Medicine causes just as much disease as it solves. We must adopt the lifestyle to get through college, medical school, residency, and fellowship is nothing close to a healthy lifestyle. Previously, we discussed the long hours and the lack of exercise, but our food inhibits our desire for health. This begins with what the hospital cafeteria sells. Despite promoting healthful eating, hospitals instead profit from diabetes-inducing food ...

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"My sister called me. I answered. And, then, I lost it: 'He died. He died,' I repeated. 'Our patient died. I literally did CPR on this guy. We tried to save his life, and he died,' I repeated over and over. The tears streaming down my cheeks were cathartic. More than signifying ...

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An excerpt from Why We Revolt: A Patient Revolution for Careful and Kind Care. It was late at the premier teaching hospital in the country, and we were overworked and overwhelmed. Those patients in most trouble had made it in, but many waited outside, a domino line ...

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For most of us, medical training through all the pains of medical school and residency is often bearable when we fantasize about life on the other side of all of this. Life as an attending physician, when the sky suddenly turns all rainbow, when the money starts to fall from those skies -- we're finally our own bosses, and then we're supposed to live happily ever after. The reality, however, ...

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"A majority of physicians see between 11 and 20 patients per day, and among all practices, the majority of doctors spend between 17 and 24 minutes with each patient. Assuming a five-day workweek, this translates to more than 900 patient interactions per year and over 1,066 minutes spent communicating with patients. Today, many ...

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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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A year ago, it would have seemed absurd for a medical resident to call out sick with nothing more than a cough and congestion. It’s different now. The calculus of cold symptoms has changed.   When one of us recently woke with a sniffle, she wondered if she should stay home. She logged into her computer and saw that ten patients expected to see her in clinic that day, including several who had ...

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After I retired, our regional medical center realized they had accumulated scores of physicians of major capability and stellar professional reputation whose careers had either concluded or entered their closing years. Though I had retired from a different institution, I had been on staff there for twenty years, so they graciously absorbed me into their newly created senior physicians advisory group.  Its purpose and activities remain in evolution with periodic ...

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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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In the middle of a busy week of balancing clinical, research, educational, administrative, and parental responsibilities, I receive an email request from a prominent journal to review a manuscript. If I agree, I will spend a couple of hours reading the manuscript, offering comments, and registering my opinion. Several weeks later, I’ll probably be asked to review an edited version all over again. And in exchange for this effort? Nothing. ...

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I wake when the sky begins to darken. As the sun buries itself beneath the horizon, the hospital beckons. Nights bring a kind of calm. I find that wakefulness, while others sleep, grants me something sacred — time, untouched. Circadian rhythms align us with light: The sun guides us through our days, the moon lulls us to sleep. Night shifts cast aside any semblance of schedule and orientation. At dusk, my body ...

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At a recent annual exam for one of us (Walter), the medical assistant had checked heart rate, blood pressure, temperature, and oxygen saturation. Inquiring cheerfully about the Fifth Vital Sign, she flashed the 10-point pain scale of emojis ranging from beaming to grimacing. The only mention-worthy pain was an occasionally aching meniscus from a forgettable high school football career. It was refreshing that she didn’t ask about burnout. Everyone else was. ...

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“I’m sorry to have to tell you this news,” I said to the couple, who were hugging each other as their baby slept in his bassinet. “I know it is very hard to hear. But I want you to know that we are here for you and your family, and our team will walk every step of this path with you.” There is no easy way to tell a parent that ...

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Years and years ago, I wrote a novel called The House of God, based largely on my experiences as an intern at what was then known as Beth Israel Hospital in Boston. At its core, the book was about the injustice in medical training. A lot has changed in medicine in the ensuing 40-plus years, not all of it for the good. In fact, all of us — doctors, nurses, patients, hospitals ...

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During the third week of my internal medicine rotation, I was assigned to a patient who would be brought to our floor following an operation. I saw him briefly as they wheeled him into his room but could hear his screams of pain all through our morning rounds. When I walked into the room, he was in agony. He could barely speak, and all he could say was, “It hurts.” ...

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"I didn't understand what you said," said the waitress. "She very clearly said she wanted a quesadilla with a side of beans!" yelled an elderly gentleman at a different table. The nervousness that arose when ordering food at restaurants grew as months passed like the fetus of a diabetic mother. My thoughts would race around what words to pick and how to pronounce them. My cheeks flushed as I stuttered sounds that ...

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"Setting: An impersonal, windowless conference room within a hospital Characters: A nurse in charge (NIC), a department chair (DC) and me (ME) NIC: Thank you for joining us to discuss the report you made of unprofessional behavior in the operating room. We’d like to start by letting you know that in this institution, we have a culture of informality. When I first got here, ...

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The following article is satire. According to several very old studies, interventional patient-centered bipedal locomotion (sometimes informally referred to as walking) might be an important part of good hospital care. Programs focusing on this treatment are reportedly under consideration by administrators at some facilities. “As we look to streamline interoperability and optimize outcomes metrics, we’re thinking about anything that we could attach a number to,” says Larry Perry, Chief Medical Information Strategy ...

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For a bunch of folks striving to stomp out malignant processes in our patients, we sure tolerate a fair amount of destructive behavior among training programs.

I’ll be the first to say I’m not the most delicate flower in the garden. Before pursuing medicine, I was a college athlete. I’m no stranger to long hours, harsh coaches, or repeated failures.

Medical students get their first bitter taste of malignant ...

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"The incident bothered me all day and the following many days. I couldn’t quite put a finger on what it was and brushed it aside and stopped thinking about it. In the wake of recent events, it dawned upon me that it wasn’t the patient’s comments that bothered me. It was the fact that no one standing in the room witnessing ...

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