Resident Physician Contributing Writer
University of Pennsylvania
Cramer is a current PGY-1 in Family Medicine and Community Health at the University of Pennsylvania Hospitals in Philadelphia, Pennsylvania. He attended the University of North Carolina School of Medicine and the Gillings School of Public Health where he received his MD and MPH, respectively. He additionally received a graduate certificate in LGBT Health Policy and Practice from George Washington University. He obtained his Bachelor of Arts in Spanish and Medicine, Health, & Society from Vanderbilt University. Cramer was born and raised in Charlotte, North Carolina.
The opinions expressed in this article do not represent those of the University of Pennsylvania Health System or the Perelman School of Medicine at the University of Pennsylvania.
On July 26, President Donald Trump released another polemic tweet informing the public that “the United States Government will not accept or allow Transgender individuals to serve in any capacity in the US military,” citing the “tremendous medical costs” that transgender individuals pose to the health system.
I distinctly remember my drive to the hospital for the first shift of my residency five years ago. It was a night shift, a fact that only added to my trepidation. My brain bounced frantically back and forth among a random assortment of topics of which I lacked, I felt, sufficient knowledge, but which knowledge I felt sure I would imminently be called upon to use in a critical situation.
“And your socks, too,” I said / She stooped to reach her feet / And the liner of the exam table crinkled and popped
On Match Day, you are assigned to a new family for the next three to seven years. This will be the city where you might buy your first home, the city where you may meet the people who will speak at your wedding. An algorithm shuffles you into your assigned place in a new family tree.
Just as we have landmarks events that shape us in the adolescence of our personal lives, physicians also have landmark events that shape them in the adolescence of medical training — residency.
I work at one of several hospitals in the country whose security force is staffed by law enforcement personnel. It’s also one of the 52 percent of hospitals nationwide whose security guards are armed with handguns.
The House-approved American Health Care Act of 2017 (AHCA) and the proposed Senate Better Care Reconciliation Act (BCRA) would approve cuts to Medicaid that hurt Iowans.
Good afternoon, ma’am. Wow, what a contagious smile you have. I hear that you are here because of a stuffy nose? They said that you tried Claritin and that did not help. You feel congested, and it’s hard to blow anything out? And no fevers, no cough, no difficulty breathing or any wheezing?
“What part of what I just said did you not understand?” The fellow patronizingly chastised me in front of the entire medical team. Her tone and body language felt demeaning, almost as if she was more intent on embarrassing me than caring for the patient.
Back in that operating room, I am dutifully holding onto the basin just beyond and under the table edge. What I see is what the mother would never wish to see; being a part of her care, we accept that burden for her, and in a much different way that she ever could from her intimate connection with it. It is our service to her, to alleviate that pain, to be an open support to her health and well-being. It is an acceptable cost, but a cost all the same.
The waves beat; / a cold, relentless torrent. / You stand against them / taking the impact
The unexpected suicide of a graduate of our surgical residency program — nearly seven years ago — still reverberates off the walls of Stanford Hospital. While he didn’t end his life on the premises (that happened during fellowship in another city), the effects of his tragic death subdue the residency to this day
Fellow Physician Contributing Writer
Stanford University
Cliff was born and raised in California’s Eastern Sierra. His passions included motocross and ski racing in his hometown of Mammoth Lakes. He attended college at UCLA where he majored in anthropology and excavated pre-contact Guaymi burials on remote Panamanian shores. After graduating summa cum laude and Phi Beta Kappa from UCLA, he went to USC for medical school on an academic scholarship. His research focused on surgical education in designing perfused cadaver models, and cost-effective means of delivering burn care. He graduated AOA and valedictorian, and matched into Plastic and Reconstructive Surgery at Stanford. Cliff completed a postdoc fellowship at Stanford’s Clinical Excellence Research Center learning value-based care, studying health policy, and getting a foundation in health services research. His current investigations include cost-effective delivery systems for burn patients, understanding the effects of reimbursement variation on surgeon decision making, and improving resident physician performance through targeting variation. Cliff aspires to be a burn surgeon with the goal of improving outcomes following reconstructive surgery. He also aims to improve shared-decision making when undergoing reconstructive burn surgery.
More than anything, Cliff loves spending time with his wife Cassandra, who is a patent litigator in Palo Alto. They are raising twin boys, Jake and Charlie, who have quickly become their raison-d'etre. The family of four loves traveling.
