Category: Hospital-Based Medicine

Should residency programs review their applicants’ social media history?

By now, I’m sure most of you probably have heard about the Cleveland Clinic first-year resident who was fired last September when it became known that in 2012 she had tweeted she would “purposely give all the yahood [Jews] the wrong meds …” The website…

Why doctors-in-training need better nutritional education

Obesity is a global epidemic, and its prevalence is increasing in every part of the world. While we have new medications and complex surgical techniques that promote weight loss, the awareness of healthy eating habits and dietary education are still th…

In medicine, what’s in a name?

Before I could see her, I could hear her. My patient, a young woman with messy braided hair, was grunting with every effort to breathe. The noises quieted slightly when I reached her bedside, but her tears continued to fall between gasps. Her body move…

Another chance to practice self-compassion

It’s Monday morning, and I’m the attending physician starting a week of inpatient service in the hospital. On my patient list is a man named Earl, age ninety-one. He’s outlived his siblings, his first and second wives and all of his p…

How EMR alert fatigue overwhelms physicians

As a hospitalist, like most in health care, I am afflicted by the slow march of thousands of mouse clicks on the electronic health record (EHR) every day I work.  But after starting a new job and learning a new EHR, I have become painfully aware of the…

10 things patients should know about hospitals

When you enter the doors of an emergency department, what you are entering is the realm of the unknown. Needles, blood, blaring alarms and all-nighters with nurses are about to become your new norm. For your whole life, you thought good food, sleep, an…

I had just witnessed my first patient die

Stepping into a hospital for the first time as a clinical medical student is a strange dichotomy. There is still so much you have to learn before you will become a physician, but you are quickly thrust into life-and-death situations. One of my early ro…

Why did it take over a week for doctors to initiate treatment?

Part 3 of a series. Patients with advanced cancer are particularly vulnerable to infection due to a compromised immune system. Moreover, the typical symptoms of serious infection, such as fever and chills, may be absent in cancer patients. If not ident…

A reflection on the last day of residency

I entered residency self-assured, if not in my scholarly achievements, at least in who I am as a person. I left slightly broken. Something happens to you in residency, and you don’t realize the transformation as it occurs. It may be the loss of a patie…

Break the reaction to high pain scores

Pain usually cannot be “treated” like a standard ear infection. Treating patients in pain requires setting realistic expectations, using a variety of approaches, and patience. One patient I treated months ago highlights these points. At 6 a.m., I was r…