I was an assistant nurse manager (ANM) in a 24 bed ICU in my younger, energetic years. Before that, I was a manager in a very small emergency department. I must say, I loved it. I loved the thrill and the challenge. I was able to work with the Joint Commission; I ordered EKG monitors and defibrillators, any equipment needed for the emergency department. I worked with the health department ...

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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 ...

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“We have met the enemy in medical education, and he is us!” My paraphrase of the “philosophy of Pogo” is pertinent to today’s crop of graduating medical students. We have inserted them into the most toxic environment for learning medicine, ever. Dr. Michael Halberstam once stated that the most powerful treatment the ER had to offer (after CPR, of course) was “the sight of your own doctor at the bedside.”  Yet look ...

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On a recent trauma call, we had a busy night, culminating in a horrific motorcycle trauma that came in early in the morning. The patient had devastating injuries and ended up dying. The detectives finally tracked down the patient’s family. I cleaned myself up, put on my white coat and had the family sit down in a private conference room. I entered with my trauma attending and a consulting specialist, ...

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Drip. Drip. Drip. It’s 8:00 p.m. I’m staring at the IV tubing. We forgot to stop the fluids. I’m standing in the resuscitation room alongside the naked, broken body of a teenage male. Unable to break my gaze on that dripping IV line, thinking, We’re going to flood him. But it doesn’t really matter. Somewhere in the background, muffled yelling comes through the doors. “Sounds like they found the family,” remarks a nurse. The tech is putting the young ...

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Christmas Eve 1990, Saudi Arabia, a few miles south of the Iraqi border - it is cold and dark as I lay on my cot, my sleeping bag around me, the constant hum of the generators in the background. I am listening to Pachabel’s Canon in D minor on my cassette player. Rain pelts the tent I share with nine other Army doctors. The sides move rhythmically with the wind, ...

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Ooh child Things are gonna get easier. Ooh child Things'll get brighter. I sing these words to my one-year-old son quite often; I believe them. I’ll never lose hope. Hospitalizations hit greater than 90,000 yesterday, and the trajectory is frightening. This is not a political issue; it’s bigger than any one individual’s opinion. People will continue to die alone and say goodbye on FaceTime. Thank your grocery store worker and the cleaning person cleaning every COVID+ patient ...

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An excerpt from The Healer's Burden: Stories and Poems of Professional Grief.

Leaning on the door of Trauma Bay 1, I survey the remains of my latest failure. The story is told in the bloody and jumbled instrument trays, monitors now silent and dark. In ...

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"Now, in her afterlife, she occasionally accompanied Maggie on excursions into my head, usually at night. Make that a double vodka. I thought I had finally learned in sobriety how to put them in the past, encased in a box, and keep them there. Still, sometimes they found a way out to ...

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I am a critical care and emergency medicine physician, I have had COVID-19 infection twice, and I’m tired. My first infection was early on in the pandemic.  I had to place a Blakemore tube in a young man who was going to die from his massive bleeding from cirrhosis.  I didn’t know then that the patient was positive for COVID, as he didn’t have any “typical” symptoms. I placed the tube ...

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An excerpt from Universal Death Care. Machine gun fire ripped me open—From Left to Right. There were too many bullets. No way could I feel each wound. They blended together like a single strike of lightning. I was paralyzed by pain. It had taken root in me. ...

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A few years back, I took care of a frail elderly gentleman who, accompanied by his wife, had come to the ER with an elbow injury after tripping over a curb in front of a local restaurant. They had been traveling from Buffalo to Cleveland and had stopped for a quick bite and a bathroom break. Before entering his room to treat him, I had been given a heads-up by Rita, ...

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She had me in her terrifying grip, and I was paralyzed.  Stuck to my chair, my heart racing, instantly isolated in my desperate confusion.  I heard ordinary sounds like two nurses chatting, papers shuffling, and a telephone ring, but they seemed distant, happening in some safe place far away beyond the dark tunnel I was now in.  No warning.  She had asked me a series of questions, and all seemed ...

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This piece is a retelling of the poem “Do not go gentle into that good night” by Dylan Thomas. As an emergency physician who has borne witness to suffering and death, I have felt the futility and bravery of fighting against the dying of the light among individuals from all walks of life. Bearing witness to suffering and death is one of the greatest privileges and burdens of physicians. May we all ...

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Meet the physician who has written multiple widely-shared articles on KevinMD. How does writing change minds and bring people together? Why is humor such an important part of her pieces? Explore how her articles come together, and why writing has made her a better physician. Rada Jones is an emergency physician and can be reached at her self-titled site, 
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In every single person, there is a furious instinct to guard, preserve, and even trap life. In your final moments, we’re wanting to latch onto your life. I was standing in the elevator when your daughter (presumably), and her husband walked in. I heard her quietly say that you looked like you were ready to go. She put her head on her husband’s chest and cried. She knew you were ready, ...

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During a typically busy Saturday evening shift in the emergency department (ED), I am summoned to the trauma room for a “tie-down,” an agitated patient needing restraints. I find the entrance choked with police officers and push my way through to see the patient.  Once there, I see a large, young appearing Black man lying on his back, his hands cuffed tightly together on his stomach, a netted hood over ...

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I have a lot of energy. I have been going and going and going for so long. And today, it hit me. I’m tired. I began this pursuit of medicine in 1983 when I decided to be a zoology major. I worked and went to medical school. And I went to medical school and worked. Then I worked and went to three years of emergency medicine residency and worked hard for those three ...

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A middle-aged man lies on a gurney. Anxious. Work boots. Blue jeans.  Stained white shirt. Rough hands. "Hi! I’m your doctor. What brings you to the emergency room?" The patient looks at me, puzzled. He’s Spanish speaking. It's the middle of the night, and I’d rather not use the translator line. We start in broken English – then I reach for the phone to call the language line. He collapsed at work, and ...

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A 4-day-old term, formula-fed male infant with an uncomplicated prenatal course and no ABO set up or other identified cause of excessive jaundice was admitted to the hospital for phototherapy treatment of hyperbilirubinemia with a peak bilirubin of 19.5. He had an uneventful hospital course and was discharged on day 6 of life.  On day 8 of life, his mother called concerned that he was fussy and had a black ...

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