If it seems like you’ve been hearing more and more about the heroin and prescription opioid epidemic (e.g., oxycodone, hydromorphone, morphine, and illicitly made fentanyl) in the news lately, you’re not alone. Over the last several months, this important public health issue has hit the mainstream. HBO ran a special called “Heroin: Cape Cod, USA” that shed light on the addiction problem across the country, focusing on eight families in Cape Cod, Massachusetts. The topic has been mentioned by both Republican and Democratic presidential candidates in debates and town halls. There is even legislation currently making its way through the Senate to address the “opioid-heroin epidemic that is sweeping the country.” This epidemic affects all of us.
Residency – especially intern year – can be compared to the trenches of war. You are enlisted for a period of time, while you dutifully carry out the orders of superiors, and fight the enemy (disease) while you tend to the already wounded and dying. It removes you from your normal life and can send you into unknown territory, consuming the vast majority of waking hours (sometimes as high as 100-120 hours per week, which is the rarely discussed loophole within the rule of “[no more than] 80 hours per week averaged over a 4-week period”). It can be doubly isolating because the only people who really understand your experience are your compatriots – the co-interns and co-residents fighting in the trenches alongside you. Further, doctors in training, like our veterans, suffer from psychiatric illness and substance abuse issues, but this doesn’t garner much attention unless there is a string of suicides or high-profile articles on the subject. (Time Magazine also ran a story about it in September 2015.) (more…)
Do you want to know more about transgender health issues and be better prepared to take care of transgender individuals? Read on.
An important development in the worldwide treatment and care of HIV-infected individuals was announced earlier this week. Read on to find out what this means for HIV treatment practices moving forward…
As part of my Global Health elective in Iquitos, Peru through the Ben Gurion University Medical School for International Health, we have been learning about the maternal health issues particular to this part of the world. “Improve maternal health” is one of the mandates of the WHO’s Millennium Development Goals, and it is ever so relevant here in Peru, where the maternal mortality rate (MMR) – though declining – is 89 maternal deaths per 100,000 live births and is higher than neighboring South American countries. It is an issue that has been highlighted by many groups and publications such as HealthAffairs, Physicians for Human Rights, and Amnesty International.
Here’s a quick run-down of some of the things I have been reading lately:
- NEJM: How should doctors react to the death of a colleague? A personal Perspective in the New England Journal of Medicine that resonates with me and reminds me of my own reflections on the way we handle death in the hospital. (H/t Gillian Christie)
I’m not really going to be able to add anything to this discussion that hasn’t already been said, but there is a gun safety issue in this country. We need to address it.
Dr. Michael Davidson, a cardio thoracic surgeon at Brigham & Women’s hospital, was shot yesterday by the son of one of his patients.
The following is Part 2 in a series about end-of-life care. For Part 1, see here. This article addresses my own experience on a Palliative Medicine elective in my fourth year of medical school.
Despite the growing number of U.S. hospitals with Palliative Care teams, there remains a real lack of understanding about the benefit that specialized Palliative Care providers can bring for patients with advanced illness. This form of care is especially valuable in patients with end-stage illness (and has even been shown to extend life by several months), but it can also help any patient at any stage of illness (regardless of prognosis). Indeed, even prescribing an NSAID for headache can be considered a form of palliation. The focus is about improving quality of life now instead of later. (more…)
I have been traveling a bit for residency interviews over the past few weeks, and given that planes, trains, and buses have become my new home, I have been thinking a lot about what I would do if a fellow passenger needed medical help. As we go into the holiday season, I imagine many people with medical training will be traveling, as well.
I was once called upon to assist a passenger in an in-flight medical emergency. It was when I was leaving for vacation after completing my third-year clerkships, and my relatively minimal hands-on experience put me as the highest-ranking medically trained person on the plane. I was thrust into a relatively unfamiliar situation and forced to apply my medical knowledge in the “low-resource” setting of the airplane.
Thankfully, the passenger was stable and didn’t require more than a history and basic physical, but the experience left me wondering how I would have responded if the situation had been more serious.
After the trip, I took it upon myself to learn as much as I could about airline medical emergencies, and what my role would be in one of those situations. I am writing this post to share what I learned. This will be especially helpful to any doctor, nurse, EMT, or other medically trained personnel who reads this and finds themself called upon to respond in the future (an in-flight medical emergency is estimated to occur about once in every 10,000-40,000 travelers).
If you are a medically trained person who has responded to a medical emergency on a plane, train, or in a restaurant, or if you are a person who has been helped by a medical person while traveling, please feel free to share your experience and insight in the comments. (more…)