Growing evidence suggests that the novel COVID-19 virus can be aerosolized.  To adequately protect employees, providers require not just “droplet,” but “airborne” precautions and the appropriate healthcare worker personal protective equipment (PPE). Appropriate PPE mandates an N95 mask. News reports for weeks have described hospitals working without the necessary protection for health care providers. This is the case in Boston-area hospitals, which are running short on these masks. One of the city’s ...

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Traffic is non-existent. Schools are closed. Restaurants are only offering take-out and delivery. Parking lots at strip malls are empty on weekends. Only a limited number of people at a time are allowed inside the grocery store.

Welcome to the post-normal era since the COVID-19 pandemic hit the scene in Northern California.

One day we will look back at this time and realize how much it changed everything. Simple ...

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I am an anesthesiologist. I am trained to stay calm when everything surrounding me is going downhill. In the OR, I am the anchor. The steady hand, the ready plans. I work with skilled CRNAs who are an integral part of the team.  We do critical care medicine every day. We don’t run from the chaos. We are always ready to fight the good fight. We don’t scare easily, but ...

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The conversations we’ve had with physicians this week confirmed that the primal fight-or-flight response has kicked in as physicians across the nation recognize the COVID-19 pandemic as an imminent threat to the survival of their practices. Some are reacting from a place of fear, while others are proactively evaluating options and making strategic moves. In surgery, there exists a time-honored adage: all bleeding stops eventually. When a patient has unexpected severe ...

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I am an anesthesiologist who practices in Omaha, Nebraska at a large university. Our institution is preparing around the clock to care for our community in the midst of the COVID-19 virus. We are all coming together – doctors, scientists, nurses, technicians, administrators, therapists, and staff to develop plans. Leaders are not sleeping; they are working. We are all preparing. Reading. Staying up to date. Trying to learn from our ...

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Recently, I realized that something needed to change in my family life. With three busy daughters at three different schools who participate in multiple activities along with my full-time job as an anesthesiologist, my life depended on accurate and concise communication. However, this was the third time in a week that a ball had been dropped between my husband and me. This time it resulted in my middle daughter, Laini, being ...

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Once, when I was a senior resident covering a busy trauma service at a county hospital, I was on call for nine days in a row while my co-chief had an uncovered vacation. It was July, and we were all -- interns, junior residents, and me -- new and uncertain in our roles. I left the hospital only twice in those nine days. When I finally signed over my pager for ...

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I live and work in Los Angeles, one of the plastic surgery capitals of the world. Quite a few of my patients have “had a little work done” — the blandly euphemistic term you’ll hear for plastic surgery makeovers of all kinds. That’s fine. Plastic surgeons have children to feed too. The problem is this: many of my patients want to convince everyone that their “look” is entirely natural. They don’t ...

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An excerpt from The Invention of Surgery: A History of Modern Medicine: From the Renaissance to the Implant Revolution. Johns Hopkins University was unlike anything ever built. Armed with an enormous endowment from a wealthy industrialist, the hospital (and its associated medical school) would be patterned after ...

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Last week, Lais and Yuri, our five-year-old twins, were volunteers at the school of medicine, for students to learn how to examine children. Full disclosure: Volunteers do get a gift card. Therefore, I asked them if they wanted to "work and get some money," and I also told them what they would have to do during that afternoon. They both said yes, and they were truly excited about the opportunity. When I saw ...

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I feel like I’m in prison. Vacation was a small taste of freedom. A fresh breeze on my face at 9:00 a.m.—the feeling of my mom’s breakfast casserole in my stomach—the small things that remind me I’m still human. I don’t know what I stand for anymore. I just yelled at the intern for not feeling comfortable consenting our kidney transplant patient. “Aren’t you a physician?!” I asked. How did I get ...

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A surgery resident from halfway around the world emailed me the other day looking for advice as she was nearing graduation.  She confessed, "I am beginning to question myself if I am good enough ... what is 'good enough' anyway?" I had absolutely no idea how to answer the question – what is "good enough" for a surgeon? First, I tried Google. "Am ... I ... Good ... Enough"? 2.5 billion hits and some ...

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Brain surgery is getting smarter. The journal Nature Medicine recently published a study that found a new imaging technique that allows pathologists to diagnose brain tumors faster and more accurately than ever before. The study focused on Invenio Imaging technology’s use of artificial intelligence (AI) in making accurate diagnoses. So, will computers replace doctors? That’s unlikely. Treating the human brain requires a human approach. But AI is ...

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I am in the operating room working with an attending anesthesiologist I have known for years. "Tell me," I ask, "Do you and your colleagues talk about the difference between Des and Sevo?" He looks at me without responding. "You see," I continue, "There was a story on the radio about a hospital that has gotten rid of Desflurane because of the environmental impact. It is ...

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Today started like any other day. I woke up, got ready, drove into work. I dropped my bag in my office, changed into scrubs, and wandered down to pre-op. After a few minutes of small talk with the staff, I found the patient I was looking for. He was awaiting a major operation. I spoke with him and his fiancé́ and laughed. They shared a few tears. As I often do, ...

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If you talk to anyone you know, it’s very likely they will tell you that they are on some form of social media. Whether this is Facebook, Twitter, Instagram, Snapchat, TikTok, or YouTube, most people are on at least 1 to 2 forms of social media these days. Video is one of the most powerful tools in marketing. According to Google, 64 percent of consumers use video to research health care ...

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Recently, I read this great article from Dr. Chethan Sathya, a male surgeon who commented on how women surgeons in this day and age are still treated as second class surgeons. There has been much good commentary and discussion on the topic, particularly on Twitter. But almost as if on cue, a different male surgeon chimed in with the following comment:

I’m 100% sure u will prefer ...

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I’ve just discharged a kid with a cough, and there are no patients waiting to be seen. “I’ll be back,” I tell the nurse, as I slip away to the hospital kitchen and unlock the door. I steal two frozen grilled cheese sandwiches from the freezer and throw them into the microwave. Minutes later, I’m in the call room. I take a couple of bites and can already feel acid rising ...

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If physicians are “muggers” and co-conspirators in “taking money away from the rest of us,” then journalists and economists are pontificating parasites who produce no goods or services of any real value. I don’t think either is true, but the recent attacks on physicians by economists Anne Case and Angus Deaton, and “media professional” Cynthia Weber Cascio, deserve to be called out. You ...

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I read the recent article on KevinMD: “I’m sorry: Why I lost my love for medicine” with great sadness. My heart goes out to the author; many of their concerns echoed deeply within me. I am sorry that we, as physicians, haven’t effectively succeeded in solving the myriad of problems facing health care today. And the author is right: Health care as a system, in the ...

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