Even with lawsuits and co-pay caps, will Insulin ever be affordable?
The sausage-making of how insulin is priced is not for the faint of heart. I’m a physician, not an economist. But the diagnosis seems plain as day: greed. More
Access to Primary Care
“Doctor, it’s taken so long to get this appointment with you!” This is the opening line of so many medical visits, and I find myself constantly apologizing to my patients on behalf of our system. After the pandemic-induced lull in routine medical care, we’re right back where we started—doctors booked for months, patients struggling to get appointments. More
Covid Vaccination: the Last Mile
The COVID vaccine engenders a unique obstinacy that seems to blot out conversation. We doctors and nurses are exhorted to listen to our hesitant patients and hear their concerns, but this is difficult to do when patients don’t even want to talk. More
Florence Nightingale in the Age of Covid-19
May of 2020 marked the 200th anniversary of the birth of Florence Nightingale. That her bicentennial fell during a worldwide pandemic is both illuminating and ironic. Nightingale’s experience as a nurse during the Crimean War led her to three insights that came to define her professional life, insights as revolutionary as they were unpopular. More
Taking Stock of the Second Covid Surge
As the pandemic raged from the winter surge through to the spring slog, my Postmortem folder lit up with a dispiriting regularity. I opened it with dread as it revealed which of my patients had perished that week. More
Coronavirus and Fear
Fear is a primal emotion, and to pretend that the medical staff are any less susceptible than the general public is folly. I sometimes feel as though we need to negotiate an armistice of sorts with our fears. There is a certain amount of salutary fear we need to accept, the kind that keeps us respectful of the high stakes in caring for patients. But we also have to recognize that there are irrational fears, the kinds that are not necessarily allayed by data. More
Flying Solo
A passed-out photographer, a hellish round of flight delays, a Fisher-Price stethoscope–what a series of out-of-hospital emergencies taught me about medicine as a team sport. More
The Yemenite Giant and the Death of Stalin
I only knew my father, Zacharia Ofri, as an unassuming high-school math teacher. As a young man, though, he was basketball star in his native Israel. But the 1950s was a turbulent time. His story weaves in Cold War intrigue, Russian Embassy bombs, the death of Stalin, Ben Gurion’s hairdo, Iron Curtain railroad trips, Nasser’s miscalculations, the 1952 Helsinki Olympics, and of course a New York City cab driver. (Plus lots of great photos!) More
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
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
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
Mothers in Medicine
We in medicine are inculcated in the culture of deferred enjoyment, of sacrificing our lives now for some distant rose-colored, board-certified future. But here’s the breaking news: No chapter with unlimited time and resources is ever going to magically open up in our lives. No fairy godmother will miraculously graft 8 hours onto your day or stock your house with groceries or impress the 16 kinds of vasculitis into your cingulate gyrus. More
Medical Humanities: The Rx for Uncertainty?
A large part of our medical maturation is facing uncertainty and then accepting it into our fold. This is far harder than memorizing all those rare diseases. The humanities can offer doctors a paradigm for living with ambiguity and even for relishing it. More
Nothing Glamorous about Opioid Addiction
Pain stands nearly alone as a medical condition that not only can’t be measured but that patients might also have an ulterior motive to lie about. I never wonder if a patient is lying when she says she is constipated or has a vaginal itch. But the reality is that there’s not much street value for Metamucil, and there aren’t any rehabs filled with recovering Monistat addicts. More
