Sometimes the minuscule moment is the most relevant; the least anticipated becomes the most profound.  Endless searches for wisdom and insight fade with each passing day, only to be shadowed by an unintentional conversation or event.  Wisdom is profound in the simple, while often hidden, complicated or forgotten in the complex or intentional.  This ironic phenomenon is as old as time, obvious in God's creations and man’s discoveries.   I’ve reached ...

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“CODE BLUE, 7 SOUTH. CODE BLUE, 7 SOUTH.” I’m up and out of my call room bed before fully regaining consciousness from my light sleep. It’s 4 AM. I should feel ready: I’ve trained with simulations labs, mock codes, and test questions. I passed my CPR and ACLS courses. I’ve done chest compressions as an intern. But this is different. I’m the resident on call, and if I get there first, I’ll be running the ...

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The report from the field was not promising by any stretch: extensive trauma, and perhaps most importantly unknown “downtime” (referencing the period where the patient received no basic care like CPR). The patient remained pulseless en route; we were all aware of the markedly poor prognosis. On arrival, the patient was swarmed by providers. Trauma surgeons at the foot of the bed cut down at the femoral artery to deploy a ...

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It’s almost 7 p.m., and I’m handed the chart of a man in his sixties. “Can you see this one first,” the nurse says, “he needs an ultrasound.” I skim the triage note, which is often like reading the blurb at the back of the DVD. If it says “pain all over for eight months,” it’s not likely to be a hot new rental. Frank Martin (name changed) has been sent from a walk-in ...

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It’s the first day on my 4th-year elective in the emergency department. I had orientation in the morning and just my luck I am scheduled for a night shift. I had the good fortune of finding an emergency physician in New York who let me shadow him before my rotation, but the truth of the matter is, I had no idea that what I was getting myself into. I guess ...

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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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