What a mess!

What the hell were we/they thinking? Maximize profits at what expense?

The assembly line model for patient care will lead to medical errors and missed diagnoses, not to mention terrible patient satisfaction.

Observations in Training

"Learning how to practice medicine is not easy. There is a tremendous amount of information thrown at us. I am constantly balancing medical school coursework, exciting extracurricular experiences that enrich my learning and prepare me for residency applications, and personal relationships that keep me grounded. At times, though, it feels like I'm running out of energy and that too much is being asked of me. This feeling is not unique to medical trainees. Anyone developing a skill or portfolio at the beginning of their career works exceedingly hard to develop mastery of their craft, and that often takes a toll." - Nihar Rama

Reflecting on the reflection I recognize the toll that medicine and medical education took on my and my colleagues. We have become fried by the system, unable to stay grounded, tossed by the ocean of change and stresses upon us through many unnecessary discomforts.

Dr. Lisa Rosenbaum, in the New England Journal of Medicine, writes of the tensions between the rigor of medical training and how many trainees are pushing back against the demands of the profession. She writes, 

"…Maintaining our commitment to excellence while remedying our failures requires distinguishing unnecessary harms from necessary discomforts."

My generation of clinicians has been unnecessarily harmed, in irreversible ways. I've always hoped that the new generation can reverse this phenomenon in order to help recreate the system that has become sick-care in the United States and beyond. 

 

There needs to be much less "unnecessary harms" to save the system from completely drowning in and upon itself.

Think Blue!

Want to live long and prosper? Think Blue.

Blue Zones, regions of the world where people live exceptionally long lives, ten times more likely to live to 100 - Barbagia region of Sardinia, Italy, Okinawa, Japan, Nicoya Peninsula, Costa Rica; and Icaria, Greece

1. Move naturally

• "soleus push-ups" (calf raises) in a sitting position
• opt for walking or biking for short distancesleg lifts or seated stretches
• take the stairs

2. Say yes to happy hour

• moderate alcohol consumption often occurs in a social context, emphasizing the role of community and celebration

3. Take time to down shift

• take a deep breath, hold for a few seconds, and slowly breathe out through your nose

4. Give your diet a plant slant

• plant-based sources of protein, like beans, including black, soy, fava, and lentils, over meat
• 3- to 4-ounce serving of pork

5. Find your crew

• love and positive social interactions have been shown to release oxytocin, reducing stress w/ long-term improvements in emotional state and physical health

6. Abide by the 80% rule

• stop eating when stomach is 80% full

7. Put your loved-ones first

• investing time in your family 
• keep aging parents (or grandparents) nearby
• commit to a life partner
• children, make an effort to spend time with them

8. Find a place you belong

• attending a faith-based service four times per month could add four to 14 years to your life expectancy
• seek out a squad that makes you feel accepted and seen

9. Know your "why"

• purpose in your day-to-day life
•     What do I love? (Passion)
•     What am I good at? (Profession)
•     What does the world need? (Mission)
•     What can I be compensated for? (Vocation)

Time to take account and seek the "blue" proven ways to age strongly and gracefully.

Ugh

As I write this, I have been sitting in an emergency department with a family member for almost 14 hours, suffering from up charges for a simple procedure in the morning.

I can't tell you how broken the system is because the disrepair is beyond repair. The rooms in the hospital are filled up and patients line the walls on gurneys with the beep beep sound of EKG alarms blaring. Every 10 minutes or so some employee comes over to the cabinet across the hall from our gurney and looks for equipment that is not there. Wasted time and effort. Frustration beyond belief. 

Nobody looks happy.

It's no wonder people get sicker when they come to the hospital. The staff is overworked. The equipment is absent. The system is overwhelmed, broken and without hope as populations grow and resources become more scarce in relation to the strain of perceived community needs. 

We are screwed!

But in a pure irony of need, a new building is being built on the property to accommodate the growing need for sick care. A building that will likely be filled with patients, not enough staff searching for inadequate equipment.

STOP Vaping NOW!

Vaping-induced #pneumonitis, also known as electronic cigarette or #vaping-associated lung injury (EVALI), is a condition characterized by inflammation and damage to the lungs caused by the use of electronic #cigarettes or vaping devices. This condition emerged as a significant health concern in recent years.

#EVALI typically presents with symptoms such as cough, shortness of breath, chest pain, fever, and fatigue. In severe cases, it can lead to respiratory failure, requiring hospitalization and intensive medical intervention. The condition can resemble other lung diseases, such as pneumonia or acute respiratory distress syndrome (ARDS), making it challenging to diagnose accurately.

The exact cause of vaping-induced pneumonitis is not yet fully understood, but it is believed to be a result of chemical exposure from the inhaled aerosols produced by vaping devices. These aerosols contain various substances, including nicotine, flavorings, and other chemicals. It is thought that the heating and aerosolization process can cause chemical reactions and the production of toxic compounds, which can irritate and damage the lungs.

Furthermore, some cases of EVALI have been linked to the use of vaping devices containing tetrahydrocannabinol (THC), the psychoactive component of cannabis. Certain THC-containing e-liquids or cartridges may be adulterated with harmful substances, such as vitamin E acetate or other oils, which can cause severe lung injury when inhaled.

The treatment for EVALI typically involves supportive care, such as supplemental oxygen, bronchodilators, and anti-inflammatory medications. In severe cases, hospitalization may be necessary, and patients may require mechanical ventilation to support their breathing. Most important...STOP VAPING!!

Prevention is essential in addressing vaping-induced pneumonitis. Individuals, especially young adults and adolescents, should be educated about the potential risks associated with vaping and the importance of avoiding the use of unregulated or illicit vaping products. Regulatory measures, such as stricter quality control standards and ingredient disclosure requirements, are also crucial in minimizing the risks associated with vaping.

It is important to note that the understanding of vaping-induced pneumonitis is an evolving field of research, and healthcare providers and public health officials continue to investigate and monitor this condition to develop better strategies for prevention, diagnosis, and treatment. If you have any concerns or experience respiratory symptoms related to vaping, it is essential to seek medical attention promptly.

Trauma

A violent assault. 

A rocky childhood.

A car accident. 

If these are in your past, they could be affecting your present health.

These are all examples of traumatic events — which, in psychological terms, are incidents that make you believe you are in danger of being seriously injured or losing your life.

Research shows that these events can trigger emotional and even physical reactions that can make you more prone to a number of different health conditions, including heart attack, stroke, obesity, diabetes, and cancer.

Harvard T.H. Chan School of Public Health

Age Argument Doesn't Work

"18 year olds can fight in war should be able to buy an assault weapon..."

Ok...then we should license (enlistment), train (basic training) and supervise all 18 y/o with any such weapon.

Then argument doesn't work. It's not the same.

It's not a different standard as long as we license, train and supervise said person.

As one NRA member attendee said, "Raise the age limit to 25...that's a start"

Attack

One of the foundational building blocks of a healthier world is consistently under attack: sexual and reproductive health and rights.

Sexual and reproductive health and rights are central to the health and well-being of patients and communities.
It reflects not only the ability to exercise rights related to sexuality and reproduction, but also the ability to make informed decisions and have full access to sexual and reproductive health services.
This includes access to safe abortion.

Each year, nearly 25 million unsafe abortions take place, representing just under half of all abortions worldwide.
As many as 25% of women and girls who undergo unsafe abortion are likely to develop temporary or lifelong physical and emotional health problems.

Lack of access to abortion does not lead to a decrease in abortion, it only increases the danger to people's health and lives.
Evidence suggests that whether or not it is legal, patients will seek ways to induce an abortion if necessary.
And in countries with highly restrictive abortion laws, the proportion of unsafe abortions is significantly higher, with profoundly harmful effects for its citizens.

What kind of world are we becoming when access to healthcare choices is restricted by a single viewpoint of non-medical voices?
We deserve "progress", not regression.

Tragedy In Front of Us

From Mariupol…

"I told the brothers that it's good for her to sleep." Ukrainian gymnast Liliya Podkopaeva, from her basement in Mariupol, where her mother died."

"We went to the toilet, slept, or ate leftovers in the basement. Mother was hanging on until the end, 3 days before our evacuation, she died. I told the brothers that it's good to sleep and don't wake her up."

"The corpses stink so much."

"I hate Russia."

"My dear uncle is there. Do you know what I heard him saying over the phone today? "Kotya? What is Katya?, I don't know you. What war, what Katya? And then writing from a burner phone: "Katenko, don't write to me. For me, my motherland is not safe." 

"I hate them! Who would have thought for a moment that such a thing would happen again. And who would think for a moment that Russia is acting like that, that it has turned into the Horde."

The pain, the suffering, the determination of the Ukrainian people is stunning. We can't survive as a planet if there are forces in the world willing and able to cause such destruction, death, and pain.