Imagine spending days or even weeks in an emergency room without treatment for a broken leg or painful kidney stone. Patients in psychological crisis across the country are living this exact scenario. Long waits in an ER, hospital room or prison for an inpatient psychiatric bed, otherwise known as psychiatric boarding, are their unfortunate reality. […]
She tells me that she sees them at night when she is lying in her bunk bed — eight to a room. Grotesque forms with masks over their heads and guns across their chests. She hears panicked shrieks, but is never certain if they are coming from the next trailer, or if they are inside […]
I have a few hundred thousand dollars in 529 plans. We have been growing them for years. Although not everyone’s cup of tea, this lump of money invested in this manner suggests that not only am I prepared to drop a boatload on college education, but also feel that it is cash well spent. Although […]
Dear first-year medical students, Welcome to medical school — congratulations! You have worked, sacrificed, waited for this moment for many long years, have left blood, sweat, and tears along the tracks of your life marathon. This is the first checkpoint in your journey. You’ve made it. Your loved ones are right here cheering your accomplishments, […]
Darkness covers the sky so that no light can enter the soul. Only a silhouette of life is possible — only a shell devoid of existence, devoid of meaningful experiences. Living is like walking in a dense forest where its canopy envelopes all who dare to enter. The falling rain is black. It covers everything […]
I began practicing as an internist/nephrologist in the early 1960s. Having rented an office in Los Angeles, I introduced myself to the local medical community and set out to build a practice. With a growing family, a mortgage and an office to support, I was hungry for patients. Hospital emergency rooms were good referral sources, […]
Can the health system survive? It comes down to the people. It is not about their work, but how they feel: feeling valued, feeling their work is valuable to those they serve, and feeling valuable doing the work. It is work as an extension of what you believe, what you love and how you want […]
I have a fantastic leader as our chief. He develops a certain softness in his voice and demeanor when he has to sit down with me and share some concerns. It’s like he is on my side. It’s like he believes in me. He thinks this was an act, but this is not who I […]
Last year, a cardiologist at my institution presented the story of a patient he had cared for and correctly diagnosed with a not uncommon condition after several other physicians had failed to do so. The patient was a 72-year-old man with near syncope after exercise for several months, with no other symptoms or clues to […]
There’s this prevailing theme in modern medicine that I don’t understand. It’s called: “Do no harm to others, but neglect yourself.” It’s perpetuated by ridiculous working hours, emotional, psychological and sometimes physical stress, minimal vacation and maximum pressure to always do a little more. Did you overwork yourself as an undergrad, watch your hair fall […]
