"If my father dies, you're going down with him." The words pierced the air, and suddenly there was silence. I hadn't noticed Frank’s son at first. He'd been pacing in the back of the family group gathered in our ICU waiting room. Now, up close, I could appreciate how large and intimidating he was. And I'd just had the thankless job of telling him, along with the rest of his family, a ...

Read more...

Burnout is a popular topic of discussion among health care professionals, but preventing it often eludes us.  While burnout is common in many professions, it is particularly present in health care.  It is estimated that about half of all physicians in the United States suffer from burnout with numbers rising rapidly.  Burnout is associated with detachment from those around us and feelings of isolation.  Burnout can lead physicians to lose ...

Read more...

“Doc, I’m tired.” This is a refrain that we hear from many of our patients who have been incarcerated in California’s prisons for decades. Now past the midway points of their lives, our patients describe how the absence of autonomy -- what they eat, how they dress, how frequently they bathe, how they spend their day, and when they communicate with their families -- has taken its toll, making them weary ...

Read more...

Not far from the busy pedestrian streets in the center of Vienna, down a quiet narrow street, lies a small cobblestoned city square. Before World War II, this city neighborhood was the bustling, vibrant heart of Vienna's Jewish Quarter, but today it is has a quiet, almost subdued feeling. Vienna's current Jewish population is only a small fraction of what it was before the war, and the quiet feel of ...

Read more...

Do you ever have one of those days, when it seems like every patient is coming in for the same thing?  And that you’ll never remember the differences, when it comes to doing your dictations at the end of the day? A few weeks ago, six of my appointments had as their chief concern “ear pain.”  But of course, in the end, no two ears were at all alike.  I love ...

Read more...

Not long ago, one of my elderly patients (who gave me permission to tell this story) began requiring blood transfusions for a condition known as ischemic colitis. Usually, it occurs because there are blockages present in the arteries that supply blood to the colon and, starved of blood, the inner lining of the colon becomes inflamed. But her arteries, it turns out, are normal. So we term her ischemic colitis ...

Read more...

Our two presidential candidates are irksome and infuriating to everyone. We are disgruntled with them. The psychiatrist in me asks the question, why are we so angry and upset with them? The majority of us voted for these two as our nominees. What does all of this say about us? Why have we put up nominees that anger and disgust us? We had sixteen other Republican candidates to choose from and ...

Read more...

Physicians are known to be masters of self-sacrifice, and self-control. They undergo years of training and make substantial emotional and financial sacrifices until they complete their training. The reward at the end of the road is a fulfilling job where he or she can treat people who are in need and enjoy the emotional, personal, and financial fruits of their labor. But is this the reality? At a time when the ...

Read more...

One thing I’ve learned is that physicians who have gone into direct primary care (DPC) practices are passionate about their decision: they not only believe that DPC is better for their patients and their own professional and career satisfaction, many assert it is the answer to just about everything ailing primary care. There is an evangelical fervor among some DPC advocates to spread the word and convert other ...

Read more...

Is it possible to break down a complex phenomenon like professional burnout into a simple triad? We do it for exotic diseases all the time, so why not? I still remember my salad days in med school vividly. Bouncing between the cockiness of amassing an entirely new body of knowledge and the awkwardness of having nary a clue how to use it, it was excitement I hadn't felt before or since. ...

Read more...

Most Popular