It seems impossible that 2020 could have brought another existential challenge to life as a lung and ICU doctor. As COVID-19 broke out earlier this year, I found myself on phone calls with physicians practicing in far-flung areas, helping host regular calls and webinar to keep doctors in my state updated on the rapidly changing science, working on triage protocols for decisions nobody should ever have to make, ...

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I had to earn my “stripes” in ICU. After I graduated from nursing school, the “big” hospitals wouldn’t take me into the ICU, as I had no experience as an ICU nurse. Back in the early 1980s, there was no such thing as an internship program. I desperately wanted to become an ICU nurse. So a small-town county hospital took me in. It was a six-bed “ICU,” and I slowly learned ...

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She started crying. This tough, capable, juggernaut of an ICU nurse looked just a little broken for a second while she cried. "It's not fair. It's immoral—or unethical. I don't know—I know it's the right thing. We have to protect the patients and staff but ... if it were my dad! I just … I can't go tell them that she can't come see him when we know he's going ...

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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 practitioner? I would argue, it depends.  About 15 years ago, ...

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"They needed the final story to let go of her body, yet retain her spirit. Looking back on it, that’s when I saw the greatest honor of all — the everyday honor of storytelling for our patients. Maybe that’s the only cure we have for death … translating what happens from the body into the world. Perhaps that is the last frontier ...

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We are tired, overwhelmed, very committed, missing our families, and carrying each patient with us as we try to deliver excellent care in a very disorienting time. We worry about the health of our families and friends and community as well as our own health, for we are no help if we become sick and cannot continue to care for our ...

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As a newly minted neonatal-cardiac intensivist, I was all ready to take on the world. I mean, caring for the babies with congenital heart disease (CHD), congenital diaphragmatic hernias (CDH) and all other congenital anomalies and premature birth. I was excited and ready for service. It was my 27th year of "being a student." I had gone through the grind of medical school, residency training, fellowship training, and an additional ...

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Barriers. Barriers of yellow tape and plastic mark our makeshift rooms. Red zippers define the “ENTER” and “EXIT.” In the middle is a window of still clearer plastic, partially obscured by taped ECGs. Barriers are put up to keep us safe, but they can do so much more, if we let them. A tap on the plastic window has become the universal command of attention from the nurses, residents, and respiratory ...

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I am an ICU nurse. I love what I do; It's not just a career: It's who I am. No other job could offer me the intimate opportunity to support and guide a total stranger through the worst (and occasionally best) days of their life. Nowhere else would I leave feeling humbled by what I do every day. Nothing compares to that. Simply put: You don't find that sense of ...

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As I held the shaky, sweaty hand of my 52-year-old African American patient, lying in her ICU bed, trembling with fear, tears rolling down her eyes, she gathered enough strength to utter “I can’t breathe.” Her words felt like a punch in my gut, eliciting a visceral reaction, with flashes of George Floyd’s body pinned to the ground, running through my mind. The events of the last few weeks had given ...

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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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An excerpt from It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation. On that night when the desperate call came to pick up the critically ill baby with MAS, I felt very fortunate that Dr. Cunningham was my supervisor. When I arrived at the hospital ...

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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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As the pandemic loomed, there was widespread concern about running out of crucial medical resources, such as mechanical ventilators. We watched as the crisis escalated in Italy and elsewhere, where hospitals seemed overwhelmed. We prepared for the surge. Hospitals, industry, and government clamored to secure both ventilators and other valuable resources such as personal protective equipment and medications. Health care professionals were recruited to New York City and other hard-hit areas. ...

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Before becoming a certified registered nurse anesthetist (CRNA), I was a surgical intensive care unit (SICU) nurse for decades. During that time, I often saw patients during their greatest time of need – trauma victims, transplant recipients, patients with brain tumors, ruptured aortas, and septic shock. I thought I had seen it all, but working in an improvised COVID-19 ICU has taught me to expect the unexpected, and has required ...

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Last weekend, my partner witnessed some of the pandemic’s collateral damage in an upsurge of violent deaths via car wrecks and shootings. A patient of mine, chief of the local SWAT team, had predicted as much: he gave people two weeks at home before they started acting out. I expected a similar weekend and was pleasantly surprised at how few calls I received by late Saturday night. But it doesn’t take ...

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The coronavirus pandemic has turned the world, and all of its citizens, around, never to be the same again. As an ICU and ventilator survivor, I focus on the drama of the patient’s room, and the reality of what is truly a tragic experience. Nineteen-ninety-eight seems like yesterday, and while it was 22 years ago, it is fresh in my mind. The vacation abroad that fall was a sunny respite from ...

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It’s been a whirlwind of emotions during the last few weeks. I started in the hospital when our cases were starting to creep up. The fear. The anguish. The uncertainty. The anger. The sadness. The crazy dreams. The donning. The doffing. The decontamination process. The week, I signed three death certificates (non-COVID), and I sent two patients to ICU (one COVID). Needless to say, I came home every night feeling sad and powerless, knowing this COVID-19 beast has us pretty ...

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Your town has more than enough ventilators if you know where to find them. Tens to hundreds of vents are sitting in almost every neighborhood in America, but are being utilized incorrectly.  Throughout the nation, there are facilities known as LTACs, which stands for long term acute care facility. These facilities are utilized for a broad array of patient care, but almost everyone falls into three categories: the first patient ...

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Moving so quickly. Round and round. Head turning, trying to keep track. 1, 2, 3, 4, 5 … faster and faster Losing count. My head spins. A doctor, Indian, like me. A friend, my age. A mother, could be my own. No time to grieve. I kept a list of your names. So I could continue to honor you, your memory, when life slowed down just enough so that my heart had time to process. The memory is clear. I was ...

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