On July 1st, four years ago, I walked through Massachusetts General and Brigham and Women’s Hospitals with an odd mixture of fear, relief, and excitement. Now, as I leave the hospital after my last shift of emergency medicine residency training, I am filled with a similar hodgepodge of emotions and reflections. 1. "You were terrified of being a doctor!" I mentioned this article to the attending who oversaw my first shift as ...

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It’s not surprising that physicians fear lawsuits, as more than 61 percent of doctors older than 55 have been sued at least once, according to the American Medical Association. But is this fear completely justified? I believe that the media tends to sensationalize malpractice with stories about high judgments and horrific cases. The facts are this:

There was the time I was hugging a trashcan in the lobby of the community hospital ED just a few blocks from my house. Not because I have a molded plastic fetish or because I like the smell of trash, mind you. I had an itinerant renal calculus, otherwise known as a kidney stone that was moving through my urinary system. It. Hurt. Like. Hell. I. Wanted. To. Die. I was throwing up ...

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Several years ago I cut my hand badly on a broken glass and required surgery to reattach a tendon. For a few weeks after the operation, I attended regular sessions in a physical therapy department devoted to people with hand injuries. There were no closed curtains in the large therapy room — we bared only our hands, after all. As I had my fingers warmed, splinted, or stretched, I observed ...

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This past weekend I spent time relearning some life lessons. On Saturday, I picked up a couple screens from the hardware store to reinstall them after they were nearly destroyed by our neighborhood bear. The bear seems to think she will find the birdfeeder that used to hang nearby, so she stands on our deck and leans on whatever is nearby (our screened porch) while she looks for it. Then she heads ...

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Henry Morgentaler died recently. He was the man who almost single handedly brought down the Canadian abortion law. Sickened by what was happening in filthy, clandestine clinics he began doing safe, albeit illegal, procedures in his office. He was arrested but always maintained that a jury would never find him guilty. And he was right. Years later when I was in medical school and then residency I marveled at ...

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One of the benefits of being an oncologist is that, as a rule, people appreciate our work.  That does not mean they want to hear about our day, and the response when someone learns my vocation is rarely, “Hey, that’s sounds like fun!” Nonetheless, at least there is a modicum of respect.  However, I found a group of people with major questions about the work of cancer docs or at least ...

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Medical care in the U.S. over-promises and under delivers. It costs about twice as much as in most other developed countries, but compared to them manages to produce only mediocre health outcomes. The profit motive has resulted in badly misallocated resources -- too much testing and treatment for people who don't need it and lousy access for many who do. The impact of advances in medical science on the delivery of ...

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Medscape published an article titled, 4 Top Complaints of Employed Doctors, and it was a very interesting read. Turns out the things employed physicians complain about are basically that they are employees. Let me lay out these employed physicians gripes for you with a little detail so you will see what I mean. I will finish this article with a solid way to address all of them. These gripes are ...

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By typical end-of-life definitions, Nelson Mandela is dying (he is in critical condition after a lengthy hospital stay, and has had multiple recent admissions). Those of us in the healthcare professions see this end-of-life equation all of the time: increasing severity of illness and frequency of hospitalizations plus advanced age almost always equals dying. Now, everyone likes to believe this equation may be altered by hopes, prayers, and modern medicine. ...

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