"I can't take this, doc. It's gonna kill me. I can't. I just can't," exclaims my patient with persistent refusal of his medication. My frustration is met with my patient care team's hesitation to give him the medication with fear of further conflict and possible escalation to violence.  But who's at fault? Any of us? All of us? My second patient, lying on the MRI table, shaking his head swiftly in ...

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I am an avid social media user, and a news junkie who watches news religiously, even when the same stories are being recycled every hour and on every major news outlet. I am a proud member of Generation X, the generation that did not grow up with the internet and read the news the old fashioned way, every morning with my parents, sharing their favorite newspapers and magazines. Several decades ...

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"Death is not meant to be rushed. Saying goodbye shouldn’t be rushed. Celebrating a life once lived cannot be rushed. And yet, we must. Taking a moment, a minute, an hour, maybe a day to feel something that normally takes far longer. Because we must. And in our hearts, the grief remains. Frozen in time in this state of mourning that ...

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It was a Thursday. It was supposed to be one of those “regular” evening shifts. Then, at 6:15 p.m., my first page went off: Bed 11, Mrs. R., Dr. H. needs to talk to you. The page came from the COVID section of the emergency department. I immediately called back. It saddened me when I learned that our patient was a young woman health care worker in her early 50s. She ...

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It’s that wonderful time of year when new interns take their first steps into hospitals as practicing physicians One of us has just completed her intern year and the other quite a while back (but recently enough to still remember some of it), so we wanted to share some tips for the pediatric interns about to start this wonderful adventure. 1. Don’t be overly anxious (as a little anxiety is expected). ...

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Yeah. I said it. As an anesthesiologist, especially as a cardiothoracic anesthesiologist, there are few things I am more interested in than how well or how poorly your heart functions and why.  And a cardiologist can help me obtain a lot of vital information in that regard.  But there several things a cardiologist cannot, and I argue, should not do, when it comes to the perioperative care of patients. First, a cardiologist's assessment ...

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With a flip of a calendar page, the new academic year is upon us. For much of the workforce, July 1st signifies the halfway point of the fiscal year, and most Americans would say that each new year starts on January 1st. However, those of us in academia, particularly those of us in medical and graduate medical education, understand how significant this day is. It is the day when newly-minted ...

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"Over the last 100 years, the U.S. has had to respond to five avian flu pandemics. The most severe was the 1918 avian influenza infecting 1/3 of the world’s population and killing 650,000 Americans. It was also the last time wide-spread containment, mitigation, and isolation strategies were used in the U.S. Seldom mentioned about the 1918 pandemic are the three 'waves' ...

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"The unparalleled and pervasive nature of the evolving COVID-19 pandemic has touched all of us in some way. There is limited, albeit growing, research on the mental health effects of disasters.  A recent review article pointed out the potentially negative consequences of prolonged quarantine, while other research from Wuhan, China, highlighted the impact of COVID-19, particularly amongst healthcare personnel. Psychiatrists and mental health professionals will play a ...

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In early 2001, my sister was tired, paler than usual. We didn’t think much of it. Then, months passed, and crimson pinpoints appeared on her skin. My brother and I took turns grasping her arm and snickering as our handprints would appear as red dots just a few minutes later. Symptoms amassed silently, but on my ninth birthday in May, something big happened. I remember hearing words like “low blood count” spoken ...

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I feet truly honored to have been asked to speak at your graduation and to have a chance to share on this day with all of you. We are experiencing a truly singular moment, and I imagine you are hoping that I might say something that would be comforting or inspiring, and I really can’t think what that could possibly be. For the last half of your third year of residency, ...

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Ever since the COVID-19 pandemic gripped New York City, I have come to dread calling home to my parents. Every conversation ultimately leads to the question: “Is everyone okay?” This is always followed by a pause as my parents consider how much to tell me. Over the past few months, I learned on an almost weekly basis of a new family member, family friend, or neighbor who was hospitalized, transferred ...

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acp new logo A guest column by the American College of Physicians, exclusive to KevinMD. The recent occurrence of widespread civil unrest in the context of the coronavirus pandemic has challenged us as physicians about our appropriate role in dealing with both. The response of doctors to the pandemic has been fairly straightforward.  The central role of individual physicians ...

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What if I told you that the most important vital sign of the COVID-19 pandemic is likely being incorrectly reported in almost every doctor’s office, urgent care center, and hospital around the country? The everyday citizen probably believes that this is an exaggeration, but most physicians know that this is unfortunately, accurate. Let’s step back a minute. Years ago, terms like sepsis, septicemia, and bacteremia were frequently used in an interchangeable ...

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"Recent articles have accused some physicians of hoarding medications for themselves during our international medical crisis. Authors such as these should be ashamed of their coverage and wasted ability on sensationalism when they could be spending their time informing the public about the dangers of COVID-19 and the actions communities, hospitals, physicians, businesses, and public servants are taking on a daily ...

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The fight. The battle. The conquest. The opponent. The enemy. The nemesis. Our collective descriptions of our response to COVID-19 are analogous to our descriptions of wartime.  We have cast the novel coronavirus as the opposition and ourselves as the mighty conquerors. Reflecting on this portrayal over the past three months – during the final stretch of my medical training before becoming an independent practitioner - I find myself wondering if this ...

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June 25 Like most physicians, I am bad at scheduling my own doctors visit. This year, despite COVID craziness, I had made an appointment with a new PCP to get Singulair refills (my allergies were a killer, and a drippy nose behind an N95 is no joke). I loved my new PCP! She connected with me on a personal level. She dealt with all my concerns without making me come in ...

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Across the globe, the month of March became a turning point for the COVID-19 pandemic. Amidst daily clinical updates, dramatic increase in cases, and rapid policy changes, International Women's Day – an observance that allows gender equality to take the spotlight – came and went. Since March, COVID-19 worsened existing health disparities, further exacerbated by unacceptable police brutality, Read more...

Every day since George Floyd’s death, I have read to my five-year-old, brown-skinned boy about reasons to love his skin. After reading a book that explained how black and brown-skinned people are not always treated fairly, he asked, “Does that mean white people are mean?”

As we discussed ways that systemic racism plays out in society, this was exactly the generalization I feared. In the process of explaining how ...

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In the wake of George Floyd’s death and the rush of similar stories from around the country, many have called to “defund the police.” While critics paint this as a reactionary response to high-profile incidents, the phrase deserves deeper consideration than that. The killings of George Floyd, Ahmaud Arbery, Breonna Taylor, and countless others are not isolated incidents. They are symptoms of a systemic flaw in our criminal justice system. ...

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