Every hospital I have ever worked in seems to have a case of split personality. During the day, a hospital seems to take on the persona of a doting mother, full of rules and regulations created for your own personal safety: “Don’t run with scissors” (dispose of sharps correctly); “Eat your vegetables” (low fat, low sodium diabetic diet); “It’s past your bedtime” (visiting hours are now over).
At the end of every year, in what was one of our grimmest rituals during training, the other young doctors and I would huddle over the local newspaper and read through the obituary year-in-review section. We would pick out the names and faces we recognized, recall their stories and marvel over the lives they led outside of the hospital.
How many times have I been asked by the trauma surgeons to see a trauma patient for respiratory failure? The reason for intubation and ventilatory support – being combative and non-cooperative.
Electronic medical records promise efficiency, safety and productivity in the switch from paper to computer. But there are glitches, as a patient of mine recently brought to light. My patient needs prostate surgery. It is my job, as his internist, to estimate the risks this surgery poses, decide whether he can proceed with the surgery and make recommendations for his medical management before and after the operation.
Patient's Age: 63 Case Year: 1995 Number of STAR Entries: 10 Diagnoses Keywords: Fistula, Diverticulitis, Hernia History Abdomen with Colostomy, Hernia and Fistula Two years prior to transfer to our institution the patient underwent a Hartmann’s operation for diffuse peritonitis from perforated diverticular abscess of the sigmoid colon.
There has been a lot talk about changing how we reimburse providers for healthcare from one that pays for services performed, to another that reimburses providers depending on what happens to the patient. I think we must take a couple of steps back and first tackle the public health crises we are facing that is putting our healthcare in danger, namely, medical errors and the growing nursing shortage.
Late in 2007 I found myself riveted by a case playing out at the University of California, Los Angeles, the medical center where I trained and had once worked as a transplant surgeon. A 17-year-old girl named Nataline Sarkisyan was in desperate need of a transplant after receiving aggressive treatment that cured her recurrent leukemia but caused her liver to fail.
Parastomal hernias are difficult in general. The most common type we see are colostomy hernias, and those tend to be most difficult because, by definition, a colostomy is a hernia defect with the bowel going through the abdominal wall. So, you have to leave the hole, but repair the hernia.
by Barron H. Lerner, M.D. Must doctors follow their own advice? The issue often comes up when the obese doctor or the doctor who smokes advises a patient to lose weight or stop smoking. But I recently got to ponder the issue more personally when the severe pain of a kidney stone hit. Despite the extreme discomfort, I continued to work.
Difficult hernias can come in two forms: technically difficult hernias with complex anatomy or unique locations, and simple hernias that present as challenging because of a patient's past surgical history. Sometimes these overtly simple hernias present with bigger technical challenges.
Martin A. Makary , a surgeon and public health researcher at Johns Hopkins Hospital in Baltimore, had a long talk with a patient last week. The man had a tumor in his pancreas that was probably benign but might not be. Should Dr. Makary remove it? Or should the man have regular scans to see whether it grew? “If you’re 25, the decision is easy — get rid of that risk,” Dr.
John Seewer, Associated Press In this Dec. 14, 2010 photo, Tanner Hisey, center, puts icing on Christmas cookies with his sister Siera, right, and half-sister Tyler Smith in their home near Clyde, Ohio. Tanner, 12, and Tyler, 17, are among 36 kids who live within a few miles of this small farming town and have been struck by cancer in the last decade.
After dieting unsuccessfully her entire life, Barbara Warnock-Morgan, 46, decided she needed to do something radical. “I was the fat kid,” she said. “Over the years I yo-yo dieted my way up the scale. I’d lose 20 pounds, then gain back 30.” The cycle was so insidious that by her early 40s, Ms.
ER docs and nurses (and paramedics) are a superstitious lot. In no particular order, here are my favorites. 1. The “Q” word. “Quiet.” it’s truly the kiss of death. The “S” word, “slow” carries the same jinx. Usually some newbie nurse or clerk who is “not superstitious” will say, “Wow, I haven’t seen it this quiet in here in a while.
People are never more insecure than when they become obsessed with their fears at the expense of their dreams. -Norman Cousins Even many years later, my dad could still recall how his mother had hovered over him and wept. When he was 6 years old, one of the horses had pulled a hay wagon over his toes while he was helping in the fields.