I've only had to declare death a couple of times. Once in a three-year-old and once in an adult. In each case the heart had stopped beating. Death was clear.Brain death is tougher to cope with, both clinically and psychologically. I imagine it would make anyone want to say, at some point, "Are you sure? Are you really sure? How do you know? How can you be sure?" Some times ...
Anesthesioboist T., MD
Don’t always blame anesthesia for problems in the OR
People blame anesthesia personnel for everything. You name it, they blame us for it. They call us by the umbrella name "Anesthesia" and if there's a problem, it's always "Anesthesia's" fault.Got into the room late? Blame Anesthesia. (Even though the anesthetist's been sitting at the bedside for twenty minutes waiting for the surgeon or the nurses to be ready.)Patient craving ice cream when she woke up? Must be Anesthesia's fault.No ...
Doctors don’t take snow days
Editor's note: This post was originally written this past winter.Boston had another blizzard today. I was really worried about this one. It was supposed to snow hard, about three inches an hour from 3 a.m. to 12 p.m. with poor visibility, impassable roads, etc. I've driven home in snow like that, and I find it terrifying. Your car won't do what you want it to, and worse, other people can't ...
Calling in sick serves as a reminder for compassion for this doctor
One of my Facebook updates on my private account was that I "have a love-hate relationship with interleukin-6. Yes, macrophages and T cells, I know you are doing your job, but how many proinflammatory cytokines does it really take to fight this thing? What's that? Be grateful you guys are even working? Oh, all right. I'll shut up and eat my soup now."Yes, I've been sick this week. It started ...
Can a doctor and a nurse be friends in the OR?
One of my best friends in med school was an O.B. nurse. Though she has moved almost all the way across the country and I haven't seen her since I was in school, we're still in touch and expect to be seeing each other at last in a couple of months.By some coincidence one of my best friends now is also an O.B. nurse. I'll call her Ziva (yes, I ...
Never forget to advocate for your patient
There are some lessons we learn and keep re-learning in medicine. For me some of these recurring lessons are,
- Listen to your "gut."
- Pay attention to the clues.
- Listen to your team.
- Don't be afraid to call for help.
- Stick to your guns when advocating for your patient.
Should humanities be the focus of prospective medical students?
There's been considerable buzz on the web recently - on the New York Times website, on Facebook, and on a physicians' forum called Sermo, at least - over a New York Times article recently entitled, "Getting Into Med School Without Hard Sciences."The article describes the Humanities and Medicine Program at Mount Sinai Medical School, a program which each year admits into the medical school 35 undergraduates who major ...
Health care reform controversy in both Europe and the United States
On my way onto the plane for my recent flight home from France I picked up a copy of Le Figaro thinking I might enjoy the article about actress Sophie Marceau, who was on the cover of everything while we were in France in celebration of her turning 40.I did enjoy catching up on Marceau - I still remembering watching La Boum in my high school French class - but ...
Treating people with humility, and every patient like a V.I.P.
People often seem to think that members of the medical world are excessively preoccupied with, defined according to, and ruled by a status-oriented system.That may have been an accurate perception a generation ago, but I've seen enough surgeons sweeping O.R. floors, attending physicians socializing with interns, and doctors having deep conversations with custodians to believe that "medical people" have matured a little past the old caste systems that governed the ...
The grief men face when their wives undergo mastectomies
I have given anesthesia for a lot of breast surgery. I don't think I'll ever get used to the fog of pain and sorrow surrounding a double mastectomy.All surgery is invasive in some way. Amputations, in particular, have a horror all their own; the idea that destroying someone - cutting off a body part, violating a coherent whole - should be necessary in order to save a life is almost ...
