Although it’s been a minute since I left clinical practice, I still strongly identify with those who wear scrubs, work hours that are hard on the body, and engage the people and fluids that causes those in polite society to avert their gaze. The reason those people seek care in the emergency department is for variations on a theme: betrayals …
From Fear To Calm
[This piece was written some time ago. Publication was held until after the trial concluded.] I began this week with a fear of the unknown. I am going to trial for the first time in my career. The weird part is that it is for the legacy of a career I’d already left behind. Nearly three years ago, I made …
The Sisyphus Year
It’s been a brutal time to be in medicine. The start of the pandemic caused an unexpected and precipitous drop in patient volume. Those docs who ran their own practices and relied on elective or non-emergent procedures for their livelihood faced significant adverse financial consequences for the evaporation of their patient base, although the Paycheck Protection Program offset some of …
On Engagement And Energy
I’ve started keeping a journal, the first time I’ve resumed this activity in a decade and a half. It brings to mind a 14 year old emptying her emotional life in looping cursive within a Hello Kitty bound book, all while lying in bed speaking on the phone with the cord wrapped around her hand – something out of an …
Has Medicine Helped You Become Comfortably Numb?
We’ve entered that stage of life: begun to lose parents, seen peers stricken with cancer as the youthful patina of invincibility fades, and started to give up pastimes we thought we’d never stop enjoying. As a result, the typical conversation with a non-medical friend my age tends to follow a template. Dissatisfaction is expressed regarding a new boss, the latest …
Service To Others As A Way Out Of Your Head
A friend reached out to check in on me, and I confessed I’d been having stress dreams for the first time in many months due to the pandemic. He invited me to nightly online meditation he leads. I’ve never participated in anything like this, but I know and trust this friend, so I accepted his generous offer. There was a …
Is It Finally Time To Establish A Routine?
I am an emergency physician, a member of a specialty whose foundation requires a complete renunciation of routine. It’s one of the vows we take before they teach us the secret handshake. No week can be reliably expected to be like any other before or after it. [The only exception: You will inevitably encounter a patient allergic to every analgesic …
How To Endure In Medicine
As an emergency physician, it’s a gift being of service to patients on the worst (or last) day of their lives. It’s not easy, and it’s not for everyone, but it lets me contribute in a meaningful way. Acknowledging that being an emergency physician provides me a real sense of fulfillment is not enough to persuade me to want to …
Lessons From Docs Who Cut Back
Chief Wellness Officers are administrative leaders tasked with ensuring that organizational culture and executive leadership align to produce a healthy practice of medicine for those tasked with working in the clinical environment. That is a complicated way to say they are supposed to help doctors either like their work more or resent it less. Structural incentives are important in helping …
There Are Many Places I’d Rather Be, But This Is Where I’m Needed
When I started this blog, I was all over the FIRE bandwagon. I felt trapped by medicine, and was looking to load up, cash out and exit as quickly as was financially feasible. Something happened along the way to the early retirement component. Cutting back on my clinical time transformed medicine from a vindictive and jealous ex-mistress whose only objective …