My wife who is eight months pregnant went to a routine prenatal appointment last week. She told the OB doctor that she was concerned she had pink eye. OB providers, along with pediatrics, family medicine, and internal medicine all constitute primary care providers (PCP) and pink eye is a common primary care condition. Surprisingly, the OB physician referred her to the nearest acute care facility. Attributing this provider's recommendation as rare ...

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Seconds after I arrive at the ER on a Sunday afternoon, I'm called to see an elderly woman who can't breathe. She's ninety-four, and gurgling for air. On my way, I pass two middle-aged women. They are hovering outside a nearby room, trying to get my attention. One gestures like a traffic guard as she tries to wave me into the room. The other throws up her hands as I ...

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How in the heck would three nurses and I ever orchestrate ECMO in the middle of the night in my community ED? I pondered this over tuna tartare while listening to ivory tower docs discuss cutting-edge modalities like they were part of treatment algorithms everywhere. The conversation turned to REBOA, and I wondered how many academicians had ever manned a single-coverage ED. Ivory tower medicine and my world, where ...

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For soldiers, there are many fears.  Will I do my job?  Will I succeed in my mission?  Will my colleagues in arms be harmed?  Will I be injured?  Will I die?  For the American Muslim who volunteers to engage the enemies of the United States on foreign soil, there is a new worry.  What will my home country do to my family while I am gone? Recently, Dr. Ghazali A. Chaudry, ...

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A friend of mine recently had a very sore throat. She knew how to manage her symptoms — lozenges, warm tea and the like. But she was worried she might have strep and would, therefore, need antibiotics. That should be a simple question to answer with a quick trip to the primary care clinic. Except that her primary care physician was booked, and if she wanted an unscheduled appointment with ...

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I remember that morning in January 2016 very well.  I opened up my Twitter feed to find many people linking to an article that made me stop dead in my tracks.  The New York Post was reporting that Dr. David Newman had been accused of sexually assaulting a patient in his emergency department.  He was accused of giving the patient a dose of propofol and then sexually assaulting ...

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Recently, Dr. Michelle Herren, a professor of pediatric anesthesiology at the University of Colorado and Denver Health Hospital, resigned after posting racist comments on her Facebook page. In particular, she wrote that Michelle Obama speaks “ebonics” and stated that our first lady has a “monkey face.” Dr. Herren ended her post by affirming that she is not racist but was “just calling it like it is.” This post remained on ...

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I remember the early trials of thrombolytics; not for stroke but for MI. During my residency, we were still comparing tPA with streptokinase. It was pretty incredible stuff. Now we’ve moved beyond that positively "medieval" method of treating heart attacks and have advanced to incredible interventions in coronary and cerebrovascular disease. Furthermore, we are able to rescue more and more people from the brink of death with advanced medications and with ...

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Recently, my friend had a patient. The guy, patient with a history of autoimmune disease came in with pain, anxiety, and tachycardia.  She walked in and felt the psychosomatic overlay. What was her intervention? Meds? Psych? Nope. She closed the door, held his hand, pulled out her mom self and let him tell her for 15 long minutes about his hard life. The nurse watched the monitor as his heart rate dropped in ...

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"Well?  Did you save him?" "No. We did better than that." He came in pulseless. The machine performing chest compressions with the rhythmic thud, thwack, thump. His ribs heaving under the force of the compressor, keeping his heart artificially beating. The plastic tube secured in his airway forcing puffs of air to inflate his lungs.  His skin slightly purple-gray, on that narrow brink between life and death. His eyes like speckled ...

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