Current evidence suggests that much of human health is influenced more significantly by contextual factors like the social determinants of health than the direct receipt of health care. This relatively new understanding has challenged the notion of “physicianhood” and what it means to improve the health of entire populations and communities. With the influx of issues that the pandemic has brought with it, this new model for being a highly effective physician has become even more important.
5:00 am, the first day on the night shift, / six deliveries completed and only one hour remains. / A call from the nurse says the patient in 14 is five centimeters dilated, / and so we enter the room to rupture her membranes.
We will recall when, during the summer of 2020, the moral and political duty to engage with the most momentous anti-racist movement since the 1960s reanimated a nation paralyzed by fear. By the fall, cataclysmic wildfires on the West Coast poisoned the air from San Francisco to New York City. Coronavirus, cultural upheaval and manifestations of climate change all bore down on us as we entered the most consequential and divisive national election in living memory.
The clock strikes midnight and just like that, / she’s been laboring for 10 hours as expected, / time flies when you can’t feel contraction pain.
This phenomenon of imposter syndrome is prevalent in many of us pursuing medicine. Especially for those of us who are first-generation physicians, we are left to fend through uncharted territories. While we try to do our best to navigate this difficult path, we are left feeling that there is someone else better suited for our spot in medicine. We feel that we are not deserving of this privilege. As we pass through these high obstacles — basic sciences, board exams, core rotations, even electives — we stew in self-doubt after each success.
She was a woman in her early twenties accompanied by her husband. She was a first-time expecting mother at 19 weeks gestation with twins. They had received regular prenatal care and had been doing everything as the doctor had instructed to ensure a healthy pregnancy. She made this appointment because she felt something was off, her motherly instincts already keen.
This piece is focused on the applications of empathy and compassion in decision-making. How can we distinguish between them? In its simplest form, empathy deals with feelings while compassion deals with understanding.
Now, I am a fourth-year medical student standing at the foot of a tall ladder. The hierarchy of medicine requires that I follow some unwritten rules in order to climb. Throughout my training, I have gotten the sense that one of those rules is: avoid trouble, good or bad. Of course, now, doctors are beginning to find their voices through movements like White Coats for Black Lives. But as a young trainee, I sometimes feel the sentiment directed at James in 2018: shut up and doctor.
Rather than ask elderly poll workers to risk their health on Election Day, medical professionals and students can volunteer to work at polling locations. Health care professionals and students tend to be in a lower-risk population and are also well-versed in the public health practices critical to safely conducting an election during the pandemic.
Mr. K had been admitted with dehydration and malnutrition secondary to diarrhea in the setting of HIV. During his stay, he developed refeeding syndrome. When the resulting electrolyte imbalances paved the way for cardiac arrhythmias, he coded twice in the ICU. The care team managed to bring him back each time, but not without consequence; the brutality of numerous cycles of CPR left him with multiple rib fractures, inflicting him with sharp pain every breath.
And with scientific advancements came cures and treatments that the healers of antiquity could have never imagined. However, these advances came at the cost of appreciating a holistic approach to health. How pitiful is it when a profession which was once completely focused on healing the whole person must now devote entire conferences and countless seminars to finding ways of injecting that back into both its practitioners and the people they serve?
It is not uncommon for transgender and gender non-binary individuals to be misgendered by health care providers or in the health care setting. This negatively affects their health and their relationship with their providers. Leaders in the field of transgender and non-binary health care recommend asking about a person’s pronouns and integrating pronoun introductions into the clinical setting.