Afshine Ash Emrani, MD
Afshine Ash Emrani is a cardiologist.
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Physician voices
Human life is a gift. Death, too, can be a gift. Is it ever appropriate for us to choose the timing of our death? Brittany Maynard, 29, was diagnosed with a stage 4 glioblastoma, an aggressive and uniformly fatal brain…
Human life is a gift. Death, too, can be a gift. Is it ever appropriate for us to choose the timing of our death?
Brittany Maynard, 29, was diagnosed with a stage 4 glioblastoma, an aggressive and uniformly fatal brain tumor. With the blessing of her family and millions of supporters around the world, she ended her life in Portland, Oregon, with a fatal dose of barbiturates prescribed by a physician. …
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Is it ever appropriate for us to choose the timing of our death?
Physician voices
Dear Robin, You were such an inspiration. You showed us courage in the face of adversity, making us laugh while your own soul was broken. Even now, at the time of your death, we find ourselves in a recently forgotten…
Dear Robin,
You were such an inspiration. You showed us courage in the face of adversity, making us laugh while your own soul was broken.
Even now, at the time of your death, we find ourselves in a recently forgotten place where all people — regardless of faith, color, or country of origin — stand united, sending out love to you and your family.
You …
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Medical lessons from Robin Williams
Drugs and prescribing
The scientific literature is replete with the failure of vitamins to support diseases. Yet, the industry is booming and people's cabinets are filled with potentially harmful, poorly studied colorful bottles that make unsubstantiated magical claims. This year, we witnessed Dr.…
The scientific literature is replete with the failure of vitamins to support diseases. Yet, the industry is booming and people’s cabinets are filled with potentially harmful, poorly studied colorful bottles that make unsubstantiated magical claims.
This year, we witnessed Dr. Mehmet Oz, a celebrity doctor who frequently extols weight loss products, supplements and vitamins on his syndicated television show come under fire from regulatory committees for false claims and poor outcomes.
The …
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Vitamins are not magic. We need good science and better sense.
Physician voices
Last week, I took a 6-day vacation. Two days before and two days after, I put in a total of 32 unpaid hours of work which was cut short by a call from my daughter asking me why I am…
Last week, I took a 6-day vacation. Two days before and two days after, I put in a total of 32 unpaid hours of work which was cut short by a call from my daughter asking me why I am working during my time off. While away with my family, I ran into people of different walks of life and noted …
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Doctors still work while on vacation
Drugs and prescribing
There is a new emerging health threat to our children: nicotine poisoning. The number of nicotine exposures in children reported to the National Poison Data System has more than tripled in the last year. Here’s the fact every parent should…
There is a new emerging health threat to our children: nicotine poisoning.
The number of nicotine exposures in children reported to the National Poison Data System has more than tripled in the last year.
Here’s the fact every parent should know: 1 tablespoon of nicotine oil can be lethal to a 60-pound child!
When doctors were campaigning against tobacco companies through public health legislation, we did not foresee a resultant new market for …
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E-cigarettes are an emerging threat to children
Physician voices
When I first met Ralph, he was 82-years-old. He suffered from shortness of breath which started when his wife of 56 years was diagnosed with a rare bone cancer. Upon further investigation, I diagnosed him with a weak heart and…
When I first met Ralph, he was 82-years-old. He suffered from shortness of breath which started when his wife of 56 years was diagnosed with a rare bone cancer. Upon further investigation, I diagnosed him with a weak heart and a very tight aortic valve which required immediate surgery. Ralph made it; his wife died. Today, twelve years later, he brings me treasures from his metal detecting hobby on the …
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A prayer by a physician
Health policy
Overwhelmingly, doctors’ reimbursement has been the target of government programs and insurance companies. The idea underlying this movement has been, pay doctors less and curtail their incentive to see patients and the cost of medical care will decrease. As a…
Overwhelmingly, doctors’ reimbursement has been the target of government programs and insurance companies. The idea underlying this movement has been, pay doctors less and curtail their incentive to see patients and the cost of medical care will decrease. As a result of this faulty reasoning, we have ushered in the era of unhappy doctors, those retiring early, and those asking for extra payments to justify the hours needed to give …
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To cut health care costs, pay doctors more
Conditions and diseases
Cardiovascular disease still remains the number one cause of death in women. Heart attacks account for 24% and strokes 7% of all deaths. Among minority women, these numbers are even higher. The challenge remains that doctors traditionally have not identified…
Cardiovascular disease still remains the number one cause of death in women. Heart attacks account for 24% and strokes 7% of all deaths. Among minority women, these numbers are even higher. The challenge remains that doctors traditionally have not identified women at high risk of stroke. Internists and cardiologists do not routinely think of stroke prevention in women, and neurologists have been busy treating stroke victims and have had no …
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How to reduce the risk of stroke in women
Conditions and diseases
I received a panic call from Jim, who had been a patient for over ten years. His 5-year-old daughter had passed out. Amanda was rushed to the ICU for new onset diabetes. After stabilization, she was transferred by helicopter to…
I received a panic call from Jim, who had been a patient for over ten years. His 5-year-old daughter had passed out. Amanda was rushed to the ICU for new onset diabetes. After stabilization, she was transferred by helicopter to a university hospital for an insulin pump insertion. He knew that her life, his life, would never be the same.
Two weeks later, I received another call from Jim. This time, …
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The depressed may appear like you and me
Health policy
The worst news in health care is not antibiotic resistance, drug-drug interactions, hospital acquired infections, lack of communication between systems of medical records, and certainly not the alarming rate of obesity in our youth. The worst news is the increasing…
The worst news in health care is not antibiotic resistance, drug-drug interactions, hospital acquired infections, lack of communication between systems of medical records, and certainly not the alarming rate of obesity in our youth.
The worst news is the increasing number of dissatisfied physicians.
The physician, also known in the system as a “provider,” has been the direct target of assault by the government. The logic has been that if the physician …
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Dissatisfied doctors can’t provide good patient care
Physician voices
Merrill Markoe's reports that she was fired by her doctor in her article, "My Doctor, the Concierge," which was both sarcastically entertaining and painfully true. She writes a powerful commentary on the divide caused by insurance companies between doctors and…
Merrill Markoe’s reports that she was fired by her doctor in her article, “My Doctor, the Concierge,” which was both sarcastically entertaining and painfully true. She writes a powerful commentary on the divide caused by insurance companies between doctors and patients. She is shocked at the rapidly growing trend of an access fee to see concierge doctor and yearns for the Hippocratic Oath’s “May I long experience the joy …
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Don’t blame doctors for going concierge
Physician voices
It was the first time I had every flunked a test. My fragile ego was shattered. It was my first year at University of California, San Diego School of Medicine, one of the most difficult to enter. I failed my…
It was the first time I had every flunked a test. My fragile ego was shattered. It was my first year at University of California, San Diego School of Medicine, one of the most difficult to enter. I failed my pharmacology test, not because I was stupid, not because it was difficult, but because I was clinically depressed.
A dark cloud covered my head and I could not see. Much of my …
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We should not succumb to spiritual darkness
Physician voices
As the year comes to a close, we physicians feel tremendous uncertainty with the rain of change from Washington. As I approach my third decade of medical practice, I feel more distant from the patient who desperately seeks my attention.…
As the year comes to a close, we physicians feel tremendous uncertainty with the rain of change from Washington. As I approach my third decade of medical practice, I feel more distant from the patient who desperately seeks my attention. I struggle daily to reconnect with her, recalling the fading reasons I embarked on this field, trying to resuscitate the patient-physician relationship which is central to our broken medical system.
Often …
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