As a woman physician, practicing for over 31 years, I have faced many misogynistic occurrences as well as misperceptions about my career choice. This blatant devaluation of women within medicine may be similar to what other women have had or continue to face daily. At large, these experiences resulted in a journey not always easy, nor welcomed, but in the end, accepted for the maturity obtained. My hope is that by ...

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The room is half-lit from the sunset. Crowding around the bed, in almost saint-like postures, is the family of our patient who is in her last moments of life. I do my best to console the family, a light touch on the shoulder, and honest stare. Then, there’s the inevitable moment, the palliative extubation. Our patient, gasping for air, head turned to her side, the room in a quiet somber. The moment ...

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I was a brand-new intern in the intensive care unit, and Cassandra was the very first patient I saw there. A petite, slender woman, she was rolled in on a stretcher, accompanied by her tall, athletic husband, Jack. Cassandra was in her 20s, like me — but mortally ill. That grabbed my attention from the start. But the biggest lesson she taught me came about because we got her prognosis all ...

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I woke up to him, pacing the bedroom. Within an hour, I was pacing the ER at his bedside. Our experience at one of the country's best-ranked hospitals lasted only three days before we were discharged home. What led us there will last a lifetime in our minds. When faced with your own mortality (or that of your husband's), you are forever changed. We are grateful for his continued recovery from myopericarditis. ...

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"Deeper compressions! Deeper! Make sure you get that recoil!" I push harder and lift off higher. I'm starting to sweat. My stethoscope is banging around my neck. I should have taken it off, I think. My hair is flying around my face. I should have tied it up. I'm on tiptoe; my legs are cramping. I should have stood on a step stool. "All right, she's getting tired. Next!" Embarrassing ... I only ...

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I read Samuel Shem's House of God twice — once in my late college/early med school years and another sometime during my pulmonary/critical care fellowship. The first time, I recall thinking it was drop-dead hilarious. I eagerly shared it with friends and family. Absorbing the wisdom of the fat man, the catchy vocabulary, and the cynicism of the narrator made me feel somehow like an insider wise to the game ...

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For what seemed like an hour, I stood staring at the flat lines scrolling endlessly across my monitor in the OR. The once pulsatile waves, rendered useless and flat due to the absence of a beating heart. After a frenzied six hours of pouring blood into the patient while it poured back out of her just as fast, the surgeons drowning in blood in their attempt to sew the new ...

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All of us nurses and physicians in the ED and ICU knew him well. He was a young, 21-year-old. A smart, articulate guy who kept going from one hospital to the next. He had a system down ... almost. This young man was a drug seeker. He knew all about seizures and how an Ativan IV push felt during the "seizures" he allegedly was having. Even though he had several identities and different ...

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“I just don’t know what to do, how to help.”  My patient’s wife was slumped in the plastic chair by her husband’s side, fatigued and beleaguered.  She had been there for hours, days, as we waited for antibiotics to start fighting back against the infection that had overwhelmed his body. “What sort of music does he like to listen to?” “Depends on what he’s doing.  Zeppelin to work on the car.  Jazz ...

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Perfect nurse. Perfect manager. Perfect puppet. An ICU physician once told me: Nurse managers have a life cycle of a mosquito. Fast and furious And then gone. Deleted until the next one shows up. It was the perfect ICU. Twenty-five beds. Dynamic intensivists. Phenomenal. And they respected us nurses and collaborated with us. We had perfect cerebral perfusion together. Experienced ICU nurses who knew what to do like clockwork — teaching the younger new nurses. Teaching them the facts of ICU. ...

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We had just exchanged "I love yous" about 15 minutes before the intercom blared: "Code blue." Just like that, my sister was gone — all from what seemed like a simple knee surgery. Simple in the fact that the type of surgery my sister was supposed to have had that fateful morning was an open reduction and internal fixation (ORIF). Thousands of these surgeries have been performed every day. But something ...

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I recently had the pleasure of participating in an administrative law judge (ALJ) hearing. Novitas, the Medicare administrative contractor had denied the E/M code 99291, critical care. The case was appealed to the qualified independent contractor, who also believed that the care, in this case, did not meet the CMS and CPT definitions of critical care. Subsequently, the case was appealed to the administrative law judge. The encounter occurred in an ...

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Our 20-bed ICU finally captured 10 intensivists — all board-certified in critical care medicine. We were fortunate enough to have one of these doctors in our ICU 24-7. Of course, they all practiced professionally with expertise. But I remembered this one the most: Dr. Jason McKenzie (name changed for privacy). He easily became our friend and "go-to" person. Clocking in at night and finding out that Dr. J was our doc, would give me ...

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Halfway into my four-week hematology consults elective at the county hospital during my fourth year of medical school, I was surprised that one of my patients was a 25-year-old woman from Romania — exactly my age. This was highly unusual, as most of the patients I had seen on this service were not this young, especially with a malignancy. What was even more unique was that she had just arrived from ...

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If you went to go to a museum in New York City and saw a live heart encased in glass, still pumping and pulsating — it would be my heart, shredded into a thousand pieces all in disarray. But it still would be pulsating. This describes my life as a nurse. Nursing was a vacuum that sucked me dry and left me dangling with nothing more to give. Three years left ...

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She was a middle-aged female who was life-flighted from an outlying facility to the tertiary care hospital in which I worked. As she quickly rolled out of the elevator, I ran toward her and saw her blood pressure was tanking with her mentation fluctuating. My hair mindlessly placed in a ponytail, my blue scrubs wrinkled, and my nerves a jumbled mess, EMS briefly gave me an account of her history: ...

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Medicine was my path. I’d decided that early in life before I knew what a career in medicine really looked like. I believed as a doctor I could help people and have a positive impact in their lives. After all, what does a teenager know about being a doctor? I’m not a teenager anymore. Here I am at 3 a.m. in the neonatal intensive care unit (NICU) at the bedside of ...

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These events happened over 18 years ago. Some content has been changed to protect the innocent and the guilty. Searching for positive changes in the health care industry. We are not a number, and the patients are not a number. I’m not good at lying. My eyes go to the left or look downward, and I start to stutter and pause. There is no eye contact, and I fall deep into ...

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I became a nurse at the age of 23. I was pregnant with my first son and dove into nursing headfirst, accepting a job in the pediatric ICU of the hospital where I worked. I still remember the call when I received the job offer. I hung up and jumped up and down, screaming in excitement. I couldn’t believe that I got my dream job, the job that wove my ...

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Matt was 40, my sister’s age. He was training for a marathon and trying to talk his many friends into joining. He lay in bed with his three-year-old son every night to help him fall asleep. It’s hard to sleep train a toddler with a newborn to nurture at the same time, but he loved spending this time with his two kids and being the dad everyone counted on. Matt’s best ...

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