As I watched the vaccine rollout take place over the past month, all I can say is that I am not surprised. I watched hospital executives who never see patients jump the line, doctors having their healthy nannies vaccinated, and health systems trusted with vaccine doses have essentially no plan. It's like we didn't have 9 months to figure this out. All I can say is that this is the ...

Read more...

"It has been over a month since I started this new hobby. I told my middle-school-aged daughter tonight, 'I am going to write a post about how ocean plastic picking has made me a better pediatrician.' She replied, 'You mean better than other pediatricians?' 'No, I mean a better pediatrician than I was ...

Read more...

It was Friday night, and after a long day of grossing, I was ready to leave the hospital when the department’s door opened, and the nurse shouted, “we have a frozen for an emergency liver transplant.” Without hesitation, I took the specimen and called the attending on call. After a few minutes, the surgeon arrived anxiously to our reading room. “We flew all the way from Pennsylvania to get this ...

Read more...

My first clinical rotation as a third-year medical student was in orthopedics. I remember the excitement of being scrubbed into the OR, with the gloried task of suctioning while the fellows did the real work. About 30 minutes into the surgery, when things were getting underway, a male physician scrubbed in and took the tool away from me — I grabbed it back, letting him know I had the ...

Read more...

It is stressful enough to live with heart disease. Now, with a global pandemic, access to health care providers has shifted from in-office to telemedicine in many instances. There are challenges for patients with heart disease in this context:

  1. Patients are often older and are not familiar with using technology for videoconferencing (Zoom, Doximity, FaceTime, Skype).
  2. The electrocardiogram and physical exam still remain the primary ways we assess the heart ...

    Read more...

This week at work, I had a patient in the hospital who had been through a pretty challenging illness, and he was going to have to be discharged to a skilled nursing facility (SNF) to rehab for a few weeks. Sadly, SNFs in my area do not currently allow any visitors due to the pandemic. The patient is very close to his daughter, who lives out of state, and she ...

Read more...

Developing the COVID-19 vaccine was the first monumental milestone on a long and arduous journey to achieving the entire U.S. population's vaccination. One of the barriers to achieving this task is the absence of a reliable, scalable way to uniquely identify each individual before or after they receive the vaccine. Furthermore, in the absence of this unique identifier, it is extremely difficult to reliably use existing state or regional data repositories ...

Read more...

"I am overwhelmed right now. I know I am not alone. I hear it in the voices of my friends, family, colleagues, patients. We are all feeling it. I am overwhelmed by this virus. There is so much to learn, so much to teach. Every day the information changes. Who is credible? Who ...

Read more...

The highly anticipated A Promised Land was the first book I could not wait to crack open over my two-week break for the winter holidays. Former President Barack Obama explains in his introduction that this work is the first of two autobiographical accounts covering the period from his state legislature run in Illinois through his presidency. This masterwork takes you through every decision he makes and helps illustrate just how ...

Read more...

Canadians breathed a huge sigh of relief when the federal government approved the first COVID-19 vaccine and saw the first immunizations take place. The end of the pandemic and the prospect of a return to normal, whatever that means, became a real possibility.

Rolling out a national vaccination program will be no small feat. In addition to the basic logistical challenges of moving volatile product throughout the ...

Read more...

With this third surge and our ICUs at zero capacity in Los Angeles, I spent  New Year’s Eve alone at my apartment, recovering from a wards rotation I had completed the night before. No revelry or celebration for me this year.  For months, this virus has been wreaking havoc on our lives and slowly,   then rapidly chipping away at our health care systems. I’ve seen the ...

Read more...

Family lore recalls that my grandfather, succumbing to stomach cancer in the mid-1960s, “died addicted to morphine.” Decades before the AIDS crisis sparked the hospice and palliative care movements, the confluences of pain, dependence, and addiction were confused and regrettably moralized. Since then, the science has excelled, but our clinical understanding of how pain and addiction intertwine remains limited by stigma, assumptions, and the separation of the underlying science ...

Read more...

I am at a loss.  While trying to explain the events to my children since January 6, I feel profound sadness and fear.  Our country is built on freedom, yet the latest in a parade of crisis’ is being used by those in power to remove our freedoms at an alarming pace and divide our country further. Less than one percent of the people who went to Washington, DC for a ...

Read more...

"Each year, medical students across the country prepare to start the long-anticipated core clinical rotations. Suddenly, we’re thrust into a world of constant adaptation and evaluation, with many highs and many lows. As I finish up the year and new students get ready to start, I’ve been asked time and time again for ...

Read more...

She shook her head no, eyes brimming with tears, chin quivering with emotion. Again, I told her that without further care, her son would never have use of his arm and possibly would die. Her voice trembling, she told me her husband would beat her if she returned home without the boy. She placed her son on their horse, his newly bandaged arm in a make-shift sling. I gave her ...

Read more...

December is typically busy in the ICU. Flu and respiratory viral pneumonia cases start trickling into the ICU, interspersed with cardiac arrests, strokes, pulmonary emboli, septic shock, and COPD exacerbations. The ICU census starts creeping up. December 2020 has been unique and challenging. There were seemingly endless days of patients coming to the ICU, only to die. People with COVID-19 and the usual ICU ailments seemed sicker than usual. Patients have ...

Read more...

This is not what I signed up for. Have you ever said this when you are rushing home 1.5 hours after the last patient left and you still haven’t finished all your charting? You grab a handful of forms to take home with you with the hopeful expectation that you will get them done tonight too. After you have done “enough” to appear to be a present parent and prepared supper ...

Read more...

"Doctor, how are you doing?" I’m really so grateful when people take the time to ask this. But when I respond, candidly, that it’s been tough and I’m definitely not doing great, I often hear, “But you haven’t had any patients who have died from COVID, have you? And you got the vaccine, didn’t you?” Fortunately, no (not yet) and yes. My heart goes out to our ICU, inpatient, and ER teams ...

Read more...

Being an internist, the day is filled with problem-solving.  The problems are often not straightforward and require thinking, rethinking, reevaluating, and reading up and researching before the problem can be solved.  However, when a sixth sense, an intuition kicks in that warns us that something needs to be addressed urgently even when we cannot specify or articulate why. Once I had a patient come in for shortness of breath that is ...

Read more...

"We in medicine are experts in delayed gratification. We’ve been in school for what, about 21 years before residency? Then we finally become an attending.  Then we can splurge a little. But still, we were told to hold back. Live like a resident. This is a great skill to have as an entrepreneur. ...

Read more...

Most Popular

✓ Join 150,000+ subscribers
✓ Get KevinMD's most popular stories