twenty-two nights you kept me awake. i counted / them last night, counted them as i lay on my bed with / eyes propped open, trying everything i could to
A quiet, frail, emaciated gentleman in his 60s who was dying of cancer. What made him different was that he was shackled to the bed, one arm and one leg bound to the bed of a barren room, lit only by the pale blue light from the window that cast the silhouette of bars on the floor. This was the prison unit.
The hospital is a stage and rounding is the show. It’s a daily performance, a dance of sorts, that takes place each morning on the floors. The performers congregate outside a patient room.
He pulled his chair up to the desk and flipped open his laptop. The young doctor, with thirteen years of pre-collegiate preparatory schooling, four years of college work, and a final four additional years of relevant medical education underneath his belt, attempted to yawn away exhaustion and scrolled through the patient list for the day.
I am doing everything to make this one last. I was dumb before. This is a second chance and I have to do it right this time. You know no one gets a third. I have a new job, I am finally getting back on my feet. So I have had to miss a few days. She says she understands, but I am not so sure.
In order for the country to make meaningful progress in tackling the opioid epidemic, we need a cultural shift in the way patients and providers think about pain.
Pharmaceutical companies and physicians are being demonized for their manufacturing and dispensing of opioid analgesics. Money-hungry executives from Big Pharma caused the crisis by brainwashing doctors to prescribe these medications left and right. Greedy doctors want patients dependent upon them for years, ensuring a steady stream of paying patients in their waiting room. Drugs drive the market. Drugs lead to big profits for everyone involved. The more drugs, the better.
By anyone’s standards, from a medical perspective, we did everything right. But all I could think about is how much we hurt this boy by saving his life. How we saved his life just enough, not to kill him, just to take away every meaningful part of human existence.
In the late 1950s, my grandmother was often told, “Medicine is no place for a woman.” As a result, she went to medical school under the guise of attending a teaching college deemed appropriate by her mother. It was a difficulty journey for my grandmother to gain acceptance to Yerevan State Medical University in Armenia.
For most of our childhoods growing up in the Midwest, the Iowa we called home was a swing state proud of its investments in education, was welcoming to refugees from around the world, and was the third US state to legalize marriage equality.
One evening, overwhelmed by burnout, I drafted a letter of resignation to my program director and saved it on my computer. The next morning, I deleted the email without sending it.
System-based thinking describes a set of subconscious thought processes aptly named System 1 and System 2. The profession of medicine relies heavily on SBT — the ability to rapidly diagnose, treat, and improvise during stressful situations is dependent on these systems, which develop and mature throughout one’s training.
Physician burnout has emerged as an increasingly concerning phenomenon in medicine. As high as 51% of physicians in a Medscape survey report symptoms of burnout. Doctors face higher demands with less time and support. Academic medical centers, which historically have been insulated from outside forces, are now seeing larger patient censuses, leaving less time for physicians to work through each patient’s case carefully.