COVID-19 has made the inadequacy of our public health and hospital-based health care system to identify, mitigate, and resolve pandemic disaster self-evident. Gaps in hospital-based preparedness capacity are abundant, including the inadequacy of stockpiles for personal protective equipment (PPE), ventilators, medications, lack of surge inpatient and ICU capacity, and an inability to rapidly scale testing or interventions to meet pandemic demands. The initial outcry placed blame on Federal and State governments, ...

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It’s 4:30 a.m. as I trudge to the parking garage with a sense of defeat. I am an internal medicine resident wrapping up a swing shift, the magnanimous buffer to admission responsibilities between the day and overnight ward teams. Though clinically tucking in patients that arrive before six o’clock is often easily accomplished well before midnight, this time had been different. Not two hours into the shift, I reached my ...

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Seven years ago, I took a hot yoga class in a packed studio, an R&B playlist bumping loudly, the woman next to me sporadically singing along with the music. Afterward, she smiled at me and said, “It was nice to practice with you!” I was new to yoga, and this was the first time I considered yoga as a practice, a word signifying a skill performed repeatedly in order to ...

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Two-paged signouts This was the picture of the unusually higher than normal patient load we have in the wards. The hospital looked grim and eerie. Gone were the days when we would start with morning report and see plastered smiles on colleagues’ faces, relaxed and ready to conquer the day. I saw patients without visitors. I’d hear rapid response teams more frequently – so I made a habit of memorizing ...

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COVID-19 has upended the medical community. Nowhere more so than in the intensive care unit. Life as an intensivist with two young children and a working spouse is never dull. I liken it to tight-rope walking with a pole for balance. I wake up every morning and balance the clinical responsibilities, teaching, reviewing journals, learning, school assignments, lunches, after school activities, bedtimes, repeat, repeat, repeat.  The balance remains just ...

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“I stayed up all night, and for what, $10 a consult?” A clearly exhausted and exasperated colleague and friend said to me one morning after his very busy call shift. As a chief resident, one of my roles is to manage the call duty schedule. As such, I frequently hear about how residents feel about call. Interestingly, many comments have to do with the economics of call: “It’s just not worth ...

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As I come to the end of my internal medicine residency, I cannot help but experience a flurry of emotions. I am sure many of you, like myself, are feeling a whole host of sensations: relief at the fact that you have now completed over 23 years of education/training; exuberant joy when you click on your schedule and realize that you have no more 28-hour calls; and sadness when you ...

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Imagine there are two individuals who have been admitted to a hospital due to COVID-19, and both desperately need ventilators. One is a 60-year-old with a heart condition, and another is a 63-year-old with chronic kidney disease. Because of resource constraints, you have to decide which patient will be able to receive a ventilator. Both patients’ families are looking to you to help their loved one through this illness. With ...

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One of the most memorable milestones in my life was my journey to becoming a doctor. A path that I look upon so fondly as it marks a time that molded much of who I am today. Charles Dickens describes my experience perfectly, “It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness …” Like many of ...

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Let me tell you a story about Francisco, a recent patient under my care in one of New York City’s hardest-hit hospitals. Suffering from severe COVID pneumonia, he gasped for air as I tried to exude empathy underneath the cold appearance of my head-to-toe, blue protective equipment. Carefully placing a breathing tube into his airway, I connected his lungs to a machine by a single plastic lifeline. Hoping also ...

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Elmhurst 2014 I first arrived at Elmhurst Hospital in Queens, NY, in the summer of 2014 as a medical student on my surgery rotation. We would take occasional night shifts as part of the trauma team. It was the first time I held a pager. Code yellow meant hurry; code red meant run. One of our first patients was a code red, a young man, not much older than I am now, ...

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I am a graduating fourth-year medical student and new internal medicine resident — one of many newly minted physicians that will be thrown into the frontline to take care of COVID-19 patients in a little over a month. It's a strange time to be graduating – we have spent years training to get to this point, yet celebrating is the last thing on our minds as we gear up for ...

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April 2020 was to be a month of personal milestones. I would be traveling to Mexico with sixty closest friends and family to marry the woman of my dreams. Twelve days later, I would celebrate my thirtieth birthday. Suffice it to say, I was looking forward to April with the excited anticipation of a child on Christmas Eve. But that was before COVID. Before all eyes were focused on the novel ...

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On Friday, March 27, 2020, California went on lockdown in the face of the COVID-19 pandemic. It changed every Californian's life, including my own. As the newly appointed chief scribe, the possibility that I would be jobless by the time Monday rolled around, was the last of my worries. What would happen to the patients who depended on our care? Or the physicians, nurses, and administrators that kept the center ...

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With the rise of the internet, people started exploring ways to get medical advice online. The medical community was initially humored by this development, thinking it is a cute way for patients to look up their symptoms before coming to see us, their doctors.  The next stage in our response was irritation. As more people flooded our offices, our emergency rooms, and our hospital wards demanding treatments ...

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I am an internal medicine doctor on the frontline of the COVID-19 pandemic in Oakland, California. Before the first confirmed case at my hospital, I could sense the fear and anxiety of the impending disaster with every interaction I had with colleagues and my patients. This was largely due to the uncertainty of what was to come, and we were mainly looking towards the overwhelmed health ...

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In a perfect world, an electronic medical record would aggregate a patient’s medical information from all health care providers into a single, comprehensive record that could be easily accessed by any provider with the patient’s permission. This information could reduce the risk of medical errors, duplicate testing, and inappropriate treatment and the associated cost of these mistakes. It could also be lifesaving in the event of a medical emergency that ...

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Elise loves this book. The protagonist is a girl who, due to a desire to fit in with her friends, denies her love of lima beans. Camilla awakens with stripes on her skin, and no one can explain it. The doctors are called in, then the specialists. The scientists and experts come next, but all are stumped. ...

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Life may never be the same after COVID-19.  With tens of thousands of Americans having succumbed to the coronavirus in the United States, some of us are considering our own mortality.  Life insurance companies have plenty of new customers.  Estate planning attorneys are busier than ever.  Many of us are thinking about how our loved ones will be taken care of in the event of our own death. Death is always ...

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We worked tirelessly attempting to resuscitate this mother of five for almost an hour. Her husband was called, and he notified us that he would be there shortly. In the end, our heroic measures were simply not enough. It is fearful to imagine being told your wife and mother to your five children is no longer alive on Mother’s Day. The uncertainty of what killed her is a tough pill ...

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