Category Archive

I show up for the morning “hot zone” shift and check in with the lead nurse in the ED. Of 60 potential clinical spaces (accounting for every gurney, chair, and our fast track area), 29 are occupied by boarders – patients admitted to the hospital who remain in the ED either because there are insufficient beds upstairs in the hospital …

Back in training, my fellow residents and I gulped ladles full of Kool-Aid from tenured professors who ruled an impressively pedigreed land of job security and underlings to perform scut. For readers outside of medicine, scut refers to the small and annoying tasks involved in routine patient care. Examples might include drawing blood at specific time to test levels of …

I’ll keep this short and sweet. One of my medical heroes, Dr. Rick Hodes, was interviewed on the White Coat Investor podcast. Rick is a Jewish medical director working with Catholic nuns at the Mother Theresa Mission in Addis Ababa, Ethiopia, caring for sick destitute patients including Ethiopian Orthodox Christians and Muslims. Together they model the world as it should …

I have read that a raccoon will wash a perfectly clean food item in filthy water before consuming it as a matter of genetically-based behavior. The inclination to rinse food prior to eating it must have historically served as an evolutionary advantage, even if in some circumstances it may harm the raccoon. In a similar vein, I hail from a …

What are your superpowers? One of mine, cultivated from early childhood and strengthened routinely in my role as an emergency physician, is the ability to frame a situation in a way that allows me to move beyond aggravations, real and imagined. (Excluded from this claim is the ability to deal with preteens and adolescents, which I consider a universally shared …

This article is intended for the otherwise healthy patient under 50 years of age who thinks he may have contracted COVID. If you have a body mass index above normal, are diabetic, use an oxygen tank, or the number of medications you take exceeds the number of grandchildren whose names you can remember, this is not written for you (in …

Being an emergency physician requires you to excel, among other areas, in one particularly important preschool skill: playing well with others. I deal with consultants from other specialties numerous times on a daily basis, often asking them to employ their unique talents at inopportune hours. One of emergency medicine’s kindred “plays well with others” specialties is radiology – in fact, …

Thanks to order to shelter in place, spring cleaning has arrived in our household with a rarely seen vengeance. Consequently, my office is in the thick of a massive decluttering effort. One of the casualties is the x-ray file I used to take out at parties. When you are an eligible resident in emergency medicine, you bring a certain cachet …

The ED can be a challenging place to work. Patients are anxious, injured, in pain, and may have unrealistic expectations of the services we provide. A smaller number of patients are also drunk, high, or acutely psychotic. Captains of industry feel suddenly powerless to control their circumstances. Said captains are unaccustomed to the symphony that arises when one is situated …

Yesterday I had three end of life conversation in a single shift in the Emergency Department. I was in the “hot zone,” caring for suspected COVID patients, and all discussions involved goals of care for seniors in their late 70s, 80s and 90s. At the ripe age of 47, those in their 70s (my parents’ generation) do not seem as …