At the very start of the pandemic last year, I met with a couple of patients in the office while we wore masks. Based on that limited experience, I quickly concluded that seeing each other’s faces was of paramount importance, even if over video. That, plus the infection risk, led me to close my office to in-person appointments. For more than a year, I exclusively conducted …
Remember the dark days of the pandemic, when the true risk of caring for COVID patients started to become clear? Remember when you could be censured by a nursing supervisor or administrator for wearing a mask in public areas lest you frighten patients or visitors?
Right around then, a third-year resident at UCLA decided to wear a mask wherever he went in the hospital, as testing wasn’t readily …
Recently, I solved a medical dilemma by changing the medication that seemed to have nothing to do with my patient’s problem.
Ethan Blake is a thin-boned, soft-spoken man with atrial fibrillation and a history of high blood pressure. He lives alone and prefers to shovel his own driveway. He also loves to walk his springer spaniel in the woods behind his house. He is in great physical shape.
At his routine follow-up …
When I decided to leave practice and explore non-clinical career options, I found no shortage of opportunities, ranging from the pharmaceutical industry to the health insurance industry and many points in between. I chose to work in the health insurance industry because jobs were plentiful, and the focus of work remained on the patient.
A typical entry-level job in the health insurance industry is that of utilization …
My Tuesday out of clinic started off like any other Tuesday. I got up (sluggish, still chronically sleep-deprived), scrubbed my face and brushed my teeth, slipped into workout clothes then set to getting my two girls ready for school. After packing lunches, brushing hair, and waiving to the bus, I sat down to do what most of us do on our days out of clinic: check the dreaded inbox. Who …
For many years I was not certain physical pain existed.
I know this is rude.
But I felt so little of it.
I could only assume that other people did too.
Like a child, with a skinned knee.
“All better,” I would say, and they would look at me.
Quizzically.
And at the knee and decide.
That it was.
I have been disabused of this recently.
With a pinched nerve in my back.
The universe often disabuses me of things.
Painfully.
If necessary.
“Doctor,” …
You have more power than you realize.
It’s no secret that medical providers feel structurally powerless in our chaotic health care system. Control over the volume, pace, and elements of our work often rests squarely in the hands of others. But know this: Your own personal power over your work remains formidable and fully intact.
If you’re stressed out, burning out, and dreading Mondays, you have the power to make quality decisions …
We have been walking down a long hallway for many, many months. We left the room we resided in pre-COVID, but we have not yet found a room to rest. We are in the liminal space of COVID. This is unsettling and unnerving — liminal space often is.
Liminal space in architecture is the area between discrete, functional spaces, a way of passage, but not the place where beds are placed, …
I broke down crying. Again. — In this cold heart, I can live, or I can die. — It isn’t even on my sad song playlist, so why am I so upset? My scientific brain encouraged me to recreate the environment, remove the variables, and play the song again in isolation. — I believe if I just try, You believe in you and I — Oh no, it’s happening a …
Since the first documented COVID death in the U.S. in February 2020, over 726,000 Americans have died. The number of deaths eclipses the death toll of any other American tragedy, whether war or the Spanish influenza epidemic of 1918, and health care providers have been involved with the care of many people who have died. However, grief among physicians over the death of a …
In March 1630, John Winthrop delivered the treatise “A Model of Christian Charity” at Holyrood Church in Southampton, England, prior to leading the first settlers of the Massachusetts Bay colony on their to journey to the New World. In his address, he referred to the new community they would found as a city upon a hill with the eyes of all people upon them. This reference to a portion of …
“When will I go home?” asked the patient.
“Hopefully, by the end of the week, if everything goes well,” said the doctor.
“What do you mean by ‘if’?”
Uncertainty. It’s the one thing that is common among all hospital patients.
When is my discharge date?
How is my diagnosis affected by the other things I have going on?
How in the world will I pay my medical bills?
Why am I taking this many medications? What do …
“They are firing me for not getting the COVID vaccine. I can make more money working at Michael’s than I do at this job. I was only doing this because I like to help people. But this is it for me. I’m quitting. I’ll miss the patients, but I cannot be forced into doing something that I don’t believe in.”
The patient care tech said to me after putting my patient …
Not long ago, my patient in a complex thoracic case developed progressive bradycardia followed by a malignant-looking multifocal atrial arrhythmia that didn’t generate any blood pressure.
“Get out some epinephrine!” I said to my resident, who was standing closer than I was to the drug cart. The resident quickly drew up a milligram of epi, but then paused. I could almost see the thought bubble overhead: “Should I print out a …
I received a phone call from an elderly gentleman who was closer to ninety years of age than 80, was taking an aspirin, and had just suffered a fall and hit his head. He did not know why or how he fell. He asked for an appointment the same day to “check me out.”
My staff asked all the pertinent questions and immediately brought the information to me. After reviewing it, …
How many minutes have you given yourself to read this post?
There was a time when none of us could tell time. Imagine not knowing what the ever-moving hands of a clock are trying to reveal. My memories skew, but in that era before I could tell time, all I remember is laughter, effervescence, and the occasional injury. (The first time I hit my “funny bone” was quite the scare!)
Now, we …
“Do you get compassion fatigue when you take care of smokers or patients with obesity or diabetes?”
This was in reply to an article on compassion fatigue I had posted on my Facebook page. The article was written by an exhausted physician caring for unvaccinated COVID-19 patients. My initial reaction was, “Of course not. That’s my job!” But it made me think, why was it that caring for unvaccinated patients seemed …
On the first day of medical school, our anatomy lab instructor handed us scalpels and told us to skin our cadavers. Early on, I learned: A good physician does not betray her feelings. A good physician suffers long. A good physician embodies resilience. A good physician is imperturbable. This lesson continued throughout training.
I contemplated leaving medicine during my second year of residency. I was no longer an intern, which meant I could …
I was recently coaching a bright, energetic primary care physician in her first few years of practice. She was working through her Life’s Purpose statement, an exercise we often recommend. At the end of her admirable statement, she tagged on “with efficiency.” Naturally, we explored this a bit. Our conversation meandered toward an interesting conclusion: the more she focused on efficiency, the more likely she was to feel overwhelmed and …
“If you think a mother’s pain is unimaginable, you should see her strength.”
You were visiting your mother when, while in another room, you became unresponsive and fell to the floor. She heard the thump of your fall and raced into the room to find you pale and barely breathing. Drug paraphernalia sat beside you.
Your mother screamed. She cried. She fell to her knees and tried to wake you, slapping your …
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