The Covenant
Burnout among doctors appears to be at epidemic proportions these days, with concomitant gushing prescriptions for wellness and resilience. But in reality, most doctors are not burned out: most love taking care of patients and want nothing more than to be able to do just that. The source of the agony is the profession—or rather the corporatization of the profession… More
EMR Ménage-à-Trois
EMRs have both breathtaking assets and snarling annoyances. But what started out as a tool — a database to store information more efficiently than the paper chart — has inserted itself as a member of the medical team. What used to be a tango between the doctor and patient is now a troika. More
Gaudeamus Igitur by John Stone
“Gaudeamus Igitur” is one of my favorite poems of all times. John Stone was a poet and cardiologist at Emory University, He wrote this poem (the title means “Therefore, Let us Rejoice” for a graduating class at Emory Medical School. More
Empathy in the Age of the EMR
We doctors have been reduced to tools of mere data entry. A higher being might peek into our exam room and be unable to distinguish the doctor from the sphygmomanometer. There is at least one upside to this mess, however. The aggressiveness of the EMR’s incursion into the doctor-patient relationship has forced us to declare our loyalties: are we taking care of patients or are we taking care of the EMR? More
The Daily Exploitation of Medical Staff
Corporate medicine has milked just about all the “efficiency” it can out of the system. With mergers and streamlining, it has pushed the productivity numbers about as far as they can go. But one resource that seems endless — and free — is the professional ethic of medical staff members. More
Doctor-Writers: What Are the Ethics?
There is a veritable epidemic of doctor-writers out there. What is going on? Are doctors suddenly in the kiss-and-tell mode? What about confidentiality? Professionalism? HIPAA? As one of the aforementioned doctor-writers, I look upon this trend with both awe and trepidation. More
Perchance to Think
In the pressurized world of contemporary outpatient medicine, there is simply no time to think. With every patient, we doctors race to cover the bare minimum, sprinting in subsistence-level intellectual mode because that’s all that’s sustainable. More
A Tense Moment in the ER
The hospital, by definition, is a stressful place for patients and families unsettled by the vulnerabilities of the human body. Add in issues of race, class, gender, power dynamics, economics, and long wait times, and you have the ingredients for combustion just hankering for tinder. More
The Insulin Wars
Insurance companies and drug manufacturers have come upon an ingenious business plan: They could farm out their dirty work to the doctors and the patients. When there’s an E. coli outbreak that causes illness and death, we rightly expect our regulatory bodies to step in. The outbreak of insulin greed is no different. More
A True Role Model: Dr. Lisa Schwartz
Lisa was my very first resident. She taught us medical students how to aspirate ascites fluid from the abdomen of a cirrhotic patient, how to diagnose granulomatosis with polyangiitis, how to wrangle a CT scan from an obdurate radiologist, how to handle a hallucinating patient who spoke only Igbo, and where to get a cheese Danish once the coffee shop closed. More
The Day After the Elections
Depression, anxiety, thoughts of suicide–these are the very real side effects of Trump policies. My visit with Mr. A on the morning after the midterm elections seemed to crystallize all the bitterness of what has been unleashed in this country, and the effects it has on the people who suffer under it. More
Prescribing Democracy
“There cannot be any doubt,” Dr. Rudolf Virchow wrote in 1848, that the recent typhus epidemic was a result of “poverty and underdevelopment.” His prescription was “free and unlimited democracy.” Hmm–a prescription for democracy. Not something you get at your average doctor’s visit. But maybe that’s what we need. More
Nursing Juliet
A dog is both Rorschach and receptacle, a two-way highway for love unbounded and unadulterated. In a world that relentlessly enforces limits, the love of a pet is a refuge for unconstrained emotion, especially for a child. More
A Doctor’s Responsibility
“Excuse me, sir,” I imagine the scenario playing out, “do you mind if I barge in on your life to see if I can save your life?” At what point does concern morph into presumption? The line between kindly interventions and condescending ones can be perilously thin. More
Child Separation Is a Medical Emergency
In adult medicine, we see daily the physical and psychological effects of early childhood trauma. Well into older age, patients retain the scars and setbacks from those early experiences. The list of effects of early childhood trauma is so expansive that it wasn’t surprising to see the president of the American Academy of Pediatrics refer to border agents’ removal of children from parents as “government-sanctioned child abuse.” More
