Fresh out of residency and having just turned 29 years old, I started my first job as a general pediatrician in Sioux Falls, South Dakota. One of the first official tasks of my new position involved picking out brand new office furniture for my private windowed office which was housed along the perimeter of the […]
In 2002, when I began my first hospitalist job, I was a dyed-in-the-wool hospital medicine convert, convinced that the transfer of inpatient care to true specialists in hospital medicine (hospitalists) would dramatically improve the quality and efficiency of inpatient care, increase patient satisfaction and decrease costs. By 2008, I had developed serious doubts, which prompted […]
I started internship July 1, 2008, as a terrified 25-year-old blank slate. Most days started with a combination of nausea and dread as I pumped myself up in the resident parking lot — conveniently located a mere 1/2 mile from the entrance to the ivory tower I called home. The days were long. The nights […]
We all have that one patient. That one patient who can always find a way to turn a good day bad, who just knows how to push your buttons in all the wrong ways. Who’s that patient for me? Let’s just call him Elton Reed. Oh, Mr. Reed … where to begin with him? When […]
We all have that one patient. That one patient who can always find a way to turn a good day bad, who just knows how to push your buttons in all the wrong ways. Who’s that patient for me? Let’s just call him Elton Reed. Oh, Mr. Reed … where to begin with him? When […]
“Tell me something you love.” I love warm chocolate chip cookies — straight out of the oven. “Thank you. Tell me something you love.” I love to read, to write, to dance. I don’t know yet if I love medicine. We were gathered in a ballroom, a group of doctors and dancers, to explore the […]
The day begins at 6 a.m. I am rounding on my nine patients, quickly examining them and providing a brief update about the plan. Like the other harried residents, I am speeding from one room to the next, trying to get everything done on time. And then, inevitably my beeper goes off — “Patient in […]
Alvin is a 42-year-old man who was never really given a chance. His parents both had severe alcohol use disorder. At age 12, his parents encouraged him to skip school to sell marijuana in order to fund their drinking. As his parents began using various illicit drugs, Alvin started selling larger amounts of marijuana to […]
What is evidence? How do we gather evidence of patient harm? More importantly, what is the evidence that counts? A research paper dating back to 2004 suggests that besides research evidence, clinical and patient experiences, as well as contextual information also constitute evidence. However, the only currency of science is data collected through systematic and rigorous […]
Sepsis, the body’s self-destructive inflammatory response to severe infection, is the leading cause of death in U.S. hospitals, particularly among the elderly. It starts as mild sepsis, advances to severe sepsis, and all too frequently blossoms into septic shock. More than 1.5 million Americans get sepsis each year. More than 250,000 die of the illness. One […]
