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The first day I started work as an attending physician in primary care medicine, I knew I had made a terrible mistake. This was not the heroic, selfless, service-oriented job or the romantic life "as seen on TV" I had imagined. Riddled with heavy school debt, despite my best efforts to join debt relief programs, I had a frustrating job with nothing but red tape and hurdles to jump over. And ...

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There is absolutely no playbook for what we are all experiencing today. The changes coming at us have been swift, mercurial, and frightening. Governments, businesses, nonprofits, and individuals have scrambled to cope with relentless waves of chaos in the wake of COVID-19 and civil unrest. I have continued to keep my solo psychiatry practice in Eldorado open and have moved to a telemedicine platform, which definitely has its trade-offs! In the ...

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Many physicians would like to use their skills on the mission field, but have a hard time finding an option that fits into their busy schedules. Several years ago, I looked for a medical mission, but I couldn’t find one that would work for me, so I came up with the idea of setting up a medical mission experience in my own town. A local mission meant I wouldn’t need to ...

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"Based on the evidence of the effects of trauma, we can predict that our health care teams, patients and families will exhibit signs of this assault through a variety of symptoms–sleeplessness, apathy, depression, and anxiety. The warning signs are already here. We read the desperate accounts and pleas of frontline workers describing the indescribable, holding the hands of patients dying alone, ...

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Throughout 2020, the United States has been playing catchup against the coronavirus. As several well-researched articles have noted, lack of appropriate and timely response has been at the forefront and can be attributed to numerous factors including the highly contagious nature of the virus and, simultaneously, a delay in formulating an adequate medical management and containment strategy. Unfortunately, this catchup game has led to one of the greatest losses of ...

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A few weeks ago, I became a full professor of medicine. The grand moment happened 28 years after graduating from medical school. The week after the promotion letter, my daughter's MCAT results were in, and she was hitting submit on medical school applications. Fun fact, I had her at age 28, my chief resident year. 

In her quest to understand the application process and career trajectories in medicine, my ...

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So long as you are trying to fit in, you will never feel like you belong. When the travesty of a “research” publication titled, “Prevalence of Unprofessional Social Media Content Among Young Vascular Surgeons” seemingly metastasized overnight into what will forever be immortalized as the sordid saga that unwittingly catapulted the hashtag #medbikini all across the internet ether, in every way possible this “study” exposed the unsavory truth about the still ...

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Novel coronavirus (COVID-19) targets older ethnic and racial minorities with lethal precision, establishing irrefutable evidence that inequality kills. Nearly one-third of those who have died from COVID are Black, while Blacks represent about 14% of the population in the areas analyzed. In Chicago, 78.6% of COVID-related deaths were age 60 or more. While ethnic and racial minorities represent 59% of the population, they made up ...

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When I describe it, many of you will instantly recall the Norman Rockwell painting of a doctor holding a stethoscope to the chest of a little girl’s doll.

Historian Neil Harris described that iconic image, published in a 1929 edition of the Saturday Evening Post, beautifully: “Such a willingness to place professional expertise at the feet of childhood magic serves to remind us, again, of things we ...

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"Someday, I suspect I will recount this time of fear with mixed emotions.  Sadly, there are people who have died and more to come, and this time will also lead us to reassess our way of life and make changes for the better.  I work from home, juggling the management of patients by telemedicine with homeschooling my daughters, still working to ...

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It was April 5, 2020. In the months prior, I imagined, she had been grappling with the isolation of her newfound unemployment.  The pandemic's solidarity was possibly a relief: the rare solace of the permission to take a pause.  Her new days were partly spent with long walks near Baker Beach, saluted by the loyal, majestic Golden Gate, the cool San Francisco sun embracing her and her high-spirited two-year-old son. ...

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When we think about holistic medicine, many assume that it requires human-to-human touch points and, therefore, doesn’t lend itself well to technology and innovations such as artificial intelligence. In fact, holistic medicine and whole-person care advocates often view technology as manufactured or impersonal and therefore dismiss its utility for health care. This is because there is a perception that health care tech values the human experience only for the purpose ...

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August 1 to 7 is National Breastfeeding Week. I wish it wasn’t. I said it. I’m a family medicine physician with experience in working with moms and newborns in their feeding journeys. I don’t support a breastfeeding week. I wish it was something else like “Moms/Dads/grandparents/caregivers Newborn Feeding Week.” When my daughter, Wendy, was born during my fellowship, I was geared up to breastfeed during maternity leave and then pump/breastfeed after returning to ...

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Choice is always available to us. Choice is a charged word – fueling political debates and challenging concepts of freedom. Many would argue that there are unavoidable obligations, legal and cultural limitations that revoke choice, but at the core of human existence is free will that cannot be revoked. While there may be consequences for choices that seem undesirable, unjust, even inhumane, and ultimately unavoidable, choice remains infinitely available, and ...

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I have noticed several articles describing how antibiotic development has bankrupted some pharmaceutical companies because there isn’t enough potential profit in a ten-day course to treat multi-resistant superbug infections. Chronic disease treatments, on the other hand, appear to be extremely profitable. A single month’s treatment with the newer diabetes drugs, COPD inhalers, or blood thinners costs over $500, which means well over $50,000 over an effective ten year patent for each ...

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"All of our patients, but especially our most vulnerable Spanish-speaking patients, need to hear concrete, meaningful, and practical instructions on how to care for each other when they live in large multi-generational families, and positive stories from people who have successfully managed infection with COVID-19. They need to hear that, as their physicians, we are here for them. I want them ...

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She started crying. This tough, capable, juggernaut of an ICU nurse looked just a little broken for a second while she cried. "It's not fair. It's immoral—or unethical. I don't know—I know it's the right thing. We have to protect the patients and staff but ... if it were my dad! I just … I can't go tell them that she can't come see him when we know he's going ...

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“I live and die by waveforms and not just a snippet.  I need to see the entire waveform and what led to an event to determine an intervention or root cause.” The intensive care specialist told me this with desperation in his voice. He’s the one who has to tell families that their loved one is gravely ill, that another cardiac event could happen at any time, without warning, or that ...

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As a physician epidemiologist and former public health official, I find myself confused by people's perceptions of risk related to coronavirus, particularly as we struggle to reopen our economy amidst a surge of cases. I'll meet an older adult with diabetes who could care less about distancing or masks, but then a healthy person in their 30's too afraid to walk outside. I'll encounter a mother who is too ...

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