Gather round kids! Let Grandpa Doctor Leap tell you a few things about the old days of doctoring in the emergency room: Back in the good old days, medicine was what we liked to call "fun." Not because it was fun to see people get sick or hurt or die, but because we were supposed to do our best and people didn’t wring their hands all the time about rules and ...

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The U.S. rings the bell on health care spending, and some point fingers at patients themselves. But why do patients choose the paths they choose? Just about every shift, I and my coworkers shake our heads, and wonder what may be driving our patients’ decisions. Parents who haven’t yet tried a drop of acetaminophen bring kids in at 2 a.m. with fevers. Patients show up with nose bleeds that ...

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For those who are not avid followers of President Trump or his decisions, often his decisions have far-reaching consequences that affect lives and people.  As a health care provider, I understand quick decision making, but also the importance of risk versus benefit and consequences of your decisions.  I would like to tell you my story and how his actions have affected my life, the lives of my patients and their ...

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It was 3 a.m. and 3 degrees outside, and I was about to discharge Mike from our emergency department for the third time in less than 24 hours. "Doc, let me finish this episode," he said, his eyes glued to the TV in the ER waiting room. Mike was homeless, and this was our routine all winter last year, when it was too cold to sleep in shop doorways or the bridge under ...

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Brian is one of the coolest nurses I have ever met. Overall, he is a cool dude. Sporting a sleeve of tattoos, he has swag. We have been side-by-side in many traumas and sick medical arrests. He always remains calm, cool and collected as he navigates the resuscitation bay. So, when Brian ran into the pediatric ED looking a little flustered, I knew we were in for something. “I just got ...

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Basing medical care on patient satisfaction is as smart as basing elementary education on child satisfaction. The patient who wants a cheeseburger while going to the OR shouldn't influence hospital reimbursement any more than the child who wants recess all day should influence school reimbursement. By tying health care funds to the opinions of patients, we are letting the kids run the school. Doctor-patient relationships are based on the trust that ...

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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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