I was a tumultuous cloud of hope and fear as I tiptoed into my new job on a recent Sunday after five months off. By Wednesday morning, with my first three nightshifts behind me, I had already stayed late three mornings to keep up with charting in an unfamiliar EMR and succumbed to stress-eating chocolate at the nurses' station. I was reacquainted with the challenges of staying awake all night, ...

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Hello, my name is Sandy, and I'm a screenaholic. I'm incessantly plugged in and over-absorbed in my smartphone. Who texted? Who emailed? What might I miss if I'm not constantly connected to a five-inch touchscreen? Like many of you, I've succumbed to our culture of screens and “now, now, now.” I'm moving at an unsustainable speed to bulldoze through tasks. My interactions with graphical interfaces are replacing interactions with actual people. ...

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"Same team!" bellowed all the frustrated parents from the sideline of a lacrosse game as we watched two teammates clash sticks while fighting to catch the same pass. Both players missed the ball, and the other team scooped it up and scored, perfectly illustrating to our kids what happens when they battle among themselves. It's easy to remind our kids that teammates shouldn't fight, but it's harder to remind each other ...

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Every mama bear fiber in my being was screaming at me that I shouldn't be there. The patient's lips were moving, but the words were basically “wah wah wah” as if Charlie Brown's teacher were speaking. All I could hear over and over in my head was the phone call from my youngest about his brother's accident at camp. “Mom, Cole's hurt. He's in the ambulance.” My eyes were seeing ...

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Am I the only emergency physician who sometimes wonders who left me in charge of an ED? I should be confident in managing whatever comes through those ED doors after more than ten years of single-coverage night shifts, but each night I hear a little voice in my amygdala questioning whether tonight will be the night I won't be able to handle something. Sometimes I feel afraid of the unknown ...

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"I'm going to write a column about dating you and call it ‘Sleeping with the Enemy,’" I announced from my rocking chair. His rocking stopped. “The enemy?” The rain was falling on the trees in front of my porch and on his parade. “Why am I the enemy?” “You know, clinicians vs. hospital administrators.” “Really?” he naively asked. “Why don't clinicians like us?” I was surprised he was so in the ...

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"Mom, that's a little unreasonable,” piped up my 9-year-old from the backseat as we drove by an ER billboard that prominently displayed an average wait time of four minutes. “That would be stressful, seeing everyone that fast.” Even my kids understand how absurd some of today's time metrics are. “Hospitals probably make more money showing shorter wait times on a billboard because people want to go there because it's faster,” ...

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Basing medical care on patient satisfaction is as smart as basing elementary education on child satisfaction. The patient who wants a cheeseburger while going to the OR shouldn't influence hospital reimbursement any more than the child who wants recess all day should influence school reimbursement. By tying health care funds to the opinions of patients, we are letting the kids run the school. Doctor-patient relationships are based on the trust that ...

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How in the heck would three nurses and I ever orchestrate ECMO in the middle of the night in my community ED? I pondered this over tuna tartare while listening to ivory tower docs discuss cutting-edge modalities like they were part of treatment algorithms everywhere. The conversation turned to REBOA, and I wondered how many academicians had ever manned a single-coverage ED. Ivory tower medicine and my world, ...

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I heard his little footsteps at 4:30 a.m. “Mama, the stockings are full. Can we open presents?” I had finally collapsed into bed at 4 a.m. after staying up wrapping, cooking, and stuffing the stockings to make Christmas morning as Norman Rockwell as I possibly could. I told him to hold his horses until 7 a.m. and rolled over for a few hours of exhausted slumber. I was thankful I wasn't ...

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