One recent afternoon in the GI endoscopy suite (not my favorite place to work, but that’s a topic for another day), I walked up to the bedside of my next patient and introduced myself as I always do.
“Hi,” I said, holding up my name badge for the patient and his wife to see. “I’m Dr. Sibert. I’m with the anesthesiology department and I’ll be looking after you today.”
The patient was …
You’re a doctor when you’re not giving anesthesia?
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 …
Why it may be time for doctors to unionize
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 …
How the board certification exams infantilize resident training
As we orient our brand-new, fresh-faced CA-1 residents to the operating room each year, I ask this question. Has anyone explained to them that much of what they’ll need to learn in the first couple of months is how to be a nurse?
We watch them struggle to draw up propofol into a syringe without spraying white foam all over themselves. We emphasize the critical difference between a surgeon’s order of …
It’s time to redesign anesthesia care delivery
Every death related to anesthesia is a tragedy; even more so when a minor procedure such as a colonoscopy leads to a completely unexpected death. Everyone knows that open heart surgery carries a mortality risk, but few of us walk into the hospital for a colonoscopy thinking that death is a plausible outcome.
We know so few facts at this point about what happened on January 21 at Beaumont Royal Oak …
How could a patient die from anesthesia for a colonoscopy?
How are two-career households with children — let alone single-parent households — going to manage with daycare centers and schools closed, perhaps for a long time to come? What damage will this do to career progression and earning potential if one parent must cut back on work? Will childcare demands inevitably delay or derail partnership or academic promotion?
When I was a young mother — my two youngest children are only …
Will women in medicine survive COVID-19?
The annual meeting of my profession’s national society last fall may have been the last old-school, convention-size, professional meeting I will ever attend. I could be wrong, but it may mark the end of an era. Disruptive change to the convention business model was inevitable, though hastened by COVID-19. This year, the leadership of many medical associations announced that their upcoming annual meetings would be virtual – if …
An elegy for giant medical conventions
I live and work in Los Angeles, one of the plastic surgery capitals of the world. Quite a few of my patients have “had a little work done” — the blandly euphemistic term you’ll hear for plastic surgery makeovers of all kinds. That’s fine. Plastic surgeons have children to feed too.
The problem is this: many of my patients want to convince everyone that their “look” is entirely natural. They don’t …
Please tell us your cosmetic secrets. We promise not to tell.
Do you think I went too far in my last blog post, calling out some journalists as “pontificating parasites” who love nothing more than to slam physicians and blame us for the cost of health care?
If you do, then you must not have read Elisabeth Rosenthal’s latest salvo in the Feb. 16 New York Times, where she says physicians are in “a three-way competition for …
Keep attacking doctors: What the New York Times gets wrong about surprise medical bills
If physicians are “muggers” and co-conspirators in “taking money away from the rest of us,” then journalists and economists are pontificating parasites who produce no goods or services of any real value.
I don’t think either is true, but the recent attacks on physicians by economists Anne Case and Angus Deaton, and “media professional” Cynthia Weber Cascio, deserve to be called out. You …
Keep insulting doctors, and good luck finding a physician in 10 years
Though the news at first stayed local in Philadelphia and the northeast, it’s gaining traction nationwide. ZDoggMD is on it. Bernie Sanders held a rally.
What happened? The venerable Hahnemann University Hospital, the main teaching hospital for Drexel University College of Medicine in Philadelphia, is bankrupt and will soon close its doors after more than 170 years as a safety-net hospital serving inner-city patients.
Why should we care? After all, there …
The disaster at Hahnemann University Hospital
If you’re a parent who is still on the fence, trying to decide whether or not to vaccinate your children, I’m going to try to be kind and helpful. Here is a link to a video by a physician and father, Dr. Zubin Damania, with facts that may address some of your fears.
If you’re firmly pro-disease and anti-vaccine, however, I am baffled at your irrationality and frankly enraged by …
A physician who’s angry at the anti-vaxxers
For several years now, I’ve been the social media curmudgeon in medicine. In a 2011 New York Times op-ed titled “Don’t Quit This Day Job,” I argued that working part-time or leaving medicine goes against our obligation to patients and to the American taxpayers who subsidize graduate medical education to the tune of $15 billion per year.
But today, eight years after the passage of the Affordable Care …
American anti-intellectualism and its impact on physicians
We’re very fortunate in anesthesiology. We’re seldom the physicians who have to face families with the terrible news that a patient has died from a gunshot wound.
But all too often we’re right there in the operating room for the frantic attempts to repair the bullet hole in the heart before it stops beating, or the blast wound to the shattered liver before the patient bleeds to death.
Despite all the skills …
Gun control is our lane: Physician opinions on guns matter
A true allergic reaction is one of the most terrifying events in medicine. A child or adult who is highly allergic to bee stings or peanuts, for instance, can die within minutes without a life-saving epinephrine injection.
But one of the most commonly reported allergies — to penicillin — often isn’t a true allergy at all. The urgent question that faces physicians every day in emergency rooms and operating rooms is …
Why it’s important to determine who’s truly penicillin-allergic
We’re all human beings, but we’re not all alike.
Each person experiences pain differently, from an emotional perspective as well as a physical one, and responds to pain differently. That means that physicians like myself need to evaluate patients on an individual basis and find the best way to treat their pain.
Today, however, doctors are under pressure to limit costs and prescribe treatments based on standardized guidelines. A major gap looms …
Why physicians should respect the pain patients report
Let me say first that any woman who has ever been harassed or assaulted should never be made to feel that it is her fault. It is always the perpetrator’s fault. Men can be boors, or worse, and testosterone can be toxic.
I went to Princeton University at a time when the ratio of men to women was 8:1, graduated from medical school in the 1980s, and raised two daughters. I’ve …
How to avoid #MeToo in medicine
When you tell anyone in health care that “sedation” to the point of coma is given in dentists’ and oral surgeons’ offices every day, without a separate anesthesia professional present to give the medications and monitor the patient, the response often is disbelief.
“But they can’t do that,” I’ve been told more than once.
Yes, they can. Physicians are not allowed to do a procedure and provide sedation or general anesthesia at the …
Safe pediatric dental anesthesia is the right of every child
No, I’m not talking about putting fentanyl into my own veins — a remarkably bad idea. I’m questioning the habitual, reflex use of fentanyl, a synthetic opioid, in clinical anesthesiology practice.
I’ve been teaching clinical anesthesiology, supervising residents and medical students, in the operating rooms of academic hospitals for the past 18 years. Anesthesiology residents often ask if I “like” fentanyl, wanting to know if we’ll plan to use it in …
Why this anesthesiologist says “no” to fentanyl
A commencement address delivered on August 5, 2017, to the 2017 class of anesthesiologist assistants (AAs), Emory University.
Distinguished faculty, graduates, honored guests:
It is a great pleasure and an honor to be here, and to congratulate all the graduates of the Emory University Class of 2017 on your tremendous accomplishment. Just think about all you have learned in the past two years. You’ve transformed yourselves into real anesthesia professionals, able to …
A commencement address to anesthesiologist assistants
Get free updates delivered free to your inbox.
