Another backboarded body rolls in. I slip from my perch at the computer and greet the emergency medical technician. “Seizure. Lasted a few minutes, done by the time we got there. Fell and cut his face.  Vitals stable. Sugar fine. Oriented but postictal.  Didn’t take his meds.” Approximately my age, the backboarded man’s chin bears a ribbon of red laces. “Dammit,” he says. A glance at the cardiorespiratory monitor shows me suitable hemodynamics, ...

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An American poet and political activist, Muriel Rukeyser, said the universe is made of stories, not of atoms.  I believe her. As a seasoned storywriter and storyteller, I walked gingerly into the adult emergency services for my first shift as a volunteer at a legendary New York City public hospital. I sported a crisply ironed red polo with “emergency department volunteer” embroidered in white stitch. Armed with a pocket notebook and a ...

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One of my most treasured stories as an ED physician belongs to a lovely couple who valued quality of life. It was a routine day in the ED when an elderly woman rolled through the ambulance doors on a cold, narrow stretcher, unaccompanied by family. She was placed in bed 5, which is where we met. She was frail and her memory was poor. The EMS run sheet reported “change ...

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Medical scribes are a burgeoning field with many institutions and practices exploring their use while the many commercial enterprises who lease out scribes are pushing for their widespread acceptance. There is no accepted definition of what scribes do or what their background or training should be. There is no mechanism for licensure of them in any state. They are poorly defined medical assistants. The field is in its infancy and ...

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The day I graduated from medical school and walked across that stage with my diploma in hand, I was sure that I had achieved the highest honor in the land.  I could not help envisioning myself in a long, crisp white coat, walking down the long hallways of the hospital, with my name badge perfectly displayed that read: "doctor." I was certain in my mind that I had finally made it.  ...

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A Southerner at heart, I find myself in love with places.  We are forever pining on about our family homes, our small town barbecue restaurant, the sound of some lake where catfish splash in the night, or the woods where our favorite treestand sits.  Sometimes our afflictions for place become the stuff of novels; Scarlett O’Hara is always associated with her beloved Tara just as Faulkner is ever infused into ...

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Physician colleagues and their hospitals have been the targets of direct attacks during the past three years in Syria. According to UN war crimes investigators, Syrian forces have deliberately targeted hospitals, attacked field hospitals, and prevented patients from receiving medical care. A United Nations Commission of Inquiry independent panel published its findings to draw attention to what it called “an enduring and underreported trend” in the conflict. The report ...

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After a relaxing weekend with my daughter, son-in-law and 2-year-old grandson, my wife and I made our way to the Atlanta airport to begin our trip home. The end of a trip -- even a short weekend -- is always sad. I never look forward to the travel home and usually want to snap my fingers and skip the travel. My wife and I have trouble packing light and so, when ...

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I heard this on the radio recently: Mom takes her new baby to the emergency department on a weekend because she thinks her daughter might have a urinary tract infection. She's right, but regulations say the baby has to stay in the hospital for two days to ensure the infection clears. Afterwards, the mom is surprised by and concerned about a $7,000 hospital bill for the baby's care. The reporter says ...

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Think for a second about the most treasured drug or device in your medical bag.  Or about the procedure you find most appealing, the disease or injury you most enjoy treating.  Personally, I really enjoy doing lumbar punctures, opening abscesses, placing IO lines and applying splints.  And because I’m an emergency physician, I am duty bound to say that I love to intubate ... and I do. I also enjoy doing ...

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