Recently while traveling overseas, I found myself in a predicament not often encountered nor taught to health professionals. I was requested to address an emergency at 30,000 feet in the air. This got us thinking: How many patients consider the possibility of a medical emergency in the air? People with chronic illnesses and the older population (who find themselves retiring and having more time to travel) need to be prepared so ...

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Leaving the nursing profession is bittersweet. My heart left nursing a while ago when I came to the realization that nursing left me first. It never was a two-way relationship. The profession left me without acknowledgment of work-related stress, specifically post-traumatic stress (PTS). First responders and emergency workers often hear the phrase, "It's just part of the job.” So we all just deal with it — or not. I've heard this ...

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A meme forwarded to me last year showed a chimp with the caption: “Monkey trained to dispense Z-Paks at urgent care.” As one of the medical directors for a multi-office urgent care practice, one of the tasks is performing a chart review. One of the patterns we see too often is ubiquitous Z-Pak prescriptions for purported cough, sore throat, sinusitis and even an allergic rhinitis this last batch. Z-Paks are one ...

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It’s 7 a.m. The hospital is just starting to wake up from its slumber, stretching arms and blinking eyes. I’m 54 minutes away from the end of another night shift. Night shifts are curious creatures. They are a part of the fabric of emergency medicine life — one of the often hated aspects of our jobs. They steal us away from our families, cutting short bedtime snuggles and picture books so ...

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I am convinced that I have one of the best jobs a writer can possibly have. I practice medicine, in an emergency department. My life, every day, is filled with conversation with humans. I see their faces and touch their hands. They bring me their children, their very children (!) and trust this stranger to make their precious ones well. I hear their stories! Such stories. Of sorrow and sadness. Loss ...

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He looked tired and worn down, more so than many of the other patients I had seen that day. He didn’t speak English and I did not speak his language, but I could feel his anxiety as it filled the exam room. One of my employees translated, in fact, what his “boss” was telling us. The boss was worried that he was more tired than usual, and not getting his ...

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On a Sunday afternoon, I arrived at the hospital for my psychiatry ER shift. As medical students, we keep an eye on the track board for new patients to see. Two names turned bright red, and I chose to follow Jackie Swanson*. Her initial ER evaluation read “Patient is a 30-year-old female here for SI, HI, and AVH in context of recent sexual assault and cocaine use.” She was brought ...

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“The patient in room 17 needs an IV line! Hey, have you ever put in an IV before?!” Everybody looked at me at once. I tried my best to maintain a confident outer appearance. But I’ll admit, I was caught off guard. I thought back to my attempted IV insertions throughout my anesthesia rotation earlier in the year. I struggled with getting the IV line smoothly into the vein. I followed ...

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Six months ago, I had severe right flank pain. In the ER, I had an ultrasound showing a possible kidney stone. I deferred a CT scan and went home with medication. I fit the textbook picture: I had abnormal imaging, and I was given a treatment and discharged. I was advised to return if the pain worsened or failed to resolve. I briefly improved, but then the pain returned much ...

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He was younger than I was — still in his twenties — but the patient had already had his chest opened twice. Deadly bloodstream infections contracted from sharing needles had destroyed his heart valves on two separate occasions. And now six months out from his most recent operation, he was back with fever and chills: ominous signs of another infection. That was years ago. The opioid epidemic hadn’t yet been declared ...

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