Internal Medicine

Shirin Karimi, MD Shirin Karimi, MD (2 Posts)

Resident Physician Contributing Writer

Cambridge Health Alliance


Originally from Madison, Connecticut, I got to experience a dynamic college experience as a Literature major at American University in Washington D.C. I served as an editor for BleakHouse Publishing, a press dedicated to using the arts to showcase the humanity overlooked in the incarcerated population. As a volunteer in a pediatric cancer ward, I was intrigued by the sentiments of cancer patients and their caregivers, whose descriptions of isolation in the hospital echoed the loss of identity and entrapment within a prison cell. From this experience, I was fortunate to publish an original book of poetry, Enclosures: Reflections from the Prison Cell and the Hospital Bed, taking on the voices of those imprisoned in the justice system and in the shackles of illness. I returned to my home state to attend the University of Connecticut School of Medicine, and delved into my passion for the medical humanities through the Arnold P. Gold Humanism Honor Society, research in cancer screening and immunotherapy, and serving the homeless population of Hartford as a member of the Board of our school-run medical clinic. I’m honored to be a third year resident in Internal Medicine at Cambridge Health Alliance in Cambridge, MA and to work at an institution that values medicine as an avenue to promote social justice.




Battling Burnout and Our Quest for Perfection

Two months ago, I woke up one morning at 5:30 a.m., as usual. I played my gym motivation playlist in the shower, ate oatmeal for breakfast, and headed out the door, as usual. I swore at the car that swerved into the lane in front of me without signaling, as usual. An hour later, I pre-rounded on one of my favorite patients, a man with wide, childlike eyes who had a great deal of difficulty expressing his feelings.

A Call to My Fellow Residents in the Era of the Opioid Epidemic

I met Julian six months ago. He was the first patient I watched go through a buprenorphine/naloxone induction. My preceptor carefully guided him through a series of deeply personal questions: How old were you when you first started using? What is your drug of choice? Have you ever injected? How much? Have you ever traded sex for drugs? When did you last use?

Figure 1. “Relationship between System 1 and System 2 thinking.” Daily encounters lead to the activation of System 1 or System 2 thinking. Problems demanding higher levels of thought either directly or indirectly activate System 2. Repetitive exposure decreases the demand for System 2 thinking and increases both productivity and the risk for error.

Systems-Based Thinking: How Subconscious Thought Affects Medical Decision Making

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.

Syed Samin Shehab, MD Syed Samin Shehab, MD (3 Posts)

Resident Physician Contributing Writer

Boston Medical Center


Syed is a medicine resident who is interested in health policy and health administration. He primarily looks at diversity and inclusion and leveraging them to create a medical workforce that can provide higher quality and better access to care for uninsured and underinsured populations. Syed wants to work on pipeline programs and on recruitment, retention and promotion of underrepresented minorities in medicine and also on creating medical school and residency curriculum that frames medical education in a social justice contest and addresses the intersection of race, sex and gender and medical sciences.