It's the first day of residency. This morning, the intern was exuberant: the white coat was starched with pride, and the stethoscope brought a new sense of prestige. In last night's lengthy sign-out, the intern proudly asked relevant questions pertaining to patients' diseases. The first patient on the list, Mr. F, has a complicated medical history. With an array of comorbidities, including coronary artery disease, deep vein thrombosis, peripheral artery ...

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My small community ED has a fairly high acuity. As such, I was recently trying to transfer a couple of patients, one of whom was an NSTEMI, pain-free but with a rising troponin. In the process of trying to arrange things, I learned that our main regional referral center was holding a staggering 150 patients in their own ED, all waiting for inpatient beds. I've spent the majority of my career ...

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"My experience with recent knee surgery that left me significantly disabled for over a month brought this to my attention yet again. I was completely dependent on others for basic self-care since I was unable to get in and out of the tub/shower without help. I was only able to walk with significant pain on crutches and was completely incapable of navigating stairs. ...

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Thinking, Fast and Slow is a well-known masterpiece of psychology by the formidable Daniel Kahneman. He diligently illuminates two different pathways of thought, which he arbitrarily titles System 1 and System 2. System 1 describes our quick thinking, our snap judgments, our gut feelings. System 2 encapsulates our deeper thoughts, the way we systematically review information, the analysis that requires time and mental effort. The work thoroughly lays out many ...

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What do you picture when you think of health care? How different is that from your vision of health? Is it possible to connect these two mental images? Can they be merged directly or at by way of a bridge? When I envision health, I see images of vitality, vibrant smiles, glowing skin, and strong bodies. When I sense health, I feel peaceful spirits, connected hearts, kind actions.  When I witness health, ...

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"I suppose those of us between zero and ninety-three are blessed in our own way as well. We are here, swirling in a jumble of the inconsequential and consequential. We’ve enjoyed some of the world’s beauty and reserve the potential to experience more. Some of us will have longer than others, but perhaps we should focus on savoring rather than quantitating ...

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1986. I graduated from LPN to RN. And I was immediately offered a new job. Manager of a six-bed ER. This hospital had three surgical suites — 50 inpatient beds and 2 L&D suites. This was a private Catholic hospital run by the nuns. The computer system was new and a foreign object. Sister Ursula* (name changed) of medical records was so overwhelmed by the volume of paper charts that she hid ...

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My Danskos literally disintegrated last month. I was in the hospital team room, finishing up my patient notes at the end of a busy hospitalist shift. I happened to look down at the floor, and there they were: black chunks on the carpet. I thought, “Who left such a huge mess under the desk?” I looked at the bottom of my black Danskos. There was a sizable chunk of the sole missing. Finally, the ...

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It’s an odd time to be a new physician. One of the best parts about working at a hospital is the sense of friendship and professional camaraderie that you build with other doctors, nurses, therapists, medical assistants, secretaries, etc. However, in the COVID-19 era, group events, bonding activities, dinners, conferences, social events, and holiday parties are no longer responsible options. This is for a good reason; according to an email leaked ...

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Like everything in life, applying for residency this year is going to be radically different. There won't be any long cross-country plane flights, no driving across state lines, no crashing at friend's places to save money on hotel nights. Residency interviews are going virtual. Medical students that need help with the residency applications virtually, can use this helpful tool to make better decisions. For some students, this ...

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I read with fascination the opinion piece published New York Times:'" But I Saw It on Facebook': Hoaxes are Making Doctors' Jobs Harder" because it's a topic that's been on my mind lately.  Particularly after I engaged in a Facebook exchange with close friends who were forwarding misinformation from the less than reputable "American Frontline Doctors" about COVID-19.  The American Frontline Doctors group was more interested ...

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"Is it possible to have it all?  Can you have a job that you love, helping people and using your brain and hands all at the same time; plus, a family, with a spouse and children, that you are always there for?  Is it possible to have a balance between your work and your family live while working as a medical ...

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Due to the COVID-19 pandemic, the number of cancer screenings performed in the U.S. has plummeted. After decades of progress in detecting, treating, and preventing many types of cancers, this nation could face a “cancer pandemic” in the next ten years as a result of this delay in routine screenings. Postponed or canceled appointments for cancer screenings will likely result in delayed cancer diagnoses, recurrence of disease, and increases in cancer deaths. That ...

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This new virus is changing everyday life-hospitals are doing their best to protect their staff and patients.  One thing I've learned is that they need to do a better job of communicating with families. My husband was 70 years old when he died of cancer and COVID-related issues.  He was diagnosed with stage 4 cancer, lung mets to the brain on December 23, 2019. Because he had only one lesion in ...

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"I know I am not alone in my thoughts; I am just echoing sentiments of other female physicians. We are mothers, wives, patient advocates, and educators. And we’re all suddenly finding ourselves in unchartered waters. In weathering this pandemic, I’ve taken time to reflect. I wish I could say I emerged from this introspection having conquered all my fears. Instead, I ...

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We love our morbidity and mortality rounds in medicine. A time when we can look over some medical mistakes and take some time to analyze what went wrong. We debate, criticize, and some of us like to imagine that we’d never make such an egregious error.

But why are we always paying attention to the negative outcomes?

One perspective is that it’s a function of how ...

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"Through my coaching of girl’s basketball in California’s Central Valley, my daughter and I were fortunate enough to know Kobe as a mentor and coach, and a person who inspired my daughter to be the best through hard work, dedication, and passion. While Kobe will live on as one of the game’s greatest athletes, he wanted to be remembered for much ...

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“We are transitioning.” In July of my intern year, this was the sentence that the CEO of our community hospital used to tell the staff that the hospital was closing its inpatient services. The emotions that traversed my mind were quite vast, to say the least. Anger was undeniably at the top of the list, but mostly directed at myself. Initially, I thought medical school definitely did not prepare me for this. ...

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One of the most harrowing challenges of COVID-19 has been the "no visitors" policy virtually all institutions were forced to implement. In order to protect our patients, our staff, our communities, we've had to put these visitor limitations into place until the tide turns. Not too long ago, I woke to my husband lying stiffly on his back, declaring, "I think I need to go to the emergency room." He'd mentioned ...

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 In today’s increasingly technological, data-driven, depersonalized world of health care, I wonder if the concept of “a good death” is even possible. The COVID-19 pandemic, in particular, has caused me to reflect on this. What does it look like? How do you define it? As I did, a patient came to mind. He was a retired minister in his 80s. I had cared for his wife as well ...

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