Yes Virginia, there are still some doctors who truly care for their patients. On December 13, 1993, my husband Bill was playing golf.  Early in his round, he suffered a massive heart attack.  Bill was 56 years old.  Thanks to the staff and emergency room staff's quick action, Bill was stabilized by the ER physician.  That same afternoon, Bill suffered a second heart attack, and Dr. Robert Barden performed Bill’s first angioplasty. To make a ...

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“Please don’t go just yet. Promise you will come to see me again?” she asked, with a frail quiver in her voice. “But of course, see you on my rounds tomorrow!” I replied, trying to sound cheery, as I turned to leave her negative pressure ICU room. I was doubtful if she would even remember my masked-gowned presence by the next day or even the next moment. For COVID with its ...

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From a medical perspective, ‪Mr. G’s case seemed straightforward. His GFR had fallen. His kidneys were failing. Dialysis would be required as the best treatment for his renal condition. When I met with Mr. G later in the afternoon, he was in despair. He could not see how dialysis would save his life and expressed anguish towards the idea of living the remainder of his life on dialysis. He deliberated declining ...

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The cardiologist was called STAT to the ED for a 50-year-old man with an acute STEMI. The man arrested eight times in the ED, each time successfully resuscitated. He finally stabilized to where he could be moved to the cardiac cath lab. The cardiologist quickly met with the wife and told her the plans and that they would do everything possible to save her husband’s life. As he turned to ...

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Consider the following sports icons:  tennis legend Billie Jean King, basketball veteran Larry Bird, triathlete Karsten Madsen, baseball pitcher Kenley Jansen, and cyclist champion Haimar Zubeldia. What do all of these well-known professional athlete heroes have in common? They are athletes with atrial fibrillation, also called AFib. AFib is the most common heart rhythm disorder worldwide, accounting for 750,000 hospitalizations per year in the US alone. It is estimated that 6 ...

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It is stressful enough to live with heart disease. Now, with a global pandemic, access to health care providers has shifted from in-office to telemedicine in many instances. There are challenges for patients with heart disease in this context:

  1. Patients are often older and are not familiar with using technology for videoconferencing (Zoom, Doximity, FaceTime, Skype).
  2. The electrocardiogram and physical exam still remain the primary ways we assess the heart ...

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Vince Hamilton has no legs. For that matter, he has lost the tips to most of his fingers as well.  It made opening soda cans almost impossible.  So when I saw him for the first time, my immediate reaction was one of sympathy. He had been admitted from a nursing home with a swollen red finger nubbin.  It wasn’t hard to figure out it wasn’t his first time around this rodeo from ...

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"We have to start understanding these as the real costs of climate change. We are paying these costs now. In my state of Oregon, people are going to start getting sick and dying in the next few days of the wildfire smoke choking the air. When they show up to the hospital ...

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It seemed like an innocuous tweet. It was just a doctor, somewhere on Twitter, declaring that it was important to learn to quickly ascertain if patients were “sick or not sick.” It was sentence; perhaps two. It spoke volumes. He was not suggesting that doctors needed to learn to quickly assess severity; to triage for treatment priority; to know when to send a patient to a specialist. Nope. It was “sick or not ...

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The academic medical community has drastically changed how we educate and share our ideas since the first wave of the COVID-19 pandemic in the Spring of 2020.  The remote meeting, often conducted via Zoom or a similar web-based platform, has gone from a rare occurrence to the default manner in which we conduct business.  As a full-time academic cardiologist with three children under six years old, to say evening meetings ...

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As the mother of a child born with hypoplastic left heart syndrome, besides going through four open-heart surgeries and coding, my son has also had eight abdominal surgeries, including a Ladd’s procedure and resection of his colon.  William also functions without his appendix, spleen, and gall bladder. In addition to every kind of therapy imaginable, he has had to endure pamidronate infusions, daily shots, G-tube feedings, and TPN. Who knows ...

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"We are social beings. Evolution has taught us that in order to survive, we must work together. Community trust (trusting your fellow citizen) is a very effective way to build community resilience when hardships strike. Studies have been done in the wake of natural disasters and have shown that social infrastructure and connections have equal, if not more, impact on the ...

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The patient arrived in cardiac arrest. He had been brought to our emergency department in the middle of the night. Although he had a significant cardiac history, including bypass surgery, he was only in his late 40s. His transport from his house to our department had been less than 10 minutes, and the pre-hospital team had done an excellent job of intubating this patient and establishing an IV to begin ...

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During my first year of medical school, a professor in my clinical skills course shared a timeless adage in medicine: “If you listen closely enough to the patient, they will tell you the diagnosis.” I accepted this statement as a fact of medicine - if I could develop astute history taking skills in my first year, this skill would serve me well throughout my medical training. However, when I volunteered ...

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Some people have high cholesterol but not much atherosclerosis. We think of their arteries as having nonstick surfaces. We know inflammation can predispose to plaque formation and plaque rupture, which is the trigger of most heart attacks. We know statin drugs can prevent and reverse plaque buildup, and make existing plaque sturdier and less likely to rupture. These drugs lower blood levels of inflammatory substances. Most doctors focus on their cholesterol-lowering ...

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"Trainees like myself travel great distances from home in pursuit of higher edification. Yet the coronavirus makes us worry about the aged family we leave behind – parents and grandparents. A WhatsApp message ensuring they’ve stocked up on acetaminophen, toilet paper and canned soup (low sodium, of course) the only assuage to our anguish. The rigors of medicine often demand sacrifice, sometimes ...

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It's the first day of fellowship, and everyone's getting to know each other. "Oh, you won't have time to work out here." I'm not the small, scrawny kid I was back in high school anymore, even if that's the person I still see in the mirror. I've added roughly 50 pounds since college, and it shows with the things people say. Being told I won't have time to work out has been ...

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One of the greatest health challenges in our lives is the phenomenon of burnout. It occurs when there is enough negative stress that persists over time. As many of us know, stress is an integral part of being human. It can be positive (an upcoming wedding or birth of a child) or negative (job loss or physical injury). At its core, stress is any physical, mental, or emotional factor, external or ...

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As a nurse practitioner, I have the privilege of helping people achieve their health care goals. But in light of recent events surrounding social justice, I find that I am increasingly challenged in new ways. Ways that my training and likely other nursing or medical schools did not address. I have that uncomfortable feeling of being ill-prepared to address the ramifications of social justice on the health of my patients. ...

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In a small community not far from my hometown, Paul sat peacefully in his self-built abode on a July day like just about any other. Happy to experience the peace of his bucolic life far from the hustle and bustle of the city, he rarely visited a doctor despite a festering back ailment that limited his ability to work. He had no retirement savings and no plan for life after ...

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