Last evening I crumbled in the arms of my patient and wept. This was unknown territory to me, an unexpected role reversal. For three weeks after my Mom’s death, I maintained a stoic distance as patients offered their condolences, as they asked about my mother, and empathized. We doctors have been trained to do this, to face death, to keep our emotions at arm’s length. But this patient, who has …
When we talk about health disparities, we talk about socially disadvantaged populations. The disadvantages can be defined locally if we are talking about local communities, regionally if we are talking about regional populations, nationally if we are talking about national residents, and globally if we are talking about global humans. Local, regional, national, and global economic disparities may define corresponding health disparities.
One among economic disparities can be technology disparities during …
An excerpt from Saving Grace: What Patients Teach Their Doctors about Life, Death, and the Balance in Between.
In my third year at LSU Medical School, we dove headfirst into full-time patient care, taking required nine-week rotations on internal medicine, pediatrics, obstetrics and gynecology, and general surgery. In the fourth year …
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“Despite these high numbers, we cardiologists often look to genetic screening last in our diagnostic workup. But without genetic screening, we can’t always see the whole picture in our cardiomyopathy patients. Once we’ve excluded coronary disease as …
“I just moved here from Portland two weeks ago,” said Ms. Shelly in a weak voice.
When I walked into the room, I immediately noticed her blood pressure was 224/108. The patient was mostly sleeping, but when I started speaking with her, it was apparent to me something was wrong.
“Do you have a history of any heart problems?” I asked Ms. Shelly.
“I had aorta surgery two times…” she murmured before falling …
Health isn’t about luck — it’s about intentionality. But even if you’re doing and saying all the right things, you might not be any closer to your goals.
I know because I was there.
As a heart surgeon, I was very good at following the rules.
But I was still morbidly obese.
I followed the food pyramid to a T.
I exercised for the recommended amount of time each day.
I thought I was doing everything …
An excerpt from South Eight.
There is little similarity between the stillness of the archer, or of Arkin’s former self on the rifle range, with the organized chaos of a dozen nurses and respiratory therapists and lab technicians pouring into Room 326 of the PCU. And yet there is something of …
Early one morning in 1996, after a sleepless night on call, I stood with my team in the VA hospital, outside room 102. I was a 28-year-old intern in the general medicine service. We were making rounds on twelve patients that my intern partner, myself, and our supervising resident had admitted overnight. We would walk room to room, and the intern would present the information regarding the patient by gathering …
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“In the majority of robotic-assisted cases I perform, automated movements are particularly helpful in delivering gear – I can easily get balloons and stents around the C-shaped curve in the right coronary artery from the cockpit just like I would be able to …
The headache wasn’t that bad. The fatigue was worse. I had slept about six hours total in the past three days. I was fortunate to have dutiful help from my husband and both grandmas, but I was still exhausted. Between breastfeeding, diaper changes, snuggling, trying to eat and maybe shower, adjusting to being thrust into the most important role in my life, feeling the joy and anxiety as only someone …
It always makes my heart sink when the CPR guidelines change.
In 1980 I became a provider of advanced cardiovascular life support (ACLS) as certified by the American Heart Association. This was a great move. Through my internship and the many years that followed, it proved comforting to know that I would act decisively and with confidence in the setting of a cardiorespiratory arrest. The ACLS course dictated dogmatic protocols – …
May is National Stroke Awareness Month, and I want to share my story of my dad’s journey after his strokes.
Doors open and shut during the early morning hours. I hear the drip dispensing the next dose and some muffled chatter outside the room. Several phones are ringing in all directions, and I listen to alarms going off next door. This means the heart rate is too high.
Snoring beside me, I …
Modern medicine, a system originally designed to fix acute health care problems, now creates more chronic health care problems than helping to solve them. I see the dangers of over-testing and over-prescribing taking place each day in my day-to-day pediatric clinical practice.
It scares me to see how many doctors reflexively prescribe pills designed to merely mask symptoms rather than take time to understand the underlying cause or that most chronic …
After I passed my emergency medicine oral boards in 2019, I learned that the American Board of Emergency Medicine was implementing MyEMCert modules, an alternative means of maintaining certification. I was so excited never to have to take a multiple-hour board exam again. However, now that I have become a holistic coach, I find myself preparing for the National Board of …
A little over two years ago, my elderly mother was admitted to the hospital. Almost 90, she’d been short of breath for days — uncomfortable, perspiring, unable to sleep properly.
Blood tests, a chest X-ray, and an echocardiogram followed, whereupon her doctor pronounced: “You have congestive heart failure, Mrs. Les.”
I arrived on the scene the next morning to find her lying in bed, iPad open to Dr. Google, earnestly exploring the …
Almost all of us know that October is breast cancer awareness month. Many of us also know that BRCA 1/2, the BReast CAncer genes, can increase a person’s chances of developing breast cancer. In fact, BRCA 1/2 is so well known that patients with a positive family history often seek genetic screening for it on their own accord. As a medical professional, I am awed by this level of …
As I look back at my career, two professors stand out. They affirmed me when I did something well (in words I wrote in my journal, would go back to and read when I was discouraged). They recognized my weaknesses but did not concentrate on them, although they did not ignore them either. Both made me think I had the stuff to be a cardiologist. I flourished; I …
Remember in Jurassic Park when Ian Malcolm describes Chaos Theory to Ellie Satler, watching a drop of water roll down her hand? It might roll to one side or the other based on any number of differences in the hair on her hand, subcutaneous blood flow, imperfections in her skin, all tiny variations in a complex system, affecting the outcome. The scene came to mind last week when in 24 …
I was a medical student learning to deliver babies, bringing new life into the world, as my mom’s life was fading away. I saw all the missed calls from Dad. I knew in my heart something terrible happened. She was in the ICU. Dad told me she had a heart attack. I flew to be with her. When I saw …
Mr. Williams is a 52-year old male who has been following me for some time. He has just been started on metformin for newly diagnosed diabetes. Lisinopril is his only other medication for high blood pressure. When he had his yearly physical, he was also found to have a high LDL “bad” cholesterol of 150. His BMI is 29, significantly overweight and touching obesity levels.
I sat down with him for …
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