GlassHospital

Demystifying Medicine One Week at a Time

Tag: Shots blog (page 2 of 2)

Holidays

Last year I wrote a reflection piece for NPR about working in the hospital on Christmas during my intern year, in 1997.

kstreetersnoglobeI remember lamenting my first December having to work straight through. A wise mentor helped me reframe my self-pity. “It’s a privilege to work on Christmas,” he told me. “Our patients count on us. You may not want to be in the hospital, but think of what they’re going through.” He smiled, as if he were welcoming me to a special club, one that I wasn’t wholeheartedly ready to join. “Your mere presence helps reduce each patient’s sense of loss.”

I had the privilege of working again this year, in much less harrowing circumstances. Several of the hospital staff gave me warm nods, acknowledging we were all part of the club — either choosing to work the holiday or ‘taking our turn.’

As an attending physician, it’s one of my jobs to pass on the tradition of medicine as a calling to the next generations of doctors. Using the essay as fodder, I asked my interns how they were coping with working their first Christmas.

One intern replied meaningfully that since he doesn’t celebrate the holiday, he’s glad to be working in place of others so that they can spend time with their families.

I was moved. I do get sentimental this time of year.

A Brief Chat with Scott Simon

I wrote a new piece for Shots, the NPR health blog. In an especially nice turn, the piece was “picked up” for a discussion on NPR’s Weekend Edition Saturday. I had the chance to answer some questions from Scott Simon, longtime host of the program and one of my favorite radio broadcasters.

simon_mother_originalSimon is well-known for many reasons, but one of the most endearing things about him is the period when he sent numerous tweets from a Chicago ICU next to what turned out to be his mother’s deathbed. His tweets moved millions of us. [It turns out those tweets will now be used as narrative thread for a new memoir about his mother.]

I would’ve liked to tell Simon about how his tweeting impacted me, but this being national radio, we had to focus on the matter at hand, and I didn’t get the chance. Still, it was a thrill for me. Our conversation was whittled down to less than three minutes, and you can stream the audio anytime as it’s now permalinked to the written piece.

Give it a read and a listen. Hope you it makes you think.

Post by NPR.

1 Step Forward, 2 Steps Back

Just a week ago the news from my home state of Oklahoma was the kind that any state covets: accolades about our excellence in high quality early childhood education.

As if unable to handle the positive attention, Oklahomans now find ourselves in the much more usual position of having a hot negative spotlight shined upon us. Stories about executions always draw controversy, but when the headlines include words like “botched” or “bungled,” my inclination is to find the nearest rock to crawl under.

By now you’ve likely heard about what went on at the Oklahoma State Penitentiary on April 29th: Clayton Lockett, a man sentenced to death for first degree murder, was executed. It was supposed to be by lethal injection, but about the only thing clear at this point is that his vein blew and the cocktail of drugs he received went into his skin and subcutaneous tissue, not into his bloodstream. As a result, he writhed in pain, and the execution was actually ordered stopped by the physician attending it.

Forty-three minutes after it began, then went awry and was ordered stopped, Lockett was declared dead. What happened? The doctor pronounced Lockett dead of a heart attack. How that could be known without an autopsy is a mystery to me.

Governor Mary Fallin of Oklahoma has ordered an investigation into what went wrong. For now, Charles Warner, also convicted and sentenced to die the same day as Lockett, is under the reprieve of a stay. President Obama also weighed in, calling for a policy review on capital punishment by the Justice Department.

I wrote a reflection about doctors’ involvement in executions (and prohibitions thereof) for NPR–just click on the box below:

Screen Shot 2014-05-03 at 1.30.41 PM

I hope this unfortunate Oklahoma story can lead us all to pause in search of a more enlightened path.

Bedside Manner(s).

NPR published a story of mine, for the second time with original collage art by the amazing Katherine Streeter.

@lenorebedsideThe story was inspired by a research project (and subsequent article) by researchers at Johns Hopkins. They followed two groups of medical interns around and recorded what percent of the time the interns performed five basic ‘etiquette-based communication’ skills:

  1. Introducing themselves.
  2. Explaining their role in the patient’s care.
  3. Touching the patient (whether in greeting, as a gesture of comfort, or as part of a physical exam).
  4. Asking open-ended questions such as, “How are you feeling today?” and
  5. Sitting down with the patient.

Interns in the study were pretty good at asking open-ended questions, doing it three out of four times. But they only introduced themselves 40% of the time (gotta wonder about that–did they assume they were familiar to their patients?) and only sat down at the patient’s bedside 9% of the time.

The researchers, led by Dr. Lenny Feldman, encourage doctors and other health professionals to slow down and sit when talking to hospitalized patients. It can make a world of difference to the patient.

In their Facebook post, embedded below, NPR asks, “What kind of bedside manner do you want from your doctor?”

The answers are great. Check them out and add yours.

Post by NPR.

#9 Dream*

It’s been an interesting week.doc-office-aca_wide-403577f90f9f2aa9fdfb92060c1f512825900d1f-s6-c30

I wrote an essay with some predictions (nine, to be precise) about where health care is headed in the Obamacare era, and it got some attention.

Please check it out: it’s on the NPR “Shots” blog, and it’s called “A Doctor’s 9 Predictions About the ‘Obamacare Era’.” Here’s a link: ARTICLE  [Or just click on the picture accompanying this post.]

I’m really happy with the response the article has been generating. If you scroll down below the article and read some of the comments, you’ll see that some folks think I’m anti-Obamacare, while others think I’m slandering Republicans. That’s how you can know when you’ve gotten it near-right. Critics from both sides!

I’ll say this: people often criticize journalists for bias. I think the comments demonstrate (if you read the article carefully) that respondents inject their own biases into how they see the article.

My thanks to the editors at “Shots” for shaping a solid piece and making it all the more logical, powerful, interesting and attractive.

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*#9 Dream: a song by John Lennon. Click here to see John and Yoko canoodling all over town.

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