There’s an ugly undercurrent that sometimes shows up in the emergency department: indeed all over the world of medicine. I’ve seen it in doctors and nurses alike. It’s a meanness, a smallness, a kind of moral judgment that can lead us to make poor medical decisions. Or it can simply make us poorer in spirit. I remember the day I had a young man who was in custody. He was 18, ...

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A number of major cities have seen shared e-scooters, or electrical scooters, take over their streets. It's certainly popular with the riders, but it is creating waves with a lot of critics as well. In Portland, Oregon, there are four companies trialing the scooters over a several-month period.  Driving around my city, I find that we are being inundated with scooters being used on the sidewalk, on the streets, in ...

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It was 5:27 p.m. on a Friday evening when the pager went off. “Ahh,” said the intern, “Three minutes before shift change, and the ER is paging for another admission!” I could see the dismay on his face as he dreaded the thought of staying late on yet another Friday night. I decided to take care of this patient myself and relieved the intern of his duties. As I went downstairs ...

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The pay gap between men and women has been a subject of interest recently, particularly in 2018 reports by Doximity and Medscape. Notably, the gap favors men, is not explained by obvious factors such as hours worked or choice of specialty, and does not seem to be improving. In-depth studies published in the medical literature have examined the relationship between gender ...

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“I give up! I can’t help these people.” Emily was completing the final month of her emergency medicine residency and flopped into her chair with exasperation. “What’s up?” I asked. We were on the final two hours of our shift together. And I, as her attending, was already feeling apprehensive about the patient encounter that awaited me. “They want so much from me, and I can’t fix them!” She began to tell ...

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Fourteen hours into their shift, the intern headed down to the lobby to pick up the delivery. Today it was Indian food. He struggled to push the elevator button while holding the bags but managed to make it up to the top floor ICU. The rest of the surgeons gathered around the table cluttered with spent pens, journal articles and unused bottles of lidocaine to eat. Someone offered up their ...

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Imagine spending days or even weeks in an emergency room without treatment for a broken leg or painful kidney stone. Patients in psychological crisis across the country are living this exact scenario. Long waits in an ER, hospital room or prison for an inpatient psychiatric bed, otherwise known as psychiatric boarding, are their unfortunate reality. Rewind to over 50 years ago — as institutionalized patients were gradually integrated into communities, the availability ...

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Have you ever been the only customer in your local supermarket? Although the experience can be a bit unnerving, at first, you soon start to notice the advantages: No line at the deli, no pushy shoppers, no carts jamming up the produce section. As you breeze through checkout, you think to yourself, “Gee, I could get used to this.” Now, imagine walking into an empty waiting area at your local emergency ...

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Since the beginning of the fourth year of medical school, I have lived in six different cities and have been fortunate to call a Michigan apple orchard, an island on the Mississippi River, and a little apartment in the Coolidge Corner neighborhood of Boston home. I come to you as an emergency medicine intern fully immersed in the second month of residency excited about what the future holds as a ...

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What is it? Kratom is a powdered herbal supplement derived from the leaves of a tropical evergreen tree that is native to Southeast Asia and is usually taken orally but can also be brewed into teas. It is commonly used by consumers as an alternative medicine to self-treat opioid addiction and chronic pain.  The leaves contain two compounds, mitragynine and 7-a-hydroxymitragyine, which interact with various receptors in the brain. At low doses the ...

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