In the hierarchy of health care professionals, I supposedly stand on one of the lowest steps of that ladder. Some say I am just a CNA. Some say I am the backbone of nurses and physicians. I say: I am a strategic part of this ladder. I do not have the medical knowledge or skills of a physician nor of a nurse. But what I do have is a heart …
The first time I watched One Flew Over the Cuckoo’s Nest, it stayed with me for days. As an internist who has had the opportunity to care for psychiatric patients, I could not watch it as just a movie. I saw the familiar faces, the emotional extremes, the silent battles between care and control. And I felt the weight of questions the film still asks us today: Are we truly …
Gasping for breath, Michael (name changed) pushed back in his chair. His legs felt like lead weights. He could not delay the rescue call any longer. The oxygen in his blood had dipped into the 80s.
An X-ray showed a shadow over the lower part of Michael’s right lung, and the hospital admitted him to treat a pneumonia. A smoker for decades, he was relieved a few days later to be …
Born a son to immigrant parents, one of whom did not speak any English early on in my youth, I struggled to assimilate to American culture, to friends, and to the everyday language and vernacular during my formative years in grade school, middle school, and even high school. My mother raised my brother, sister, and me while my father worked two, and sometimes three, jobs to make ends meet. Mom …
I had heard about night float: a daunting rotation for interns as they cared for patients they often were not well acquainted with, putting out fires until their usual team could take over in the morning. Given this reputation, I was surprised to find a night float week on my schedule as part of my internal medicine clerkship, a core rotation as a third-year medical student.
My first patient was a …
When I began my internal medicine residency in 1987 at Boston City Hospital, all new interns were enrolled in the Housestaff Association, the residents’ union. Some of my resident peers were active leaders in the union. Coming from Minneapolis …
As a doctor working in a primary health care setting, it’s become routine, almost expected, to hear patients ask for a drip. Sometimes it’s after they’ve listed their symptoms, sometimes they say it right after walking in: “Doctor, please just give me drip.” And often, the complaints aren’t serious. It could be catarrh, a mild fever, or even plain tiredness.
At first, I didn’t understand it. I’d look at the patient’s …
Today for the first time, I got flowers from a grateful patient.
And I reflect on how rough the week has been, all the things that seemed impossible and insurmountable, and everything that has brought me to this point. The patient is going on hospice, he’s going to die, yet he felt that I made a significant impact that he wanted to show his gratitude. And that almost brought me to …
When I was a new hospitalist in a tertiary center, I once told a colleague, “Looks like I got an easy admit.” He just stared at me.
It didn’t take long to understand why.
Vitals can be stable. Labs can look clean. But patients—especially those we assume are “simple”—rarely are. There’s a language beyond numbers: the way a patient breathes, a hesitation in their tone, the look in a spouse’s eye. Over …
The slow beeping of the monitor comes to a halt and someone eventually shuts it off.
Click clack.
The machines are quiet now. I take one more look at the innocent, boyish young face and wonder what kind of life he had led. I leave the room, along with the rest of the team. A hand draws the curtain closed.
Death.
Quite literally, the most final force on Earth. The permanent, irreversible cessation of …
It’s July—the official new year for medicine.
You’re either a brand-new intern, wide-eyed and exhausted, equal parts proud and terrified, or maybe you’re stepping into fellowship, wondering how you’re suddenly supposed to be the expert. You’re navigating hallways you haven’t mapped yet, still figuring out whether your badge works on the north wing or the south elevator, trying to remember where you parked, and already questioning if you made a huge …
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Hospitalist Jasminka Vukanovic-Criley discusses her article, “When grief hits all at once: a morning of heartbreak and love.” Jasminka shares a deeply personal account of a Saturday morning where unexpected news of …
I entered medicine like many young physicians do—eager, determined, and drawn to its promise of excellence. The white coat, the respect, the thrill of diagnosing a rare disease or saving a critical life—all of it called to me with undeniable force. I studied relentlessly, passed my boards, published research, and spoke on conference stages. Those achievements came with a sense of pride, even joy. But they were not the full …
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It was early morning—likely the first appointment of the day. The music in the waiting room had not even been turned on yet, and the smell of coffee was just beginning to meet the air. After a few minutes, I was called back to a room and sat in the exam chair, already in scrubs and mentally preparing to scurry off to work right after. In fact, I was already …
An older woman with osteoporosis fell at home, developed back pain, then went to urgent care and was diagnosed with a “muscle strain.” During a follow-up visit in my office, she told me she’d had transient urinary incontinence after her fall, and on exam she had midline back tenderness, hip flexor weakness, and hyper-reflexive knee jerks. This woman had suffered a vertebral fracture, not a pulled muscle.
One of my patients …
Several decades ago at our local hospital in northern Los Angeles County, an onslaught against doctors began. The administration marginalized and discredited them. It was not due to a lack of medical skill or knowledge, as certain physicians were labeled “troublemakers” and “threats” to health care in our small community.
The chief of staff and I, the chairman of the Department of Medicine, were members of the staff, some of whom …
It’s 4:30 in the morning. I can see the small clock across the room. I lie in a hospital bed. The woman who approaches, the nurse, I know a bit. She greets me with, “I need to take your vitals.” I know there is more to her message, but she doesn’t say so yet. The light around my bed is dim.
I’m in a hospital, a large one in a fairly …
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Former American College of Physicians treasurer and infectious disease physician Janet A. Jokela discusses her article, “Internal Medicine 2025: inspiration at the annual meeting.” She shares her personal reflections on the profound …
After 35 years in health care, I thought I’d seen it all—until it happened to me.
We talk about burnout, compassion fatigue, and systemic issues in medicine. But there’s something more silent, more painful, and far more personal happening in hospitals and clinics across the country: Generational warfare.
The young eat the old. And the old? We’re expected to disappear quietly.
In my early years, experience was respected. Elders were mentors. Wisdom mattered.
Now, …
This article is satire.
Dr. Donovan Trumble was not your average internist.
In fact, if you asked him, he wasn’t your average anything.
He called himself “the most successful physician-researcher in America—maybe ever,” and once declared during grand rounds, “If Sir William Osler were alive today, he’d be my opening act.”
To the faculty at the Ivy League medical school where Trumble had once chaired the Department of Clinical Egotism (officially “Translational Medicine,” but …
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