Thursday, September 5, 2019

Vol VII No. 769 - Part 4

A nurse's powerful ER exit letter


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KevinMD Plus: Sep 5, 2019

A nurse’s powerful ER exit letter

Dear hospital, The last three years, I have had the pleasure of working in our state’s renowned emergency department and level-1 trauma center. My departure closes out a decade of my nursing career as an emergency room and flight nurse. This department — the staff, in particular — will forever hold a very special place […]

We are anesthesiologists. We got you.

I am a cardiac anesthesiologist. I want to explain what anesthesiologists do, who we are, and why it is important for the public to know. Anesthesiologists are physicians. Anesthesiologists are the guardians of the operating room. Anesthesiologists are leaders. If you get in a car accident, we are there. If you develop an infection and […]

How this resident physician managed to stay happy and resilient in medicine

When I walked into my first shift on labor and delivery as a brand new OB/GYN intern, complete with a freshly starched white coat, I was 33 weeks pregnant. As I listened to my chief resident effortlessly sign out the labor board, I was terrified. As the words pre-eclampsia, chorioamnionitis, and postpartum hemorrhage swirled around […]

Why can e-cigarettes advertise on TV?

Why does e-cigarette maker Juul advertise its product on TV when cigarette ads are banned? The short answer: Because it can. For nearly 50 years, cigarette advertising has been banned from TV and radio. But electronic cigarettes — those battery-operated devices that often resemble oversized USB flash drives with flavored nicotine “pods” that clip in […]

When physicians inappropriately judge

All physicians naturally make judgments regarding the parents they are interviewing. For example, we assess how accurate and plausible their history is. We try to decide if they are telling us the whole story and, if not, if they are inadvertently or deliberately holding something back from us for whatever reason. All experienced physicians do […]

An interview with a medical student who failed the boards

The first two years of medical school are geared towards learning enough so you can pass your first round of Boards. All the sleepless nights and the tears can be overwhelming, but to finally get to the finish line is an incredible achievement. It reinforces that these first two years were worth it and that […]

There’s a lot about medicine that is pretty good. Sometimes we need a little reminder.

Recently, I had dinner with an old colleague that I trained in residency with. It’s been a while since we’ve graduated, but the topic turned to how our lives have changed since those early days. Over drinks, my friend said something that stuck with me and inspired this post. “You know, things aren’t perfect. But […]

How to get ahead in your finances: Pay yourself first

If you’ve ever delved into the world of personal finance, you might have heard of the phrase “pay yourself first.” In fact, many investment gurus mention this approach as one of the keys to getting your finances on track and building your net worth. This concept can seem confusing initially, so let me break it […]

In defense of pimping in medical education

The definition of pimping in the medical field is different than the colloquial usage by artists like Jay-Z, Snoop, and Kendrick Lamar. Although most people are aware of pimping in the vernacular language (which will not be discussed further, I would suggest avoiding most rappers terminology if you desire to research), the medical use of […]

My hand surgeon should have been paid $4.5 billion. Instead, he didn’t get even $1,000.

I believe that health care providers aren’t paid anything close to what they are worth to society. I don’t mean this in the sappy emotional sense in which the “value of any human’s life is infinite,” or any other subjective standard. I am talking about real-world, measurable economic impacts. Using the entrepreneurs’ 10% reward as […]

The patient with a pocketful of IDs

All of us nurses and physicians in the ED and ICU knew him well. He was a young, 21-year-old. A smart, articulate guy who kept going from one hospital to the next. He had a system down … almost. This young man was a drug seeker. He knew all about seizures and how an […]

What is patient autonomy?

I yelled for the nurse as I wrapped my arms around Mr. John. He was suffering from a violent acute dystonic reaction from a dose of Haldol the night before. Severe muscle spasms overtook his entire body. I saw the whites of his eyes as his gaze shot to the ceiling. He had lost all […]

Can entrepreneurial geriatrics fight ageism in health care?

Ageism in health care abounds. Older adults are often overtreated or undertreated for various conditions. The presence of things like fatigue, chronic pain, arthritis, and even cognitive impairment are often accepted as “normal” parts of aging — by physicians and patients alike — despite the fact that many are preventable. According to a recent opinion […]

Explaining Peter Fonda’s lung cancer

Actor Peter Fonda, son of Henry Fonda and younger brother of Jane Fonda, passed away August 16 at his Los Angeles home. Fonda, who was 79, is probably best known for his role as Wyatt in Easy Rider, a movie he co-wrote, produced, and starred in. Fonda was nominated for the Academy Award for Best […]

A primary care physician’s decisions are questioned and second-guessed daily

A 67-year-old woman with a high-stress job had a vigorous disagreement with her neighbors last week. She developed severe substernal chest pain and called 911 fearing a heart attack. She is thin, has never smoked, has normal blood pressure and normal cholesterol. She is not a diabetic and runs on a treadmill for two hours […]


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