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"Three Fleet enemas?" I ask the nurse. She isn't much interested in a conversation with me about anything. She is busy. "This man, so far as I understand it, does not have a colon." It looks to me like they want to reconnect his colon," she says as if I hadn't said what I just said. "I am not a doctor," I remind her, "but I don't see how that is possible. Too ...

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As I held the shaky, sweaty hand of my 52-year-old African American patient, lying in her ICU bed, trembling with fear, tears rolling down her eyes, she gathered enough strength to utter “I can’t breathe.” Her words felt like a punch in my gut, eliciting a visceral reaction, with flashes of George Floyd’s body pinned to the ground, running through my mind. The events of the last few weeks had given ...

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As medical students with backgrounds in public health and global health care operations, we were shocked by the action on the part of the Trump administration to defund the World Health Organization (WHO). This decision undermines the global community's progress in combating the COVID-19 pandemic and will ultimately cost the lives of thousands of individuals. To appropriately support the WHO, it is critical to understand its vital functions and limitations, ...

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"When I first heard about medical schools fast-tracking graduation for students and shifting young residents into high need areas to fight the pandemic of COVID-19, I thought of how panicked those students and residents must feel. Asking them to step in to fight a battle we don’t know how to win, and envisioning them witnessing the suffering and death of multiple ...

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The COVID-19 narrative is strong and pervasive: we must sacrifice either jobs or lives.  This debate has seemingly polarized our society on moral and ethical grounds. For many healthcare professionals, the intrinsic value of life is self-evident.  No price can ethically be placed on the value of health and human life. Fortunately, from an economic point of view, the choice between the economy and health might be a false dilemma. The intersection of ...

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Primary care is at the heart of each and every health care system. Effective and efficient primary care leads to positive health outcomes across the board, most notably lower rates of mortality and hospitalization, and higher life expectancy. But to achieve such results, primary care needs an integrated system to support efficient care delivery. Despite the diligent work performed every minute by doctors, nurses, and other clinicians, ...

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A colleague of mine once asked me a question that haunts me to this day: “If you care about social justice this much, why are you in medical school?” I was stunned, and I had no response to offer them. That day, I walked away to preserve my peace, but I have an answer now. I have an answer for every doubter who believes that it is not a physician’s job ...

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Recently in Minneapolis, George Floyd was killed by Officer Derek Chauvin, who held his knee on Floyd’s neck for more than eight minutes, including almost three minutes after Floyd was unresponsive. This senseless murder is now added to an already long list of occurrences of police brutality that disproportionately affects communities of color. The need for an independent autopsy to confirm the ...

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It’s 4:30 a.m. as I trudge to the parking garage with a sense of defeat. I am an internal medicine resident wrapping up a swing shift, the magnanimous buffer to admission responsibilities between the day and overnight ward teams. Though clinically tucking in patients that arrive before six o’clock is often easily accomplished well before midnight, this time had been different. Not two hours into the shift, I reached my ...

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Coronavirus has overwhelmed hospitals, staff, and supply chains, stripped many Americans of health care coverage along with their jobs, and affected billions of people worldwide with mounting fatalities. Despite its massive human toll, the pandemic offers the promise of a much-improved health care system for the future. Our response to this tragedy paves the way for integrated, value-based health care systems in which patients receive the care they need without exhausting ...

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In anticipation of the strain on resources and staff in New York City, part of the battling strategy included deployment calling for providers from all areas to directly devote their efforts in the care of COVID-19 patients.  Despite being relieved temporarily of the role of a nephrologist, the COVID-19 population soon showed that managing renal disorders was still part of daily duties. With COVID-19, providers have been ...

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The stereotypical orthopedic residency class looks like a construction scene from the Flintstones, a few burly white men playing with tools. I can spend time here listing off different statistics and percentages showcasing why orthopedic surgery is the least diverse specialty in medicine, but just the fact that the stereotype is what it is should be enough. With this history in mind, it was almost a shock to see AAOS ...

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A guest column by the American College of Physicians, exclusive to KevinMD. Since the beginning of the COVID-19 pandemic, the signs have been everywhere – celebrating the heroism of health care workers. It's a wonderful sentiment that as a physician personally makes me feel very good about our profession and what we do. It's also ...

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This pandemic has taught us that undergraduate medical education is nimbler and more adaptive than we have previously assumed it to be. COVID-19 has propelled medical schools into an online, remote learning age. It has beseeched educators to creatively deliver new means of teaching human anatomy, pathophysiology, and clinical skills. It has driven administrators around the world to revise graduation requirements to enable students to enter ...

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"The USMLE has failed the medical education community, and subsequently, future patients, as medical students will undoubtedly have irreplaceable damage from this experience; however, like all tests, it is possible to learn from mistakes and improve. In these unprecedented times, we as students understand the need to be flexible, but in return, we ask not to be forgotten and left abandoned ...

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Like a lot of doctors my age, I was too busy to have checkups, working 60 hours a week plus night and weekend call. But that all changed in 2013 when at age 67, my dentist felt a submental lymph node. A CBC had 35,000 white cells, and I had chronic lymphocytic leukemia. When I told my wife that patients with CLL live a long time and die of something ...

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Strangulation and traumatic asphyxia. Not even a few days ago, according to the Hennepin County Medical Examiner, that is what likely killed George Floyd. Later, they decided it was neither and instead of corroborating what America watched an officer do in a harrowing video – suffocate a man to death – they decided Floyd likely died due to underlying health conditions and potential intoxicants in his ...

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I know you don't know me, but I feel like I know you from your transparency and radical honesty in all of your public communications. I know that you speak truth to bullsh*t while remaining civil. I know that you are more than aware of the lack of adequate mental health services across the nation. I know you see the catastrophic toll medicine takes on the mental health needs of ...

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Seven years ago, I took a hot yoga class in a packed studio, an R&B playlist bumping loudly, the woman next to me sporadically singing along with the music. Afterward, she smiled at me and said, “It was nice to practice with you!” I was new to yoga, and this was the first time I considered yoga as a practice, a word signifying a skill performed repeatedly in order to ...

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