A few weeks ago an emergency room doctor called our infectious disease physician group concerning a patient who had returned from Liberia and was having nausea and vomiting. Several of the patient’s family members had died of Ebola. As panic struck us, our decisive question was: When did he return from Liberia? The Centers for Disease Control and Prevention guidelines for screening and isolating patients for possible Ebola infection are clear: ...

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Instead of being hysterical about Ebola, respect it Some years ago I was in Australia’s Northern Territory. The intrepid explorer that I was, I was croc-spotting from the comfortable heights of a bridge over the East Alligator River. The river derives its name because it is east of something. And because it’s croc-infested. I was reading a story about a German tourist (it’s usually a German) who was attacked by ...

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Oft expectation fails, and most oft there. Where most it promises. - Shakespeare, All’s Well That Ends Well It may seem a strange thing to say, but I believe the U.S. suffers from unrealistic expectations. We expect government, health, and hospital officials to get things right the first time around. This is unrealistic. People, and believe it or not, including politicians, are never perfectly competent in things they are never experienced before. Disease ...

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A month ago I published a post predicting that paramedics, emergency nurses, and emergency physicians would be exposed to patients with Ebola and have difficulty picking out these patients from the many other patients who present to the ED with similar symptoms. In light of the events in Dallas, Texas, this seems prophetic, but it is really not so difficult to explain ...

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Although I never disclosed this in my medical school interviews for fear of being just another cliche ("Hollywood sparks interest in medicine story"), I decided to become a doctor in 1997 at the age of 11 when I first saw the movie, Outbreak. For years and years, this was my favorite movie. The scene where they showed the electron micrograph image of the Ebola virus had me captivated. I was staring at ...

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Ebola in the digital age: How doctors can confront it With the recent attention given to the Ebola outbreak in West Africa and the cases diagnosed in the United States, one of the main ways in which the public is being informed is through social media. Every single day on Facebook, I see at least one story posted about the Ebola epidemic and its potential impact on the U.S. public and ...

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What happens when your faith, commitment and professional integrity collide with great personal risk? This is what I imagine is happening across the country to physicians, nurses and other health care workers as we all face the Ebola tragedy. Sure, people dying in far away Africa bring an ache to our hearts. Admiration for those working with aide groups  brings the passing thought so easily conjured from the safety of our ...

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Over the past several years I’ve written about the inadequate state of clinical documentation, which is largely unchanged since the days of Osler, (except for a bit more structure introduced by Larry Weed in the 1970s) and was created for billing/legal purposes not for care coordination. One of the most frequent complaints in my email box these days is a sense that the current record is filled with data, but little knowledge and ...

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Ebola is frightening but not for the reason you may imagine. A little over a year ago Asiana Flight 214 crashed while landing at San Francisco International Airport resulting in 181 injuries and 3 deaths.  As an emergency medicine resident, this fast-forwarded my training as I took care of many of the patients arriving in our emergency department.  I left that day inspired that I had the education and training to ...

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Recently at our community hospital, after we concluded a nearly two-hour standing room only Ebola preparedness meeting, I practiced donning and doffing the personal protective equipment (PPE) for Ebola cases. PPE is the protective wardrobe health workers wear when examining a patient with a contagious infectious disease. Each disease has a different level of transmission and requires an appropriate level of protection. I wear gloves 25 times a day to examine ...

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