ...

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In neurology clinic, I was asked to see a young man with epilepsy -- a seizure disorder -- due to cerebral palsy from birth. It was one of my first clinical encounters of my first rotation of medical school, the tenuous transition from knowledge-absorber to translator and caretaker. I walked in to find a patient who was wheelchair-bound and largely non-verbal, and who interacted with the world by tracking gaze ...

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"Hey, Rick. They warned you about me, I hope?" My routine med student opening line elicits a slight smile from my balding forty-two-year-old patient and the patient's wife. As we shake hands, I continue the script. "I'm Nat -- the medical student. What brings you in today?" "Well, I'd like to transfer my care to this clinic. We've brought my medical records." Together, they heave stacks of papers onto the desk. Rick's hands slide ...

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This past month has been a particularly difficult one for me because I’ve been on our float rotation. I have worked only night and swing shifts throughout our hospitals; this means my work hours are primarily from 8 p.m. to 10 a.m. There are certainly other rotations during which I worked longer hours and had more emotionally draining conversations, but I have never felt as burned out as I have this ...

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Post-apocalyptic portrayals of medical school. Depressive symptoms in 43.2 percent of resident physicians. 34.1 percent of medical students experience burnout by third year, and that percentage increases during residency, ranging from 41 percent to 74 percent by specialty. We lose hundreds of doctors each year to suicide, at a rate that is twice as high as the national average. Burnout increases the risk that a physician will make a mistake, which ...

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Curiosity and apprehension. I experience this tension as a young man ushers me through large daunting doors with “Authorized Personnel Only” posted in bold red letters. Inside, a massive machine dominates the room, and yet my focus turns to the patient lying on the table, face covered in a white mask holding his head still while the technician targets the malignant brain tumor. “All right in there?” the specialist asks, and ...

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There's been a bit of kerfuffle over resident duty hours lately. For those unfamiliar with the topic, physicians in training in the United States have traditionally lived in the hospital -- hence why they were called residents -- and available to patients 24/7.  Over time, concerns about patient safety led to limits on how many hours could be worked consecutively in the hospital.  In 2003, the maximum number of ...

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“She is not yours to grieve.” That statement, from another physician, hours after Ava died and as pent up tears rolled down my face, left me embarrassed and ashamed. The message: She was my patient, not my child. Never mind the amount of time and tenderness I had poured into her care during the month she spent in the pediatric ICU. I had no right to mourn her death. I am a doctor. As ...

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As physicians, we are trained to look for change. We look for changes in lab findings and change medications, and we ask our patients, “what has changed since I saw you last?” We are always trying to get our patients to change in one way or another. Doctors are hardwired to seek changes that produce a dopamine release in our brains. We love it when patients see an improvement in ...

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On my medicine sub-internship, I took care of an elderly man who was a retired military surgeon. When he first came into the hospital, mentally altered from an underlying infection, he was irascible and unpleasant towards many staff members, swatting their hands away as they attempted to draw blood for lab tests. As the infection came under control, the shell of rage fell away to a quiet dissatisfaction. The bed was ...

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