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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I heard his little footsteps at 4:30 a.m. “Mama, the stockings are full. Can we open presents?” I had finally collapsed into bed at 4 a.m. after staying up wrapping, cooking, and stuffing the stockings to make Christmas morning as Norman Rockwell as I possibly could. I told him to hold his horses until 7 a.m. and rolled over for a few hours of exhausted slumber. I was thankful I wasn't ...

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I hugged them longer than any 10- or 11-year-old wants to be hugged by their mom, and tried not to cry tears of gratitude that they were in my arms. The last kid their age I saw was the one I had resuscitated and admitted to the PICU just hours before, and it took my breath away to think about that happening to my sons. I had to make one ...

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One of the terrible things about being a physician who has spent his adult life working in emergency rooms is that you have a certain terrible clarity about the dangers of this life. It’s why we’re forever pestering our loved ones with phone calls and texts: "Are you there yet!" Or telling the children, "Be careful! After midnight there are too many drunks on the road!" Met, of course, with ...

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Man collapses at 30,000 feet. Quick, who’s in charge? Hint: It’s not the doctor. Last month, Dr. Tamika Cross was told to sit down when she tried to help an unresponsive man. Why? Apparently, the flight attendant was looking for an “actual” medical doctor, not a black woman. Turns out she’s not the only doc making headlines for being turned down in a medical crisis. What ...

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Buprenorphine was a fantastic drug in the emergency department. Patients would come to our ED feeling awful from opiate withdrawal, and we made them feel so much better. We can recall so many patients coming in vomiting, anxious, sweaty, dehydrated, and looking awful -- and with one or two shots of buprenorphine, we made them feel well enough to take on the task of beating opiate addiction. A clinic in ...

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It’s August. I’m looking out the windows of our log house and across the immense variety of green leaves, on oak and birch, mountain laurel and sycamore, magnolia and honeysuckle. It’s a rain forest here. Indeed, after a long dry spell, we’ve had days and days of soaking rain, with breaks in the clouds so that the sun raises steam from the earth like water coming up in the garden ...

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Every day, millions of women across the United States find themselves in predicaments confronting the quality of their appearance. And their makeup. While this may seem a non-issue in the emergency medicine world, it is something that you, as a female professional, or that your female colleagues, have no doubt encountered. Before walking out the door, you have to consider not just what means of transport to take to work, but ...

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