“Until I know you better, I will tell you how to breathe!”
It’s my first day at the pediatric orthopedic hand specialty clinic on my pediatric ortho rotation in my third year of residency.
I have just been barked at by the professor emeritus, a retired Army colonel, who runs the service.
He didn’t tell me how to breathe, but he affected it.
Prior to this, my upper-level resident told me that I have …
Do patients truly understand?
The question is not meant to be rhetorical. I have many conversations throughout the day with patients across all socioeconomic backgrounds and with varying levels of education.
The discussions include details surrounding their disease-specific particulars, treatment options, and surgical protocols. Patients digest my thoughts and then respond with specific questions of their own. They ask for instructions as well as the nuances of the healing process.
I confess that …
Hand disorders and injuries often result in significant functional deficits if not diagnosed and treated in a timely manner. Unfortunately, in Canada, hands are often undertreated or treated too late, with potentially serious consequences for both the patient and society due to prolonged disability.
Hand conditions are complex and require specialized knowledge to diagnose and treat correctly. Unfortunately, primary care physicians rarely have the training or expertise to accurately diagnose and …
I’ve had the opportunity to interact with a wide variety of patients. Along the way, I’ve heard some pretty memorable and interesting things. I thought it might be fun to share a few of my favorites.
One of the most common things I hear from my older patients is something like, “Doc, it’s just hell getting old!” Our standard response is usually …
I live in a state of chronic dissatisfaction and disillusionment, particularly when it comes to time. Is it the curse of the modern age to try to do too much? Is it just my location or life path? Have people always struggled with this?
If this constant struggle with time was a crime against anything else, I might be seen as an oddity or someone who doesn’t learn from their experiences. …
There is no escape from our ultimate decline and death. The sooner we accept and embrace that reality, the freer we are to live life to the fullest now. So when I speak of reversing the aging process, I’m really referring to reversing the acceleration. If you recall the Newtonian physics from your high school physics class, acceleration is the velocity …
I’m a hand surgeon. After six years of academic practice, I opted out of the public and universal health care system my country is famous for to create the first private hand surgery practice in Montreal, Canada. That was 12 years ago.
Opting out of the system means that I do not get any payment or reimbursement from the government in a country where private insurance does not pay for private …
One weekend, while taking hand trauma call, we received a pre-arrival page about an incoming patient, a plastic surgeon, who had injured himself while moving a glass table. The information we received was devastating — a wrist laceration through the median nerve of his dominant hand. After his arrival in the ED and the formulaic introductions at the beginning of any encounter, he frankly asked, “So, honestly, do I need …
Most people with scoliosis will never require surgery. But who does need surgery, and how do you know?
Often diagnosed in childhood, scoliosis is characterized by an abnormal curve in the spine that can range from as small as 10 degrees to more than 100 degrees. In pediatric patients, this can result in pulmonary problems if the curve is severe.
However, pediatric patients’ complaints are mostly centered around their appearance due to …
Have you heard that computer use causes carpal tunnel syndrome? In fact, there is a near-universal belief that technology gadgets can cause all sorts of hand problems. Both the lay public and most healthcare providers believe that entities such as “Blackberry thumb” and “repetitive strain injury” truly exist and that common hand problems such as flexor tendonitis and basal joint arthritis of the thumb are caused by repetitive typing or …
Primum non nocere. First, do no harm.
All doctors are familiar with this credo. From ancient precepts such as the Hippocratic Oath promising to abstain from doing harm to the modern bioethics principle of nonmaleficence, the calling of physicians involves striving to help alleviate suffering and avoid making it worse. In our increasingly complex health care and data environment, avoiding inadvertent harm can be more difficult than one might expect.
“You’re my last hope.”
The words come from a patient I have no prayer of helping. He has had decades of back pain. He has had several surgeries, injections, hardware in, hardware out, but nothing has helped. He is unable to work. His struggle with back pain has ruined relationships, ruined his financial stability, ruined his mental health. His goals and mine are aligned. We both want to make his life …
My first patient of residency was Mr. John. He endured life-threatening injuries that left him without speech or the ability to move his limbs. Every day had obstacles, and I met most of his family over time. Mr. John was a family man who looked after others first before himself. A self-made man. He was a man who was physically strong and dedicated to every project and goal he set …
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“In my medical training, we were taught five ways to treat pain: lifestyle modifications, physical therapy, medications, injections, and surgery. Lifestyle modifications are positive changes in diet, exercise, sleep, and stress levels. This is the first-line treatment for painful inflammation. Yet we tend …
From an early age, I shared the soccer field with my younger brother, and later, we shared an orthopedic surgeon when I tore my ACL. I worked hard and excelled at my public STEM high school in New York City. I was also an athletic trainer in high school and college. I fit the classic stereotype of the injured sporty kid going into orthopedic surgery, right?
Not exactly.
Only Read more…
An excerpt from Cutthroat: A Surgeon’s Fight against Big Government, Corrupt Businessmen, and a Broken Healthcare System.
The media, the business world, insurance companies, and even the government have done an amazing job of portraying doctors as the culprits for the exorbitant costs of health care.
They’ve been able to …
A little-known fact about doctors that most patients would find horrifying is that physicians don’t keep track of their results.
If I botch a knee surgery so badly that my patient requires five repairs by a different specialist, I might never find out. As a result, I will continue to use a flawed technique on patient after patient. The fact that I never hear from any of them again will be …
There are not many situations in general medicine where a doctor can affect an instant cure, and the patient will call them a “miracle worker.” Most patient visits end with a prescription or two or some instructions along with the admonition, “You’ll feel better in a few days.”
One exception to this rule: dislocations.
A simple dislocation happens when the end of a bone is pulled out of its socket (or niche) …
“In the end, the patient-physician relationship is crucial to overall decision-making for any plan of care, treatment, or surgery. There are many variations in the reviewed studies in health care literature as to the cost-effectiveness of second opinions in medicine. These studies could be easily misconstrued that there are …
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