Flossie Marks used to complain now and then about shortness of breath on exertion. She never had chest pain and, after all, she carried firewood from the basement to feed the wood stoves and fireplaces in her large Victorian house. At 81, who wouldn’t be a little short of breath doing that? Last summer, she finally sold the house where she and Eli had raised four children and hosted nine grandchildren ...

Read more...

We all went into medicine to save lives. Deep within even the most cynical of us, is still that pre-med hopeful that believes we can and should restart each non-beating heart, make the non-breathing breathe and fill with blood those who’ve bled, filling them back with life. We expect that a patient’s condition will improve while under our care, or at least not worsen. Intellectually, we know we’ll not be ...

Read more...

Patients admitted to the hospital ward sometimes get sicker instead of getting better right away.  Often this can happen acutely. Depending on the circumstances, ranging from a "rapid response" for unstable vital signs to a cardiac arrest (a "code”), previously uninvolved hospital staff might be called on to help.  Despite the commotion, these events are a period of time for the health care team to shine.  At inpatient emergencies, ...

Read more...

You live like this, sheltered, in a delicate world, and you believe you are living ... And then some shock treatment takes place, a person, a book, a song and it awakens [you] and saves [you] from death. - Anais Nin On June 12, 2013, my driver and I were on our way to Sierpe, Costa Rica from Manuel Antonio when the road entered a palm tree plantation.  About 50 meters in ...

Read more...

This place sucks had become my mantra as I powered through every bloody, chaotic, understaffed shift. Fresh out of residency, I had accepted a job in the ER of a community hospital which -- though it had appeared calm, functional, and replete with helpful consultants during the 15-minute tour I took during my interview -- had turned into exactly the opposite when I was slugging through the night shifts alone and disgruntled ...

Read more...

I will always remember my awkward medical school interviews. Filled with bioethical scenarios and questions to measure my ability to prevent an impaired physician from practicing, the interviewers seemed hardly interested in my prior career achievements or humble beginnings. Such discussions carried on through the first two years of medical school. They never taught us how health care reimbursement works or why different specialties pay differently, but there were plenty of ...

Read more...

This isn’t a debate about vaccines. The fight here has nothing to do with that. For the record, I strongly support the concept of vaccination. Public health is better in the 21st century because of it. Measles? Mumps? Oh, I can find you in the United States, but we aren’t living our lives every day petrified of an outbreak. Smallpox? Polio? Where did you go? Not here, that’s for sure. And, ...

Read more...

michael davidson This week the local and national attention has been riveted on accusations that Bill Belichick and the Patriots football team deliberately deflated the footballs used in the division championship game.  Football, remember, is a multi-billion dollar industry in which the commodity being sold is grown men throwing brown, oblong balls at each other and knocking each other down.  Boston.com, a ...

Read more...

american society of anesthesiologists A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. In an emergency, the first question people often ask is: “Is there a doctor in the house?” When you have a medical problem, the best advice is, “Ask your doctor.”  Most people automatically assume that “doctor” in this context refers to a physician with a ...

Read more...

1. Before anything, advertise yourself as a protector of the public against incompetent physicians. 2. Design the examinations for each specialty with a “one size fits all” approach. You can achieve this by disregarding the fact that many physicians prune their practices over time to accommodate to the demographics of their communities and their availability of specialty care. This has particular significance for internal medicine and family medicine. Also, by including a large ...

Read more...

378 Pages

Most Popular