I was a tumultuous cloud of hope and fear as I tiptoed into my new job on a recent Sunday after five months off. By Wednesday morning, with my first three nightshifts behind me, I had already stayed late three mornings to keep up with charting in an unfamiliar EMR and succumbed to stress-eating chocolate at the nurses' station. I was reacquainted with the challenges of staying awake all night, ...

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I always warn my medical students to be careful what they say in front of patients, or patients' families or friends. "You never know who's listening!" I add. They may think that I'm exaggerating — but I have my reasons. Early in my career as an internist/nephrologist, if I had a free moment, I'd head for the emergency room. I might get a referral, and the coffee and conversation were usually ...

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Jenna had it all: She was smart, pretty, inquisitive and popular, with just one more year until she graduated from high school. She was at the top of her class and couldn't wait until high school was over, and she could become a pediatrician just like her dad. One day, Jenna would be an MD. "One day at a time," her parents always told her, even though she wanted to rush to ...

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I’m an emergency physician. In common parlance, an ER doc. Which means, like a little kid who will eat dirt on a dare, there’s not much I won’t try in the practice of my profession. Many of my colleagues have had far more challenging careers than me, I assure you. But I have some stories to tell. Cyanide overdose while moonlighting as a resident. Patient nearly dying from bite by ...

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I first experienced the impact of drug shortages in the U.S. in my first month of my residency training in emergency medicine. The most common drug used to sedate patients for intubation, etomidate, was on national shortage. I learned to use the second most common drug, Propofol, until it went on shortage too. We use it as the first line medication for sedation for painful procedures like re-aligning broken bones, ...

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I recently opined about a decision by Anthem to deny paying for emergency room (ER) care that it deemed to be non-emergent.  My point was that insurance companies should not be obligated to pay for routine, non-emergent care, recognizing that we need a fair and reasonable method to define a medical emergency.   In my view, payment should not be denied to a patient who reasonably believes he needs ER care, even ...

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A survey of 1,000 volunteer adults found 71% regularly watched medical television dramas, but only 12% said the shows “were a reliable source of health information.” The participants were given some brief vignettes describing scenarios where CPR was administered: a 54-year-old who suffered a heart attack at home and received CPR by paramedics, an 80-year-old with a postoperative cardiac arrest in the hospital after surgery, and a post-traumatic arrest in an ...

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She is 61, and she can’t help but smack her lips together repetitively. She has no teeth, and the curvature of her spine makes her a miniature version of what she once was. Her frizzy hair is a purple-gray tone, and there are dark particles of something in the knots alongside her left temple. Her clothes are too loose, and there are food stains on her shirt. The ambulance arrived ...

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She came up to me and said, “You saved my life.” I remember meeting this woman while I was walking my dog in a woody park near my home and I was taken aback.  She didn’t look like someone who should be dead; she was young and vibrant and out for a hike. Then she added details.  She had an ectopic pregnancy. She came to the ED in shock. She ...

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Can you imagine flying home from a family vacation and having a first-time anaphylactic reaction in the air? Did you know that airlines are not required to stock their planes with easy-to-use auto-injectors that any adult or child could operate? Francine's family was flying back home from vacation on American Airlines. Her 10-year-old son, who had no history of food allergy, ate the warm mixed nuts they served and immediately had stomach ...

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