#ATS2022 – The American Thoracic Society Meeting

We went to talks about the science, but also about the challenge. Holding that we are mothers and also doctors and that we felt we failed at both. We failed at so many things. But we didn’t fail. Because we were there. And here we are. Holding that we took calls about who gets the last ECMO bed or the last ICU bed. Holding these decisions and feeling the weight of it and the guilt, and also holding other places, where those decisions were made differently. How many people did we kill? How many did we help? We did the best we could – is that enough? They tell us it is, and yet some of us are holding and turning things over in our minds, because maybe we could have done more. Maybe we should have turned right when we took a left, but we can’t quite see that left was better. Was it?

Weekly update 8/26/2021

Dear Riverton team, We are so grateful to be here with you.  We hear you and we see you.  This week we were excited to share your great work with Dr. Harrison. He was able to hear from some of our frontline caregivers and to offer support, gratitude and to take back feedback. We really … Continue reading

Hospital at Home

Mr. Smith was a sixty-eight year old man who came to the Veterans Affairs hospital where I was a medical student complaining of chest pain. “With chest pain, it’s all about the story,” my resident, the physician in charge of our team, said.  We talked to him to find out what he was doing when … Continue reading

Morbidity & Mortality Conference, a post mortem

When things go wrong in medicine, as they invariably do, we try to figure out what went wrong, and why.  We try to learn if there’s anything we could have done better and what we should do next time. It used to be, in the days of the Giants, that the physician responsible for the patient … Continue reading

A New Therapy for Asthma

I first met Carol* (name and identifying details have been changed) when she came to my clinic after a severe asthma attack had sent her to the Intensive Care Unit.  After a few days, she had been extubated and had acquired a new diagnosis, asthma.  When she saw me in clinic, she felt better than … Continue reading

What I Learned at the ATP Reunion Conference February 2014

I. Capitation is coming Although Brent was careful to stress that despite this being gospel among those who “have drunk the kool-aid” it is not universally accepted. Still, the alternative narrative is just more of the same – more efficient fee for service – or aspirations for competing as one of a handful of fee-for-service … Continue reading

Physician Compensation

Doctors are burned out and they don’t enjoy their job as much as they used to.  But looking broadly, physicians are still spared the economic difficulties and loss of autonomy that are present in most other sectors where people are still lucky enough to be employed.  There are issues that doctors rarely face: unemployment, inability … Continue reading

The State Fair

“I got run over by a golf cart at the State Fair,” my five-year-old cheerfully says to the Emergency Department technician who is checking us in. A utility cart knocked him down – he is a five-year-old running along the grass by the path, and some asshole wasn’t looking as he turned into my kid … Continue reading

Evidence-Free Pregnancy Advice

I know why the hoopla around Emily Oster‘s new book, Expecting Better, bothers me, it’s because she hasn’t let you in on obstetrics’ big bad secret… and here it is…. from a pulmonologist. What Ms. Oster points out, and where she is absolutely correct, is that the data to support most pregnancy advice, indeed, most … Continue reading

The Women’s Table

Oh, no. I’m at the loser table, I thought walking into the large room for our summer intern lunch.  I sat at my assigned table with the other female bioengineering summer interns and the one female manager, while looking around enviously as the male interns I worked with sat elsewhere with the men.  Every woman who works in a male dominated field wants to be sitting at the table with the highest level leadership, and we know, just as everybody … Continue reading