I read Samuel Shem’s House of God twice — once in my late college/early med school years and another sometime during my pulmonary/critical care fellowship. The first time, I recall thinking it was drop-dead hilarious. I eagerly shared it with fri…
Category: Critical Care
If a doctor has a bad day, someone dies. Remember that.
For what seemed like an hour, I stood staring at the flat lines scrolling endlessly across my monitor in the OR. The once pulsatile waves, rendered useless and flat due to the absence of a beating heart. After a frenzied six hours of pouring blood into…
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…
The power of music in the ICU
“I just don’t know what to do, how to help.” My patient’s wife was slumped in the plastic chair by her husband’s side, fatigued and beleaguered. She had been there for hours, days, as we waited for antibiotics to start fighting back against the infec…
Perfect nurse. Perfect manager. Perfect puppet.
Perfect nurse. Perfect manager. Perfect puppet. An ICU physician once told me: Nurse managers have a life cycle of a mosquito. Fast and furious And then gone. Deleted until the next one shows up. It was the perfect ICU. Twenty-five beds. Dynamic intens…
Pulmonary embolism: the killer clot in your veins
We had just exchanged “I love yous” about 15 minutes before the intercom blared: “Code blue.” Just like that, my sister was gone — all from what seemed like a simple knee surgery. Simple in the fact that the type of surgery my s…
A lack of understanding for what physicians really do
I recently had the pleasure of participating in an administrative law judge (ALJ) hearing. Novitas, the Medicare administrative contractor had denied the E/M code 99291, critical care. The case was appealed to the qualified independent contractor, who …
A lack of understanding for what physicians really do
I recently had the pleasure of participating in an administrative law judge (ALJ) hearing. Novitas, the Medicare administrative contractor had denied the E/M code 99291, critical care. The case was appealed to the qualified independent contractor, who …
Remembering a physician, suddenly taken away
Our 20-bed ICU finally captured 10 intensivists — all board-certified in critical care medicine. We were fortunate enough to have one of these doctors in our ICU 24-7. Of course, they all practiced professionally with expertise. But I remembered this o…
The importance of being there for your patients
Halfway into my four-week hematology consults elective at the county hospital during my fourth year of medical school, I was surprised that one of my patients was a 25-year-old woman from Romania — exactly my age. This was highly unusual, as most of th…
