These articles are written by anonymous clinicians. They have been selected and edited by Kevin Pho, MD.
Despite advancements in health information technology (HIT), the prevalence of diabetes in the United States continues to be high and is the seventh leading cause of death. Diabetes management in underserved communities has challenges concerning health care access for high-risk groups, often resulting in debilitating health outcomes worsened by adverse socio-economic consequences. Optimal HbA1c levels, controlled for by risk reduction, are essential. If diabetics encounter barriers to health care services, …
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As oncologists, we encounter numerous patients on a daily basis and form emotional bonds with many of them, especially if they survive long enough and continue to see the same doctor for several years. This bond can grow so deep that we feel their pain, cry with them, and sometimes even realize that some of our patients are our soulmates.
According to Wikipedia, a soulmate is a person ideally suited to …
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While we appreciate the importance of trust, not all patients have the same windows of opportunity to establish it with their physicians. The nature of each specialty and the severity of the patient’s condition influence how quickly and deeply trust can be created and maintained. The STEMI patient will quickly learn to trust the interventional cardiologist, and the trauma victim, and the surgeon.
Not surprisingly, it’s very challenging for physicians …
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I have been fortunate in my forty-five-year medical career never to have been sued for the care I delivered to a patient. I attribute this, in part, to being a family physician and having ongoing relationships with my patients and, in part, to being willing to admit to my mistakes if I make them and things turn out badly. I see how gut-wrenching going to court is for doctors so …
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When I finished my pediatric residency almost 20 years ago, I embarked upon a career in general pediatrics because I didn’t enjoy any particular subspecialty enough to commit my career to it. After spending several years in a mostly outpatient setting (peppered with child abuse consults, circumcisions, and an unsatisfyingly small number of hospitalized patients), I knew I had to change and move across the country to pursue pediatric hospital …
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I was surprised when I began receiving gift cards to a national chain of coffee shops in recognition of positive patient satisfaction comments from my emergency department patients.
Reviewing them in my provider report card genuinely felt good, especially when someone remembered my name in a follow-up phone call while saying something positive. Still, the token incentive met with disapproval for several reasons.
In particular, the most meaningful comments expressed gratitude for …
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I have to write a “perfect medical school personal statement.” I have to write about learning and growth. I want to show empathy and grit. Most of all, I must resonate with the medical school admissions committee reading my story.
The overwhelming consensus around Student Doctor Network, the forum of terrible but successful premeds, is: don’t make waves. Adcoms can be radical feminists or religious fundamentalists, born from wealth or recently …
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Most people, should they be in need of a transcatheter aortic “valve-in-valve” replacement procedure for a failed aortic valve replacement, would be delighted to have one of the world’s foremost experts (who has performed over 6,000 of these procedures at one of the world’s foremost heart hospitals) perform the procedure.
But not my father, despite having dyspnea on mild exertion owing to a trans-valvular gradient of 50 mmHg.
Naturally, he wanted a …
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Recently, I read an article by an ICU nurse that discussed the disturbing trend of replacing seasoned nurses with inexperienced ones in the name of cost-cutting. This issue is not limited to the ICU but is rampant in every area of nursing.
As a psychiatric nurse with 45 years of experience, 35 of which were as a board-certified psychiatric nurse, and a former mentor and preceptor, I have witnessed the …
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The word “career” has two meanings. A career in medicine fulfills both meanings quite neatly. In the traditional sense, it can be defined as an occupation undertaken for a significant period of a person’s life. On the other hand, it can mean moving swiftly and in an uncontrolled way. As in, “Her car careered across the road and into a ditch.”
Being a physician is a blur of late nights, cold …
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Speech recognition software is an important part of my clinic workflow. I use the industry-leading application, which has saved me at least 1,000 hours of documentation time over the last decade. My typing is much slower than my speaking, and since my goal is to leave the office at a reasonable hour every day, using it is the obvious choice for …
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A good cup of soup can be comforting during illness. It’s like a form of medicine. Soups have many vitamins and minerals, protein and carbohydrates, and of course, water or cream to help stay hydrated. Salt makes a sore throat feel better (like warm salt water gargling) and heat clears nasal congestion (which relieves pain and sinus pressure). As such, a typical cup of restaurant soup costing $5 or $10 …
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Why is it that physicians are seeking alternative avenues to boost their income? It may seem counterintuitive for busy clinical doctors to pursue a side gig, why? In a post-pandemic era, physicians are plagued by colossal debt and increasing rates of burnout. More than 100,000 physicians have left the profession since the start of the COVID-19 pandemic. My peers are frustrated, tired, and seeking a way out. For many, …
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I was brought to tears today, suddenly, unexpectedly, by the ringing of a bell. I had passed a small sign earlier, and I knew that the ringing signified the completion of someone’s chemotherapy. As I heard cheers, I thought how amazing this group of individuals (who I could not see, closeted as I was behind a curtained space) had a shared experience of crossing the finish line.
There is a lot …
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On waking up from anesthesia-induced unconsciousness, I was dressed in an unfamiliar pink surgical bra with multiple Velcro straps. As if I were a doll, someone had clothed my limp body without my knowledge, and I had no idea who. Even then, I had a vague sense, groggy and feeling an odd lack of sensation on the right side of my chest that I had been violated.
“Violation” is an …
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I’ve been practicing internal medicine for over a decade now. I was drawn to this field because of my admiration for Dr. William Osler and the superb physicians I have met who embody his qualities. As an internal medicine physician, I am expected to be a critical thinker and a “doctor’s doctor,” specializing in complexity and solving problems with multiple layers, like peeling an onion. However, I never imagined that …
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The first dying patient I saw as a medical student was a man newly diagnosed with lung cancer, a chronic smoker with now oxygen-dependent COPD. In rounds, our medical team stopped outside his room, and the learned men and women pontificated about what to do next with the man. Chemo? Radiation? Both? I pretended to listen and rubbed my chin with feigned discernment, trying to understand the conversation like any …
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I screen patients for skin cancer on a regular basis, and one of my research interests is to find new biomarkers of cancer prognosis – to be able to separate out cancers that won’t actually do someone any harm versus cancers that could very well spread, grow unchecked and uncontrolled, and potentially end a life. I know that cancer treatments have advanced beyond my imagination in recent years, with …
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Recently, I found a lump that was diagnosed as breast cancer. It is Stage IA, with a high chance of cure, but of course, more information might change that sooner or later. I have entered the uncertain world of being a patient – before this, as a physician myself, I happily avoided seeing the doctor.
While my cancer should be curable, and this will just be a …
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I’ve moved recently, and in the process of moving, invariably, one discovers old items. This had gotten shelved in the fracas of those years, work changed overnight, changing employers, moving. However, in a discussion with a close friend today, this resurfaced as she’s grappling with patients and family who are not seeing what she’s seeing.
Summer 2020
It’s another Sunday night family dinner. Conversation centers around catching up on the latest family …
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