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Career transition is talked about a whole lot more these days than it was in 2004.  Maybe I just notice it more now.  Back then, I felt like I was the only one doing it.  You know how it is when you are going through something difficult, and you feel utterly alone and unsure about what you’re going to do tomorrow?  That was me, only I also felt like a ...

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Gilead's $1,000-a-pill antiviral remdesivir is no wonder drug. We knew this when it failed for hepatitis, the disease it was created for. And then when it failed for Ebola. And then again, when it failed for COVID-19. But like a bolt, in late April, a breakthrough: in a second trial for COVID-19 patients, remdesivir sped time to recovery—proof of benefit,
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They are physicians, mentors, partners, mothers, sisters, friends, colleagues - but most evidently, at the moment, they are heroes. I (virtually) sat down with five women physicians, at all points in their medical careers, who are working in several of the largest emergency departments in Texas, to talk about their experiences with the COVID-19 pandemic. One of the themes that I heard from each of these physicians was that the inevitable ...

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He could hear the football game playing on a radio outside his room, so he knew someone was there, and he knew he was dying.  He screamed and screamed as the paralysis from what he was sure was sepsis took over more and more of his body. No one answered.  Only his wits and knowledge could save him, he realized when the only thing he could move was his neck. There was the ...

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I am writing this as I lay in bed, feverish, sweaty, and persistent dry cough. I have been sick with presumed COVID-19 for the past ten days. I have quarantined myself from my wife and two sons, unable to hug or reassure them that everything will be okay. Additionally, my wife is 39 weeks pregnant. Therefore, I will be unable to accompany her in the delivery room and may not ...

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When a coalition of medical organizations, led by the American Medical Student Association (AMSA), petitioned in 2001 to cap medical resident work hours, they were turned down by the Occupational Safety and Health Administration (OSHA). Despite their rejection, students and young doctors were determined. They knew that exhausted residents had poorer health and made more ...

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"Howard wants to go to the hospital. He knows he isn't doing that great. He says he is having homicidal thoughts." This from my supervisor, Linda. Homicidal thoughts on the part of any client get our attention, especially so with Howard, because years before, he killed a man with a gun. I believe it was in a fight. "He wants you to take him to the hospital, Ray." "Sure," I say. "You think ...

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Over the past two months, health professionals and community advocates have brought to the fore of national attention what has been the lived experience of many within black and brown communities for ages — racism kills. The substrate of structural racism and systemic inequities, now combined with a catalyst, COVID-19, is accelerating fatalities among those who are disproportionately burdened by chronic diseases ...

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Health care is enjoying an abundance of positive attention as a result of the coronavirus pandemic. My question, my challenge, is how can we sustain this love-fest between the public and the health care profession even after we obtain a vaccine or an effective treatment for COVID-19? Let’s be perfectly honest: six months ago, the American health care system was considered, even by physicians, as broken and in dire need of ...

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I rounded recently on a 100-year-old veteran of the Battle of the Bulge. It was a terrible and costly battle fought in Belgium during the winter of 1945, the coldest and snowiest in memory at that time. The German army made a desperate last stand against an increasingly overwhelming US force. Hundreds of thousands of lives were lost. He was there. He lived it. It is not a forgotten memory ...

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Every day our governors announce the COVID death toll and highlight a family who lost a member of their family too soon. COVID took a 35-year-old mother. It took a 48-year-old father.   These deaths are tragic.  But a frequent refrain is that this virus mainly kills those with extensive health problems, it kills the old, it kills those that would die anyway.   The National Center for Health Statistics (NCHS) estimates ...

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We’ve all heard the phrase, “survival of the fittest.” It suggests that in the competitive, “free market” world, it is the “best” who survives and it’s “the cream” that rises to the top.  But is that true for doctors?  Do patients get better care when competition rules the health care marketplace? A few years ago, a doctor from a large primary care group contacted me to give a talk to the ...

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“Failure was not an option” is a phrase that I’ve heard so many times as entry point conversations with the many burned out physician moms and women in medicine I have coached.  And in many ways, they are right. However, the context from which it is said is oftentimes what has led to the experience of physical, mental, and emotional exhaustion. When I was first out of residency, I decided to ...

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Every year, National Nurses Day is celebrated on May 6 to raise awareness of the role nurses play in society. The date also marks the beginning of National Nurses Week, which begins on May 6 and ends on May 12, Florence Nightingale’s birthday. In addition to the annual celebration, the World Health Organization has smartly declared 2020 the “International Year of the Nurse and the Midwife,” in recognition of their ...

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“You forgot your stethoscope!” The medical student dutifully pointed out as we were on our way to the patient room. “I don’t need it. But let me grab it anyway to pretend. But don’t tell anyone I said that!” I replied.  Her eyes widened with disbelief at the blasphemous statement.

At the turn of the millennium, the world was already going through seismic changes in how it conducts itself ...

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While recently on board an international flight, an in-flight medical emergency was called approximately one hour into a ten-hour journey. The overhead page most travelers may have heard while on a plane, “Is there a doctor onboard the aircraft?” The air hostess quickly led me to the front of the aircraft where an elderly passenger had vomited a substantial amount of blood in the bathroom and near her seat. I requested ...

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I wake to a WhatsApp call. It is my aunt, who lives in India. “We are all worried about you,” she says. “All of us here are praying for you. Make sure that you stay safe.” Coincidentally, she is a nun, so I’ll take her prayers whenever I can get them. I promise her that I will stay safe, and then I get ready to enter the ER. I don ...

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“I stayed up all night, and for what, $10 a consult?” A clearly exhausted and exasperated colleague and friend said to me one morning after his very busy call shift. As a chief resident, one of my roles is to manage the call duty schedule. As such, I frequently hear about how residents feel about call. Interestingly, many comments have to do with the economics of call: “It’s just not worth ...

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