2019 is here. I started my year by doing an urgent care shift on New Year's day.  It was not quite as busy as I expected; most of the shifts I've done around the holidays were high-volume, with lots of flu, other respiratory infections, and lacerations sustained while cooking holiday meals.  New Year's day was a little slower on the illnesses, but the acuity of the injuries was high.  That's what ...

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“What took you so long? I’d have thought you would address this issue sooner.” I felt a like a scolded child sitting in the principal’s office. In fact, the small couch I was sitting on rested nearly a foot lower than the chair on which he perched. All the while, the exam table glared back with unfriendly eyes. I smirked and tossed the question back in his lap with a degree of ...

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Finishing my ER shift for the day, I waited for the shuttle at a busy intersection. Within a minute of drowning myself in music, I saw an obese man at the bus stop suddenly collapse to the ground. I removed my backpack and ran the fastest I have ever run in my life across the street to him. His body was shaking violently, and I waved and yelled to the nearby police ...

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About two months ago, a 15-year-old Native American male was riding around in a stolen car on the reservation. “M” and the driver were drinking. And somehow, after he exited the vehicle at 4 a.m., the car struck him. Hours later, it became clear that something was wrong. M was transferred to our pediatric hospital as a trauma and was found to have an unstable vertebral fracture. Conservative treatment with ...

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2016, Kenya I arrived in casualty (the emergency department) to see a minimally responsive Kenyan boy with a body wasted from malnutrition. His mother stood at the bedside cradling his head, her eyes full of fear. His parents had traveled for days over rugged mountain roads in the rains to get to the hospital. My colleague told me his blood sugar was 10 mg/dL, and the nurse had gone to gather ...

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I am just another average physician. It wasn’t my first return from maternity leave, but this busy ED shift wasn’t going well. I kept putting off breast-pumping to complete “just one more thing.” Then my son’s school secretary called. I had told our nanny the wrong pick-up time. She wasn’t answering her phone. I was disappointed in myself and frustrated that I couldn’t leave. But I am a physician — I ...

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1. Murphy’s Law as it applies to the ER: If something can go bad, it will do so in a hurry. If it can’t possibly go bad, it will still find a way. 2. Clock’s First Rule: All the patients will crash at the same time. Usually when the computer system goes down. 3. Clock’s Second Rule: The sickest patients will come just before the shift change. 4. Haste’s Theorem: The healthier the ...

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An excerpt from Doctor Brooklyn: Love & Life at the End of a Knife. “Goddamn, you’re getting married? Are you outta your mind?” “I’m going to tell Goldie your advice on marriage. I predict you will spend the next twenty years sleeping on that very lumpy couch you own,” Zach said to ...

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With over 22 million page views for the year, thank you for making 2018 such a success. KevinMD continues to be the web's leading platform that highlights the voice of the many who intersect with our health care system, but are rarely heard elsewhere: physicians, advanced practitioners, nurses, medical students, and patients who can share their insight and tell their stories. This year, I'm ...

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A New Mexico woman, suffering from Dercum’s disease (adiposis dolorosa) which causes painful fatty tumors, is suing a Santa Fe hospital and an emergency physician claiming she was the victim of two negligent acts in 2016. One, according to the Albuquerque Journal, she told hospital personnel she was allergic to Dilaudid but went into cardiac arrest after receiving an injection of the drug. Two, despite the presence of a lawfully ...

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