I sometimes work as a church security volunteer.  And when I do it, I get to simply stand and watch.  Watch for someone sick or injured (we have defibrillators and wound care equipment).  Watch for someone coming to cause harm.  Watch in order to call the police.  Watch to keep the children safe. And it occurs to me, when I do it, that watching is incredibly important.  I know this as ...

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I carry you in my heart. Not your cold and quiet and still little body.  No. I carry the you that I never knew. The you that your parents grieve. The you that will never grow up. The you that laughed and played that nobody new will ever meet again. I carry you in my heart. It was that you that made me grit my teeth when I heard they were bringing your body ...

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The recent pardon of a convicted child rapist by the ex-Kentucky Governor has sparked a lot of controversies. The basis of the pardon was- “the victim’s hymen was noted to be physically intact.” Evolving studies have continuously shown that the hymen is not a reliable or accurate means to conclude sexual assault. But if physical damage is the only criterion used to assess ...

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I work in the ER. It’s not an easy job. Not glamorous either. At least not as glamorous as my mother-in-law used to think. Years ago, when I declared I was going into emergency, she looked at me askance. She didn’t ask why. She looked at me with her wise old eyes. “Let me tell you about ER,” she said. “I know all about it. I watch every show.” She was politely dismissive ...

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I'm an ER doc, and I spent my last two decades in the house of medicine. First, training to become a doctor. Then, trying to be a better doctor. No matter how hard I tried, I've never been the "perfect doctor." I started wondering: what makes one a "perfect doctor"? The perfect doctor lives in the moment, focusing on the here and now: This patient. This case. This encounter. They devote ...

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I overheard a disappointing phone call while supervising a radiology resident recently. I could tell that the resident was struggling in a conversation with an emergency department physician, so I asked him to switch over to speakerphone. Eventually, I heard the emergency physician say, "Listen. This is how it works. A patient points to what hurts. Then I have that part scanned, and you tell me what is wrong." Disheartening as ...

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Having recently testified in several legal cases involving strangulation, here are some facts we all need to know about this extreme form of domestic violence (DV). I invite other subject matter experts to share their personal opinions on what is important. 1. Strangulation is assault with a deadly weapon - an act with known potential lethal consequences. Formally defined, strangulation is an external force applied to the neck cutting off blood ...

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"Slowly comes the hour, it's passing speed how great." - Samuel Cowper Our careers will end someday. Of course, we know this deep down, but I think we lose sight of it amid our training and the day-to-day grind of our jobs. But just this past week, I was given a little reminder. At our Christmas party, we took some time to honor one of our colleagues on his journey to retirement. He had spent ...

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One of the most important purposes of a physician is to alleviate pain and suffering. Pain is the most common symptom prompting an emergency department (ED) visit. Emergency physicians are responsible for managing both acute pain and acute exacerbations of chronic pain resulting from a broad array of illnesses and injuries. It has been shown that emergency medicine providers are not necessarily good at treating patients uniformly. Since the 1990s, numerous ...

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Relaxing on the couch, my family already in bed, watching TV to calm my mind before leaving for a busy night shift in my emergency department, I was shocked to see an advertisement that insulted me, my colleagues, and my profession. A trailer for a show called “Nurses” is shameful. The idea behind the show is admirable — nurses do not get recognition from society for the work they do and the ...

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Ninety minutes before my Sunday night shift, my two-year-old, Titan, comes screaming up the stairs looking like a scene out of a slasher horror movie. His older sister sheepishly admitted to chasing him into the edge of a door frame. We created an ED bed on our kitchen counter and slipped a pillowcase up his arms, behind him, with him laying on it, to help restrain him, telling him it ...

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Year 2000. I’m sitting in a semi-fancy hotel ballroom near LAX along with several hundred slightly edgy emergency physicians. We’re all awaiting the start of our ABEM written re-certification examination. This was in the old-school days of live exams. We had an MD master of ceremonies, a famous EM leader; and I can still remember his message to the assemblage. “If you’re re-certing for the first time, welcome, relax, good ...

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I think I’m finally burned out. And it’s been a long time coming. It likely started when my private physician-owned emergency group got bought out by one of the big corporate groups. The changes were small at first. Turning us into hourly paid employees instead of an RVU-based salary. Shiny new VPs and directors sending us emails. Things seemed fine for a while. Then came the many, many emails about better ...

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It’s hard to explain what we do. And so maybe, it’s hard for others to sympathize with our situations. I mean, physicians, mid-levels, and nurses in emergency departments are tied to computers in often cramped work-spaces, even as they are required to be at the bedside almost constantly for the latest emergency or (in other cases) the latest bit of pseudo-emergency drama. If you haven’t worked there, or haven’t for a ...

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There are many disparities in health care. Black mothers have a much higher rate of maternal death than do white women. All women are less likely to get guideline-advised cardiac care than do men. Among the many such examples, perhaps the hardest disparity to solve is that of the poorer access to health care faced by rural communities. People living in rural counties have higher death rates from cancer and ...

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There is always that one patient. The one with the over-attentive, aggressive family member, who writes a complaint. The one you tried to help, but no matter what, the wait was too long, the nurse too unfriendly, you didn’t sit enough, you didn’t reassure enough, pain meds took too long, you didn’t make them feel important. That one patient who has the time, negative energy, and physical health to write ...

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"Words Kill" is a brilliant song about the perils of texting and driving. Spread the message. Courtesy of The Fever Breakers, a band made up of hospital employees. Their socially conscious songs are crafted in the basement of the hospital using a piano used for cancer patient music therapy and subsequently recorded in a studio.

As a young medical student, in my early 20s, I was still too inexperienced to know how a physician was "supposed to" act. But I took the model of stoicism that I learned from my East Indian father and applied it to the medical model. Lectures on "professional detachment" reinforced this. I remember being told that it was the doctor's job to keep a professional distance from a patient. By getting ...

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Like all doctors, I’m a lousy patient. My doctor is a lovely man, but going to see him? That’s right there with weighing myself, getting a flu shot and doing my taxes, and behind celebrating Thanksgiving with the in-laws and getting a root canal. And I’m not the only one. If I had a dollar for every patient who told me they hate doctors (no offense), I’d be long retired. If you’re ...

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Working as an emergency physician at a level 1 trauma center and as an Army reserve officer, you learn to expect the unexpected – but working as the ER doctor taking care of patients impacted by the most deadly and destructive wildfire in California history last year changed me. As I walked into work last year to start my clinical shift as the attending emergency physician, our hospital began receiving multiple ...

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