Margaret Edson’s 1999 Pulitzer Prize winning play, Wit, tells the story of the final hours of Vivian Bearing, PhD, an English professor dying of cancer.  Early in the course of her disease, one of her doctors sees the value of her case from a research point of view and asks her to enroll in a clinical trial of an investigational therapy.  In the film version of the play, which stars ...

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Scientific evidence pointed to an extremely poor prognosis. Numbers and statistics emphatically declared her imminent demise. My 33-year-old patient was not going to survive. The physicians presented the data to the mother and recommended withdrawal of care, but she remained indecisive. She struggled for two days with the possibility of her young daughter dying. Her child was in the critical care unit in a vegetative state. It was a parent’s worst nightmare. I took ...

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The recent celebration of Employee Well-being Month got me thinking a lot about how physicians are treated as employees with regard to well-being. There is a general consensus that the issue of physician well-being needs to be addressed at both the level of the individual physician and the level of the system in which physicians work. Unfortunately, this insight has thus far failed to lead to significant improvement in the overall ...

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A lone figure stood at the entrance to bed 14, intensive care unit 2, floor 15-North. Though it was 2:30 a.m., he stood with rapt attention. He looked out over the hallway, eyes scanning. He looked like a gargoyle brooding over his castle, protecting it. He looked unlike anyone I’d ever seen in an ICU. He was a slightly pudgy yet wholly muscular 5′ 10” or so, with a few days ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. Recently, I’ve been thinking about how physicians express condolences. This weekend, I attended calling hours to visit with the family of a recently deceased patient. As I drove back from the funeral home, I tried to recall when I started to attend my ...

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I have never wanted to be the medical advice columnist. “Dear Dr. Leap: My feet sweat all the time. I’ve tried everything! What should I do?” Nope, I’m not your guy. Nor do I want to opine on study after study about statin drugs for cholesterol or discuss whether women should take estrogen. There are physicians who love those questions! And I think they’re fantastic. But I’m an emergency medicine ...

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I am a practicing hospitalist physician in Dayton, Ohio. Dayton has emerged in the last year as the city with the highest per capita death rate from opioid overdoses. When we measure the number of deaths here we talk about how many there are per day, not per week or month. We have been inundated with heroin and other products laced with fentanyl or carfentanil. Every other drug, including marijuana, ...

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Recently, I had the privilege of presenting the Clinical Specialty Award for General Surgery at the 2017 Graduate Awards Celebration at Western University of Health Sciences College of Osteopathic Medicine of the Pacific (COMP-NW). It was amazing to hear all the accomplishments and meet so many wonderful new doctors in this year’s class. I also got the opportunity to meet a few proud parents and professors. The list of accomplishments of ...

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My husband, the anesthesiologist, came home one evening, he was solemn, affected, not himself. His patient died in the recovery room. It was sudden and unexpected for my husband. Despite the team’s swift efforts and perfectly executed code, the patient died anyway. It’s relevant to note that his patient was an almost 90-year-old man with significant congestive heart failure, probably chronic kidney disease, and complete occlusion of one of his ...

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Some days, it is about crossing paths with others that bring a smile to your face. Here is one such individual. Sitting in my office was my new patient and her husband. She was a just-pregnant Brazilian woman wearing a warm smile; he was an older, overweight, unkempt American who sat uncomfortably in the chair. I imagined he had never been to a gynecologist’s office and was perhaps unsure what to ...

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