"Today and for the foreseeable future, COVID-19 is a serious threat, virulent and contagious, not only leading to an impressive display of human vulnerability and arrogance, but also demonstrating how innovative and creative humans can be during a time of crisis. On a daily basis, I am inspired by the outpouring of courage, ...

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“The nipples are equal and reactive” is a phrase I came across in the physical exam section of a note that I had dictated, courtesy of my Dragon.  I have a Dragon.  Not a cool Game of Thrones dragon, heroically swooping in at a critical moment, but a program that recognizes my voice and transcribes it into comically broken English in my patient’s medical record. At times, my Dragon has ...

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"I recently represented a physician in a noteworthy peer review case at an academic medical center. The medical staff president initiated a complaint against a surgeon, who would later become my client. The complaint was that the surgeon inappropriately collected cash payment from an uninsured patient at the hospital’s point of ...

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On a recent trauma call, we had a busy night, culminating in a horrific motorcycle trauma that came in early in the morning. The patient had devastating injuries and ended up dying. The detectives finally tracked down the patient’s family. I cleaned myself up, put on my white coat and had the family sit down in a private conference room. I entered with my trauma attending and a consulting specialist, ...

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I have never felt so alone. I was lying in bed with severe abdominal pain. Pain I never had before. Well, at least not for a reason. As I lay there, I kept thinking, what if I die while I wait until morning. It was the middle of the night. I had not felt well since earlier the week before with a severe diarrheal illness. One that only babies have with ...

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When you flick a domino, a chain reaction is inevitable. Joseph Epstein succeeded in creating such a reaction. His inflammatory Wall Street Journal op-ed deriding Dr. Jill Biden’s academic title has become a call to arms across the social media landscape. The armies of Twitter and Facebook have assembled across the pixelated landscape. Hasty battle plans in forum posts are drawn, ignoring the decorum of discourse ...

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Whether or not you’re a health care provider, chances are you’ve spent the year thinking, talking, and reading about health care.  We’ve had national conversations about everything from the global pandemic to rising health care costs to rationing resources to the politicization of medicine.

Much less discussed—but very much affected by all of this—is the unintended consequences the pandemic has had on our medical students and residents.  In March, ...

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"Studies have repeatedly demonstrated a vast majority of pain physicians don’t feel like they have adequate training in meeting the unique needs of this patient population, though most agree that such efforts are very necessary. This disconnect between demand and supply is a problem, a big one. With the current pandemic stretching ...

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Imagine turning off your pager forever. If you are a solo-practitioner on call 24 hours a day, I suspect this thought has crossed your mind. Coordinating time off for vacation, being constantly interrupted at your children's recital or athletic event, and even making it home to prepare dinner represent common challenges in this setting. A particular obstacle as a solo-practitioner involves the difficulty of running a small business - a ...

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You were a twenty-one-year-old Black man. When we received you, your eyes were open I asked if you could hear me You whispered a phone number and “Mom.” To the green sterile operating room With your breaths of anesthesia, Your final conscious moments Your pain ceased. We worked on you for hours, Terrell. I swear we tried With fourteen units of O negative Surgeons explored your wounds. They clamped your major arteries. Until your heart failed And we watched you leave us. I was a ...

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An excerpt from The Healer's Burden: Stories and Poems of Professional Grief.

Leaning on the door of Trauma Bay 1, I survey the remains of my latest failure. The story is told in the bloody and jumbled instrument trays, monitors now silent and dark. In ...

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As an anesthesiologist, I fully understand that providers in my specialty, along with emergency room and intensive care providers, must care for patients with COVID-19 at close physical range during aerosol-generating procedures (AGPs) such as tracheal intubation and extubation, without the option of “social distancing.”  Consequently, we currently rely on personal protective equipment (PPE), operating room ventilation systems, preoperative COVID testing, and hopefully, in the future, on vaccination and herd ...

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I recently met a student and aspiring surgeon who asked me if I was happy with anesthesiology and a career in medicine in general. I told him that aspiring to medicine is wonderful and that while I am indeed happy with my career choice, it does come with daily challenges, both professional and personal. This led to a discussion of work-life balance, particularly with regard to family life, in which ...

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The practice of anesthesiology is the practice of medicine. People who go to medical school and do a residency in anesthesiology are best equipped to deal with anesthetic delivery because they are qualified physicians before starting four years of specialty training in anesthesia. Many also have a fifth year of subspecialty training before entering their practice.  With all this training, why is it that we cannot figure out how to ...

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You may already be aware of what a tummy tuck is and who should get one. One thing, perhaps, you’re confused about is what kind of tummy tuck would work best for you. If that is correct, worry not. We’ve got you covered. There are several different types of tummy tucks, each designed to address particular areas of the ‘tummy’ in a specific manner. Considering each of us has a different ...

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How are two-career households with children — let alone single-parent households — going to manage with daycare centers and schools closed, perhaps for a long time to come? What damage will this do to career progression and earning potential if one parent must cut back on work? Will childcare demands inevitably delay or derail partnership or academic promotion? When I was a young mother — my two youngest children are only ...

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Our obstetric anesthesia team sat down to debrief after a particularly harrowing case. We had just replaced our patient's blood volume twice over after she went into labor with a placenta previa accompanied by a placenta accreta. The operating room had been the usual controlled chaotic scene of multiple teams intensely focused on their responsibilities. It was noisy. Too noisy. I had to remind everyone to restrict themselves to essential ...

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There is nothing more indelible than the words of an unhappy patient. In fact, in the past ten years, I can count on one hand the number of patients who have expressed dissatisfaction either in person, online, or on patient portals.  Even though negative patient interactions are so rare, unfortunately, I’m consumed by them.  I ask myself the same question that other physicians ask themselves every time something goes wrong: ...

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Explore why this general surgeon wrote a novel, and how writing helps with the stresses that accompany a surgery career. What is his #1 tip for those interested in surgery? What are the challenges facing the profession today? How can surgeons find that elusive work-play balance? And why should aspiring doctors start a journal? Arthur Williams is a ...

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It had been a long day. Our progress notes were done. The last scheduled case in the operating room was done, and it was time to wrap up loose ends and sign out my patients to the night team. But that's when Room 4 died. I walked onto the Burn Unit. The nurses were frantic. Can you page the Intensive Care Resident? He's bradying down. The patient's heart rate was steadily declining ...

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