Feb
27
Death at 30,000 Feet and Other Random Notes
February 27, 2008 | Leave a Comment
(I’m still sick. I Still can neither think coherently nor marshal my thoughts into orderly battalions but must instead send them out in little raiding parties to do whatever damage they can. -PB) Let Me Through, I’m an Interventional Cardiologist Let’s be fair. Interns and residents occasionally have trouble running codes. I know that it [...]
Feb
22
Random Notes from a Febrile Mind
February 22, 2008 | Leave a Comment
(I am sick, the flu or somethin’ and I lack the energy to sustain any coherent ideas. Fortunately I am also on vacation which is great! Trust me, only the experience of residency training can make you happy to be sick while on vacation. Here are some completely random thoughts, some of them completely non-medical. [...]
Feb
17
Circus of Chief Complaints (Your Tax Dollars at Work): Part 2
February 17, 2008 | Leave a Comment
(In reponse to some nervous emails, yes, every patient mentioned had a complete history, review of systems, and physical exam. I’m just distilling the salient elements of the conversation. Okay? -PB) Actual Patient Interaction Number Six: “So Mr. Smith, what brings you to the Emergency Department, a place where we handle medical emergencies, at 3AM.” [...]
Feb
15
Overdoctored
February 15, 2008 | Leave a Comment
Rocking Your Fragile World-View Let us again consider Albania, a tiny country tucked into a little corner of Europe which is only now emerging out of the communist Dark Ages in which it had stagnated while the rest of Europe moved on. This very poor country sits on the Northern border of Greece for whom [...]
Feb
12
Circus of Chief Complaints (Your Tax Dollars at Work): Part 1
February 12, 2008 | Leave a Comment
Actual Patient Interaction Number One: “So Mrs. Smith, how’s your pain?” “Oh doctor, it be paining me real bad. Can I get some Dilaudid.” “How about we start with some Nubain?” “What’s that?” “It’s a synthetic narcotic, kind of like Demerol.” “Is it any good?” “Sure, it works great and doesn’t give people the rush [...]
Feb
8
The Non-Crisis in America’s Emergency Departments: The Death of Triage
February 8, 2008 | Leave a Comment
Staying Power I suppose the only good thing about my patient’s twelve-hour wait in the Emergency Department waiting room before he even made it into a room, and his subsequent two-hour wait before he finally saw me, was that the results of the basic lab work ordered in triage where immediately available and, as his [...]
Feb
5
How I Am Learning to Throw Money Away With Both Hands and a Big Shovel
February 5, 2008 | Leave a Comment
Other People’s Money Medical care is expensive and to a large extent this is unavoidable. Medical knowledge has advanced considerably in even my lifetime and there are hundreds of new medical therapies and technologies of unquestionable value to both individuals and society as a whole. It is therefore impossible to bring back the Good Old [...]
Feb
1
A Real Question From A Real Reader: Panda, Can I Hack It?
February 1, 2008 | Leave a Comment
(Another real question from a real reader, really sent to my real email address. -PB) Ian writes: “You’ve described what Emergency Medicine is like but what would you say are the ideal qualities of Emergency Medicine doctors? (I seem to handle stress and emotions very well and can easily remain calm in pressing moments)” Let [...]