Very many years ago, as a medical student, I remember caring for a twenty-something-year-old in the intensive care unit (ICU) with a very severe infection that resulted in her being in the ventilator for months. Let’s call her Jane. Her hospital course was complicated: re-infections, loss of digits, muscle wasting. The ICU was closed to families during morning rounds which is when all the doctors in their white coats gathered and ...

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I visit him in the ICU day in and day out. It's the man with the fedora. I see him every day because he is not going anywhere. The metastatic cancer has ravaged his colon, bones, liver, and lungs. His oncologist is willing to try more chemo — but not now — maybe someday “when he is stronger.” The man has already failed several other regimens. The oncologist hasn’t seen ...

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“Why don’t you just get a shotgun and blow his brains out next time? Better yet, next time stay the hell away from my patient!” I was frozen, and the ICU attending wasn’t even talking to me. My co-intern had barely started her presentation when she met damnation. Mind you — there was a senior resident, a pulmonary fellow, and a team of nurses caring for the patient also. Yet the ...

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The ICU nurse positioned the mirror in front of my face. “You look more like yourself now, Dr. Berk,” she said. She was right! The nurse, whose name was Meghan, had just shampooed, dried and brushed my hair. Clean and coiffed for the first time in over a week, I appeared normal — except, that is, for the tubes sticking out of my left nostril and my mouth. It was 2009, and my ...

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May lay in a hospital bed, her wrinkled skin covered with sensors that monitored her every breath and heartbeat. Her husband sat at her bedside gently stroking her withering gray hair as her chest moved slowly up and down accompanied by the soft whoosh-whoosh of the ventilator that breathed for her. He stared expectantly at her face as if at any moment she would rise and free herself from the multiple ...

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We had no choice in becoming the “crazy” family that left a hospital against medical advice. Our four-day-old daughter was completely helpless, her condition deteriorating and the staff was ignoring our concerns. I carefully turned off the blue lights, removed her from the isolette, placed her in a car seat and eloped from the pediatrics unit. As a hospitalist, I constantly obsess over medical errors. The majority are more subtle than ...

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Multiple strokes, respiratory failure. Cardiac arrest — twice. At first glance, I thought that I was reading the medical chart of an elderly person or at least one who had some other predisposing medical conditions to explain her current state. But I was staring at the body of a 28-year-old woman. She had a youthful face and frizzy hair from being propped up on the same static-charged pillow for the last few ...

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Death is on our floor. It has been there for far longer than I have. On my first day in the cardiac surgery ICU, I was running late. I hurried past the dimly-lit rooms, their monitors regularly chiming their final lullabies of the night before the receptionist brightly greets the morning shift nurses and flips on all the fluorescent lights outside the twenty rooms on this floor at 7:00 a.m. sharp. There ...

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A recent sports injury required me to have surgery. As a cardiothoracic surgeon, my experience as "the patient" reminded me of lessons-learned years ago on finding one’s purpose. You should never underestimate your capacity as a health care professional to dramatically impact the lives of your patients. As a pre-med in college, I interviewed at Johns Hopkins Medical School under an early decision program. I was beyond excited. After my interview, ...

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It's 2:02 p.m. when my pager beeps. I pull it out and read: "Juan may have just passed. Going in now." As a social worker in the region's only cancer specialty hospital, I provide emotional support for patients and their families — including talking about their wishes for end-of-life care. Juan is a sixty-five-year-old Ecuadorian man with stage 4 pancreatic cancer. I've known him for about a year. Polite and easy to ...

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