A presentation given to the bioethics committee, Sacred Heart Hospital, Pensacola, FL. My presentation today is about the challenge, professionally and emotionally created by certain external forces, which encompasses bioethical issues when one's roles merge. I am privileged and blessed to have many roles in my life: physician, wife, daughter, mother, now grandmother, sister, aunt, friend, and colleague.  At times, these roles blend, other times, they are murky and can cause intense ...

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"How much experience do you have with human suffering?" It was a question asked of me at my first medical school admission interview, and it took me by surprise. I was expecting to be asked about my volunteer experience, my research, or my desire to become a physician. The simple truth is that most of us really don't have that much experience with human suffering when we're in our 20s. The ...

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Medical school and medical training attempt to teach subjective humans how to think and practice medicine objectively. This may be one of the unique fallacies of modern medicine, but that’s a subject for a different blog. Nevertheless, even in the highly emotional field of emergency medicine I’m usually pretty chill. That is, until someone’s dying, and then all of my equanimity can go flying out the window, for better or worse. Such ...

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As I entered the exam room to meet my new patient, I initially thought of the orange-haired heroine in the animated kid movie, Brave. Although the middle-aged woman's hair was not quite as orange as the heroine's, it was long, expansive in breadth and wavy in texture. Her hair seemed to engulf her petite frame. As I looked at her more closely, she appeared rather slim. Her layering of clothing ...

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My patient’s son stood vigil outside her hospital room day and night. His eyebrows were frozen at an anxious angle. Although his mom was healing well from her injury, I could see that he was worried about next steps. He asked staff repeatedly about his mom’s pain management, and reviewed every therapy session she attended. His mom, on the other hand, was deceptively charming. She was a thin, well-groomed elderly woman ...

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I never realized the true meaning of palliative care amidst the harried practice of emergency medicine. The pressure being placed on me to do more often becomes the same expectation I place on patients to receive more treatment. Gloria, the wife of my patient with terminal mesothelioma, shed a light on palliative care for me with the insightful words, “We know that there is no cure -- we just want to ...

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Poor bored government. So much time on their hands; so little real work that needs to get done, all they can do is micromanage poor physicians like me to death. Well, they can try. For its first forty-five years, Medicare was (in)famous for the very narrow limits on things it covered. It would pay for medical care when you were sick or injured, and that was basically it. No preventive care. ...

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On September 12, 2015, the California Legislature passed a controversial bill legalizing physician-assisted suicide. California would become the fifth state to allow doctors to prescribe lethal medication to terminally ill patients who request it, after Oregon, Washington, Vermont and Montana. During the debate over the passage of the bill, everybody weighed in: patient’s rights advocates, dying patients and their advocates, religious groups. The one group that I didn’t hear about ...

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What do I need to know as I age?  While scientists ponder the questions of water existing on Mars and if it can essentially sustain life, my duty it to assess if there is life left in Oliver -- a nursing home patient transferred to the ER. Oliver was not oxygenating well but appeared to be resting comfortably. Reportedly, Oliver had fallen that day and EMS discovered a sizeable bruise ...

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It is a pattern oft repeated in a lifetime: You go to the doctor’s office, get a prescription, and go home. You go to the urgent clinic, get care, and go home. You go the hospital, get better, and go home. But some people are very surprised when they go to inpatient hospice, are stabilized and told to go home. Inpatient hospice could be within a hospital, nursing home, or a dedicated hospice facility. The ...

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