Posted by denitzablagev on October 5, 2014 · 5 Comments
“They need you in room 13” she said when I answered the phone and I ran back to the ICU. The patient was coding and for each minute that felt like an hour, we tried, and failed, to save her. She wasn’t breathing, her heart wasn’t working, and despite the 30 people gathered in the room, … Continue reading →
Filed under doctor, dying · Tagged with code, code leader, code status, death, DNR/DNI, doctor, dying, epinephrine, ICU, patient, running a code, Thank you
Posted by denitzablagev on March 21, 2014 · Leave a Comment
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 →
Filed under doctor, evidence in medicine, medical costs, medical decisions, quality improvement · Tagged with acid reflux, airway muscles, American Thoracic Society, asthma, asthma exacerbation, bronchi, bronchial thermoplasty, doctor, Emergency Department visit, European Respiratory Society, evidence, evidence-based medicine, GERD, Guidelines, inhalers, lack of evidence, medical decision making, medicine, new therapy, patient, prednisone, procedure, pulmonologist, Recommendations, risk of harm, severe asthma, uncertainty in medicine, unproven benefit
Posted by denitzablagev on October 7, 2013 · 1 Comment
“Sticks and stones can break my bones, but words can never harm me.” I learned this saying when I came to America, but before that, I learned a different story. A wood cutter got lost in the forest, it was getting dark and cold. He met a bear, who offered him to come to his … Continue reading →
Filed under doctor, medical education · Tagged with axe, Bear, break my bones, doctor, emergency department, emphysema, ICU, insensitive, intensive care unit, patient, sick, smoker's cough, sticks and stones, The doctor, vulnerability, words, world's worst mother
Posted by denitzablagev on May 8, 2013 · 2 Comments
Time heals all wounds, they say, or, in medicine, if not all, then many. But with our improved efficiency and throughput of patients, we fail to allow this most magical treatment to work. The pace and intensity of medicine has increased exponentially over the past several decades. We see more doctors, have more procedures, take … Continue reading →
Filed under doctor, evidence in medicine, medical costs, my tirades · Tagged with adrenal incidentaloma, bedside, CT scan, doctor, doctor-patient relationship, echo, emergency department, healthcare, incidental findings, incidental pulmonary nodule, medicine, patient, rationing, science, slow food, slow medicine, time heals all wounds, voltaire
Posted by denitzablagev on April 2, 2013 · 2 Comments
Anxiety ranks among my least favorite diagnoses. In medicine, we have a long history of blaming a variety of diseases on anxiety. Even in the recent past we attributed gastric ulcers to stress until it was proven that a bacteria that lives in the gut is responsible. Indeed, who would have thought: a bacteria living … Continue reading →
Filed under access to care, Denial, doctor, medical education, my tirades · Tagged with anxiety, cancer, depression, doctor, fatigue, health, medicine, multiple sclerosis, patient, shortness of breath, sigh, woman, women
mybetterdoctor 