It's the beginning of October, it's Sunday, and it's been an uneventful shift thus far. However, in exactly seventy minutes, a patient that I've just seen -- one that I think has nothing more than an upset stomach -- will collapse and begin a fight for her life. I'm at the nursing station scribbling on a chart when a lanky man leans over me, a toddler in his arms. He's looking at the ...

Read more...

These seem unrelated, but give me a chance. I was eating outside at a restaurant with my 5 month old, Max, and a car with a modified muffler hit the gas right in front of us. In Australia, you'd call the driver a "hoon." The noise terrified my boy, and I felt something I'm not used to: protective rage. When Max stopped crying my mind went to struggling families, kids, ...

Read more...

It was 2 a.m. on a typically hectic Friday overnight shift in the emergency department. A young woman, Kelly, checked into triage, accompanied by her older boyfriend Jim, who explained that Kelly had abdominal pain and some vaginal bleeding. Jim wanted her checked out and maybe some pain medicine to help her rest at home. Kelly had no identification. She appeared younger than her stated age of 18. I also noticed track marks ...

Read more...

I was saddened to hear that one of my favorite libertarians, the wonderful journalist John Stossel, has taken ill. True to form, however, he's taking it in stride (he nonchalantly quipped, "seems I have lung cancer"), and I want to take this opportunity to wish him very well indeed. I enjoy his reporting and writing, and have learned a great deal from Mr. Stossel over the years. But that doesn't mean he's always ...

Read more...

I remember seeing so many charts in my career on which the well-meaning emergency room physician wrote the following:  "Follow up with your primary care doctor."  Or, if they didn’t have one, "Follow up in one week with a primary care doctor."  I laughed to myself.  Usually, the people we say that to have either no insurance, inadequate insurance or inadequate motivation to even call the persons to whom we ...

Read more...

Monday morning. As I click through the usual beginning of the week barrage, I open an email from my ER chief. My heart drops into my stomach, where it begins to race. He's forwarded a letter of concern from a specialist from a different hospital. It's about a patient that I failed to help, and failed to diagnose, so she had to seek help elsewhere. As I read the details, I remember the case. I pick ...

Read more...

In 1991, I took a sub-internship in cardiology with a clinically-minded attending named Eddie Atwood. One day he stopped me in the hall: “You have a few minutes toward the end of the day?” “Sure. What’d I do?” I just knew some sort of defining verdict headed toward my Dean’s letter, to be shown to all residencies and preserved in an archive of medical student iniquities, was surely coming. “You students are ...

Read more...

I settle into the bent-wicker chair on my lanai and try to relax. It’s a perfect island day, the temperature warm, the breeze cool, and I gaze out over the pool to the tops of the coastal mangroves. I’ve just come home from a shift at the local free clinic, and my mind is occupied by the work we did today.  My fourth-year medical students encountered some difficult patients, and ...

Read more...

I have a lot of ER stories that involve drug addiction and drug seeking behavior. I knew a patient who intentionally dislocated his shoulder three times in one day to receive pain medication. Another had a friend who stole an entire dirty needle box in order to rummage through it for injectable drugs. I have been told by patients that pain pills were eaten by dogs, stolen by neighbors, lost in ...

Read more...

It's October, and it's beautiful outside; warm, sunny with a lazy breeze. Colorful. Two hours into my ER shift, I meet Bridgette, a 77 year old who volunteers four days a week. She arrived by ambulance, but walks easily, and feels silly for being here. She sits comfortably on the exam table and tells me her story: Two hours earlier, she was gardening at the seniors’ center when she had a sudden sharp pain in ...

Read more...

Most Popular