I rushed to the ER and was met by the trauma team, which included the on-call third-year surgical resident, a medical student, trauma nurses, a respiratory therapist, an on-call anesthesia resident, and two ER technicians. The patient arrived on a backboard, intubated, with a neck collar in place. There was a large, blood-soaked bandage on the patient’s right lower chest. The head EMT called out his report:

Victim is a 20-year-old college football player with no significant past medical history who was walking to a party in a nearby town when a stray bullet struck him in the back, exiting at the right costal margin (edge of the ribcage near the right flank). This took place at approximately 10:40 PM and we arrived on the scene at 10:50 PM. The event was witnessed, and the victim supposedly sunk slowly to the ground without further trauma. The patient was alert and talking when we first arrived but quickly lost consciousness and was intubated. He had a large wound on his right that was packed with dry, sterile gauze. His vital signs have been variable but mainly stable. We have placed a 14 gauge IV in each arm, and have started normal saline wide open.

I was in charge and after the patient was transferred to the ER stretcher, I ordered a lateral neck x-ray, had the medical student insert a Foley catheter, and I and the third-year resident did our initial examination. The patient had good peripheral pulses, his blood pressure was 100/50, and his heart rate was 150 beats per minute. We turned him to examine the entrance wound, which was just to the right of the spine between the 4th and 5th ribs and 1 inch in diameter.

The exit wound was at the right costal margin and was 8 inches across with perfuse bleeding from the intercostal vessels and the surface of the liver. I re-packed the wound, ordered 4 units of O- blood STAT, and had the nursing staff call the on-call attending surgeon to tell him to come in.

He was 30 minutes out, so I decided to attempt to over sew the bleeding vessels in the exit wound while the blood was being infused. I had the third-year resident load up a 2–0 silk on a needle driver and as I pulled the bandages back, I told her to tie off the vessels that came into view. After two failed attempts, and with her hands now visibly shaking, I told her to get it right this time or I’d do it myself.

Visibly steeling herself she was able to get the bleeding vessels over sewn within 10 minutes. At this point, the patient began to become unstable with dropping blood pressure and his heart going into a rapid flutter pattern. This happened so suddenly that everyone froze in place for a second before I yelled “CALL A CODE” and began to get the defibrillator ready. We gave the patient bicarb, epinephrine, and lidocaine but he quickly went into atrial fibrillation.

I shocked him 5 times, with further doses of epinephrine and bicarb in between, but after 10 minutes the patient became asystolic and I stopped the code. I had the nurses call the attending to head back home, and I went to confront the patient’s family with the news. After telling them that their son/brother had died of his wounds, I next asked them to donate his organs so others might live. They agreed and I called the transplant team who arrived within 15 minutes.

I went back to the trauma bay and found my third-year resident sitting on the floor quietly crying. I sat next to her, silent for a few minutes. She was training to be a surgeon and I knew the last thing I should do is try and comfort her. So, after a few minutes of silence, I said, “So, what did you learn tonight?” Without missing a beat, she blurted out “that I’m not going to be a god-damn trauma surgeon!”

After that, she dried her eyes, and we began to discuss what happened. The patient was stable, the bleeding was under control, and he was conscious and talking at 10:50 PM. By 11:40 PM he was dead and there was nothing we could do to stop that. We discussed what might have happened and in the end, she was calm enough to head back to do the paperwork.

Later I found out that the bullet that struck the patient was a 5.56 high-velocity round fired from an AR15 over 200 yards from the victim. The shock wave caused by the bullet passing thought the victim literally “cooked” the right ventricle of his heart and the only reason he didn’t die at the scene was that he was an NCAA-level athlete and his damaged heart was able to keep functioning for almost an hour.

The third-year resident went on to become a very successful transplant surgeon in Boston, and I became a cancer surgeon.

The victim’s family was informed that 22 people benefited from their son’s sacrifice and their generous donation of his organs. The State of Connecticut passed one of the first anti-assault weapon bans in the country the following year.

That one night in 1992 changed a lot of lives. I still have occasional nightmares about it, though it did make me and the third-year resident better physicians and surgeons.

The post How a Trauma Death Can Turn Doctors into Better Surgeons appeared first on Medika Life.

“Honey, I’m home.”

This announcement as you walk through the door is often followed by a question that years of marriage can bring you to dread. The “How was you day?” question.

It has become an ingrained response in most couple’s lives, asked out of courtesy, out of concern, out of genuine interest and out of habit. Doctors nurses and other healthcare workers, both men and women, are experiencing a side effect of the pandemic few have had to deal with before and that many are ill-equipped to face.

The problem of how to best communicate their day to their spouses or partners, most of whom are not medically trained and exist in another bubble, away from the horrors of the Covid frontline. How can someone not intimately engaged with the medical profession express an understanding for their working conditions and the associated trauma they endure on a daily basis. Most front liners now choose to remain silent. They internalize.

for doctors, the more personal and germane impacts of the pandemic on their psyche are internalized and this can have disastrous consequences for their home life as well as impacting their health, both physical and mental

Many of these professionals are feeling more and more isolated as the separation between home and work becomes more pronounced for a number of reasons we’ll examine below. They feel unable or are unwilling to share their problems with their partner. The inability of their partners to grasp the scale of death and frustration they now confront each day, lies at the heart of the problem.

Although they can and do discuss the less personal aspects with colleagues, the more personal and germane impacts of the pandemic on their psyche are internalized and this can have disastrous consequences for their home life and wreck havoc with their health, both physically and mentally.

So just how do these professionals cope with these two distinct existences, the family life and loving partner and a professional life, now filled with death and despair on a daily basis? Before we go any further, I feel its is essential to point out that while many of you may find help and advice that is pertinent to your situation in this article, there is no one simple solution that resolves all relationship issues.

We are all fundamentally different and each relationship is unique and special in its own way. There are however a few fundamental perceptions that we all apply to life that are of relevance here and I will examine each below in turn. If these bear relevance to your situation, they may offer you food for thought and allow for insight and empathy into the factors that influence your partner, and by consequence, you.

You may choose to address your issues on your own or engage your partner in the process. There is no one simple solution, merely paths to follow and choices to make that are relevant to your life, your personality and your situation. These are yours to make and if they are beyond the scope of your abilities, I strongly encourage you to seek help from a responsible, professionally registered therapist.

Life from your partners point of view

Living with Dr Covid

Even if you’re not directly on the frontlines, you’re still out there engaging with sick people on a daily basis. It’s what doctors do. Your partner has accepted the long days, long nights and varying levels of exhaustion you bring home. It is part and parcel of being married to a doctor. It is a lonely life and not suited to everyone. Many fill the space you leave with children and their own careers.

the fear of death is something unique to all humans, we all suffer from it and deal with it in our own ways

The pandemic has added a new element to this already difficult dynamic. Danger. Every time you walk through your front door, that embrace and kiss hello could prove fatal, to both your partner and your children. You have become a vector for the spread of Covid and your partner knows this, even if the awareness is on a subconscious level and they have not articulated it. The potential for internal conflict around this one simple fact is vast.

Your partner loves you, they understand your need for empathy and a safe nest to return to and yet, your very presence now threatens their health and if you have children, by association, their health and safety. You can work out for yourself the paths available to someone following this train of thought.

They will at different times view you with anger (why do you continue to expose them to risk) or with love and empathy (understanding for how difficult your situation must be) or with admiration (your commitment to your patients despite the dangers). Any or all of these emotions can surface at different times and your partner may not be aware of why.

Covid Overload

Find me a person who isn’t sick and tired of seeing and hearing about Covid everywhere they turn and I’ll show you a nun that mud wrestles vertically challenged (see, I can be politically correct)individuals on her days off. We are all fed up with it. It is everywhere and your partner is not immune to covid fatigue.

Imagine then their joy on your return home to be regaled with yet more tales of Covid and doom and gloom. They may even, of late, have refrained from the standard “how was your day” response in the hopes of avoiding these dreaded conversations. It isn’t the same for everyone and some partners have far more empathy and tolerance than others, we are all so very different. If you aren’t partnered with a saint, then keep this in mind.

You may also choose not to share out of choice, a protective instinct to shield your partner from the horrors of the pandemic you face each day. This is noble, but not well thought through. You are cutting off the very life line that may offer you salvation should you need it.

You are also depriving your partner of the ability to properly assess, understand and support your varying moods and needs. If everything is rosy, why are you constantly in a foul mood or alternatively, why have you’ve suddenly clammed up and don’t say much or isolate yourself from the family. We interpret our situations based on the information we have to hand. Limit your partners understanding of your life and you’re asking for trouble.

The medically challenged

Your partner didn’t fall in love with a doctor, they fell in love with you. The doctor is merely along for the bumpy ride and medical partnerships are difficult, make no mistake. Building a strong relationship requires time, a luxury most doctors don’t have in abundance.

Most non-medical partners find discussions around medical topics difficult and challenging, particularly if they exist in an isolated family based bubble, away from your life. Police and the military suffer a similar fate and it causes very similar problems for them, problems that many doctors and healthcare professionals now face. How much of your work do you choose to bring home and how much of it chooses to come with you.

How to best resolve personal issues away from the safety of the relationship without jeopardizing the relationship itself.

Why do you need to speak out?

This is a very important question and goes to the heart of why you are experiencing emotional and relationship issues. You need to try and answer this honestly and it will require more than a little introspection.

If you’re used to openly discussing and sharing things with your partner and you suddenly, because of the above and other factors, find yourself unable or unwilling to do so, you have an issue that needs addressing. Any changes to the dynamic between you and your partner will affect both of you. It’s important you identify your needs correctly, only then can you set about correcting the problem without aggravating it.

Resolution through dialogue

If you find you have a real need to confide in your partner and currently don’t or cannot, this is easily addressed. Honesty helps. Sit down with them in a quiet safe space where you wont be interrupted and explain slowly what is happening in your life and how you feel. Then ask them about their life and how they feel. Allow them the space to speak openly and avoid being confrontational. You’re trying to find common ground, not dictate policy, so LISTEN.

Most issues in relationships that develop over time are the result of miscommunication and assumption. They are often resolved simply by open, honest, respectful and caring dialogue. This requires time and effort, both worthwhile investments for your future happiness and wellbeing. If your partner is willing and desires to help you, it is selfish of you to prevent them from doing so. Imagine, if you will, if the roles were reversed. We are designed to want to care for the wellbeing of those closest to us.

Keep this fact in mind

No matter how supportive or loving your partner is, they are often not qualified to assist you in resolving complex metal issues that are troubling you. They are not in a position to offer you strategies you can engage to resolve these issues.

A professionally trained therapist can. If you are still facing issues despite a loving and supportive partner or spouse, then you must seek professional help. It is often easier acknowledging things to a stranger, than to those we live with. Particularly if we perceive these things to be flaws or weaknesses.

Go solo Joe

If you’re not in the habit of seeking solace and resolution from within your relationship, then you are left with the option of self-therapy and this can often manifest in an activity away from the confines of work and home that allows you time to process your thoughts on your own. Its a difficult balancing act as it encourages separation between the partners and reduces their reliance on each other, but for some, this option is the preferable choice.

In practice, an activity like fishing for instance, fits the bill. It’s outdoors, provides fresh air, is hugely therapeutic and offers plenty of time to think. It’s also an acceptable activity that wont drive a wedge between you and your partner. You can even drag them with, settle them on a blanket with a book or let them wonder around the lake or river with the kids, leaving you free to enjoy the absent fish and your own thoughts.

Perhaps find a colleague of the same sex to drag along instead for company if you don’t do well on your own This will also offer you an opportunity beyond the confines of work to discuss issues surrounding the pandemic that bother you. Chances are the same things bother your colleague.

you aren’t looking for sympathy, but rather to make sense of the situation that you are currently embroiled in

You can choose to live two separate lives, leaving the doctor at the door when you enter your home, but this will not resolve your internal conflicts and the need you have to verbalize them to someone.

Speaking about our issues, putting thoughts into words, helps us formalize the issues that swirl around in our heads. It allows the listener, if they are so inclined, to provide their perspective. At the end of the day, you aren’t looking for sympathy, but rather to make sense of the situation that you are currently embroiled in. Most importantly, you are looking to develop strategies that will enable you to make it through the pandemic with both body and soul intact.

Any solutions that can be arrived at with the involvement of your partner are, in my opinion, always your better option. We are stronger together, but as I’ve said above, this route isn’t always suited to an individual. You may also find your partner lacks the stomach for the position you’ve been placed in. It doesn’t make them terrible partners, we all have our limits.

Writing is another option that can offer solace and inner peace for some and is cathartic for the resolution of internal problems, but we aren’t all writers. If you’re feeling confused, depressed, disillusioned and disheartened and your spouse or partner is unable or unwilling to act as a sounding board for the problems you face in your profession, it is critical you find a solution that best fits your unique situation and personality.

Don’t ignore these issues, but address them with the importance they deserve. The slippery slope into the darker side of our personalities is greased with good intentions. Find a friend, catch a fish and most importantly, find your sounding board. If need be, pay a therapist to listen. There is no shame in acknowledging that some things cannot be resolved on your own. Failure lies in not addressing the issues in the first place. They will resolve on their own, but you will not like the outcomes.

A quick note on feel good medication

Don’t, just don’t. I cannot be more clear about this. There is no solution to be found in a bottle of meds that will benefit you in way. None. You’re not exhibiting psychopathic tendencies and your not bipolar. You’re having issues dealing with a really difficult situation that has spilled over into your home life.

There isn’t a chemical imbalance in your brain and unless you want to create one with medication, please avoid pills. These won’t improve your life. They will simply dull your senses and alter your personality, whilst increasing your risk to suicide and severe depression. It is even more difficult for medical professionals to avoid the temptation of medication, as most have free access to prescriptions.

You’re far better off seeking the advice and counsel of friends who have both empathy and a working understanding for your environment and situation. For the most part, this isn’t going to be your partner, unless you‘re fortunate or living with a health professional. Obtaining and developing coping skills and mechanisms to deal with your issues will last you a life time, pills are simply problems you’ll need to address tomorrow and every day thereafter.

Best of luck and thank you for your service to our communities.

The post Covid’s Silent and Sinister Effect on the Married Lives of Healthcare Workers appeared first on Medika Life.

Not unlike how the Internet we use today outpaced dialup. But if you work in the medical field in America, chances are fairly likely that even if you haven’t used a fax machine yourself in the last decade, that you have at least walked past one on your daily rounds.

If you’re asking yourself why that is, you’re not alone. It is a question that has asked by many over the decade. Especially if we consider the massive evolutions in medicine in the past few years, such as using computer vision to detect melanoma or Artificial Intelligence to diagnose breast cancer, it is reasonable to wonder why these emerging technologies co-exist with ones that have been gathering dust in other industries.

The benefits outweigh the costs of going digital.

Depending on who you ask, the fax machine is still relevant in medicine for a number of reasons — from IT security to HIPAA compliance and other regulations. The same argument could be made for going back to paper for all medical records. While it may be a lot harder to conduct a widespread ‘hack’ of a patient’s paper records than an Electronic Medical Record (EMR), it is safe to say that the benefits have outweighed the costs of going digital.

No system is perfect, of course, but the introduction of Electronic Health Records (EHRs) and EMRs has provided numerous benefits to both medical professionals and patients. EHRs help support improved patient outcomes — from improved safety to error reduction, the gains are many. A survey of medical providers found that 94% found that EHRs make records more readily available. The survey of patients found further benefits in improved care, from increased access to medical care to a reduction in prescription error.

For all of the arguments in favor of fax as a more ‘secure’ and ‘private’ means of transferring clinical data, there are probably as many points of evidence pointing to the flaws in the system. The list of data breaches associated with medical records being sent to the wrong fax number, for example, probably outnumbers the number of pages in the fax machine at your local provider.

Legacy systems are still en vogue in the healthcare sector in the United States and may still be for some time. Regulatory systems and the judicial system advance at a much slower rate than the fast-paced industry that is technology. However, given the recent constraints on the medical field brought on by the pandemic, we are overdue for the widespread adoption of newer technology.

Telemedicine makes medicine more accessible for Doctors and their patients. It is important we utilize technology, of course, after accounting for the potential risks and doing our due diligence to mitigate them. This is no easy task, but its one we must undertake to help improve the industry, for everyone’s sake.

The post Why Do We Still Use Fax Machines In Medicine? appeared first on Medika Life.

1. We’ve heard your embarrassing question before.

Unless you make a big deal, we likely won’t remember how you once asked us about toenail fungus.

By the time we’ve graduated, we’ve been exposed to all types of questions and scenarios. We have heard the stories about how patients accidentally brushed their teeth with hemorrhoid cream, tried to swallow suppositories, and have been unable to remove tampons.

Those of us working in hospitals have likely experienced trauma patients and death. Although we never get used to it, familiarity does make it easier.

So relax, we would rather you ask us than guess or choose not to treat your condition. We promise not to laugh (unless you want us to).

2. Although we are drug experts, we know about general health conditions too.

Pharmacy school isn’t only studying drugs. We spend the first few semesters on basic anatomy and physiology. Once we know how the body normally functions, then we move on to disease states. Learning what can go wrong helps us to understand how drugs work. Each lesson builds on the other.

So, we will know about chronic disease states like high blood pressure, diabetes, and osteoporosis, and be able to answer questions you may have.

3. Please don’t ask us where the sale items are in the store.

We probably don’t know, and unless it’s a slow day, usually don’t have the time to check for you. And don’t expect us, or the people in line behind you, to appreciate checking out all the items in your cart.

That being said, we don’t mind going into the cold medication aisle and pointing out a few choices since that is within our scope of practice.

4. We’re masterminds at solving insurance issues, but we appreciate your patience.

Every insurance card is a puzzle. Some of them require a zero before the member ID, some want the person code after. Some don’t want the letters, some require a special group number that isn’t on the card. We likely know the major carriers, but sometimes we get thrown for a loop.

We are also used to insurance rejections. “Refill too soon”, “drug not covered”, “prior authorization required”. All of these issues require time to dig into.

Also, please know that we have no control over your copay. Yes, last time it was $20, and now it’s $30. Copays go up all the time. Deductibles start over every year.

If we have billed the insurance, the price comes from them.

5. We will remember if you are rude to us and our technicians.

We see a lot of patients and fill a ton of prescriptions every day. Unless you are a frequent guest, we will likely have forgotten your name five minutes after saying goodbye.

However, we remember the ones that yell. We remember the ones that make unreasonable demands. We remember the ones that try to bully our students and technicians for problems that are out of their control.

We understand that you may be sick and in pain. We know you likely spent hours in the ER or doctor’s office and just want to go home. We’ll give you a pass for that, but we are still human and deserve to be treated with respect.

6. Technicians aren’t pharmacists, don’t ask them drug questions.

Speaking of our technicians, they do a heck of a lot of work. Without them, our pharmacies would implode. They receive special education and training to be able to perform their job.

That being said, save your medication questions for the pharmacist. Legal requirements aside, the pharmacist is the one with 6 plus years of education, residencies, and credentials.

On the flip side, we are extremely busy and if every caller asks to “speak with the pharmacist” just to find out the price of their medication or if it’s ready for pick-up, questions a technician is more than qualified to answer, then we can’t do our work efficiently.

7. We work tirelessly behind the scenes during your hospital stay too.

A pharmacist will review each medication order for every patient who enters the hospital. Just like at the drug store, you can rest assured that we have screened the order against your allergies, checked if the dose is appropriate for your weight and age, and reviewed it for interactions with other medications you may be taking.

Sometimes we even consult with other members of your health care team in determining your treatment plan.

If you have ever received an antibiotic or blood thinner in the hospital, chances are a pharmacist calculated the initial dose and monitored it daily.

8. Don’t bring a grocery bag full of your prescriptions to the hospital.

Patients are not usually allowed to keep medications at the bedside, so guess what will happen to the prescriptions you bring in with you? Your family member will be asked to take them right back home.

The alternative is to have your medications stored in the pharmacy. This means they go into a drawer somewhere in the back corner. The nurse who drops off your medication receives a receipt. It’s up to them (and you) to remember to pick them up at discharge.

You can imagine how many “patient’s own meds” get left behind.

The exception to this rule is if you are taking a rare, brand-new, or essential drug. Hospital pharmacies stock the basics, but we won’t carry everything. If we don’t have it, we will ask a family member to bring it in so it can be continued during your stay.

9. If we don’t have the drug in stock, we will help you find it.

Did your doctor order a medication that we don’t stock? No problem. Chain drug stores are all connected by the same computer system making transferring prescriptions easy.

The same goes for hospital stays. We can call our buddy hospitals and borrow medications from them. A courier will pick up the drug and deliver it to us. Again, we appreciate your patience as this process can take a few hours.

10. We are human.

We have an outstanding assortment of technology at our disposal. Robots fill medications. Barcode scanners ensure the correct bottle of pills is chosen. Electronic prescriptions reduce transcription errors. Automated dispensing machines allow nurses to choose the correct drug at the hospital.

Many sets of eyes see a prescription order from start to finish but remember that the last link in the chain is you.

When you get your refill home, take a moment to look at it. Are the pills the same color and shape as last time? Is it a new prescription? Most pharmacies include descriptions of what the tablet looks like on the bottle’s label. Did the nurse scan your wristband before scanning the medication bar code at the hospital?

All of these steps will help to ensure your safety. Medication mix-ups happen. They can be bad. Help us to prevent them.

11. Doctors’ handwriting really is terrible.

Sometimes we rely on clues in the strength or indication. Sometimes we pass it around and everyone takes a guess. Worst case, we have to call the office. That’s why we are grateful that most prescriptions these days are electronic.

However, electronic doesn’t mean fool-proof. Doctors can still choose an incorrect drug from a drop-down or predictive text list.

That’s another reason you should always ask questions about your prescription. We can determine pretty quickly that the wrong medication was filled if we counsel you on diabetes medication for your earache.

12. We went into this to help others, not for the money.

Even though we sometimes look frazzled and stressed, please know we genuinely want you to understand your medications. We will always take time out for questions, counseling, and concerns.

We went into pharmacy school to be health-care providers, not to drive around in Lamborghinis.

Trust us, the money we are making barely covers the cost of our education. Most of us work more than one job. There are easier ways to make money.

We do it because we care.

The post 12 Things Pharmacists Want You to Know appeared first on Medika Life.

Feeling burned out and overwhelmed? Here are some strategies that might help you during these very difficult times.

Check-in with yourself

Are you feeling anxious? Depressed? Angry? Scared? Worried? Try to identify all of the emotions you are experiencing. If it helps, write it down in a journal. Exploring your recent thoughts and feelings enables you to make sense of what is happening in your inner world and how the health pandemic is impacting you.

Access mental health supports

If you need professional help, reach out to your doctor if you are noticing difficulties with your sleeping and eating patterns, mood, energy, and if you are having distressing thoughts. You can use the Employee and Family Assistance Program (EFAP) mental health services available to you through your workplace for free, short term counseling for you and your family members.

The Ontario COVID-19 Mental Health Network offers temporary, free, short term, individual counseling to healthcare workers, where interested workers are matched with a therapist through their network website .
The Canadian Psychological Association is also offering free, short-term therapy by registered psychologists and has more information on their website.

Another resource is The Centre for Addiction and Mental Health (CAMH), which offers short term psychotherapy and psychiatry services via their website.

If you feel you need more intensive or ongoing psychosocial support, reach out to a therapist through Psychology Today to find a counsellor who has a therapeutic approach or style that fits with your needs.
If you need urgent support, call a crisis line in your local area, which you can find through websites such as this one. In mental health emergencies where you feel you are at risk of harming yourself, call 911 or go to your nearest hospital emergency room.

Challenge negative thoughts

In health care, where you are surrounded by upsetting news daily, it is common to have a whirlwind of thoughts going around in your head that might further increase your stress and anxiety.

Some examples may be: “I’m going to get COVID-19”, “I’m going to give COVID-19 to my patients”, “My family will get COVID-19 because of me”, and so on.

While there is sadly no guarantee in life that these things won’t happen, we can still try to challenge these thoughts with more positive ones that may feel real to us, such as: “I’m following all of the safety protocols to protect myself, my patients and my family”, “I’m doing everything I can to be safe”, “I’m washing and sanitizing my hands regularly and that is the best strategy to stay healthy”, or “By staying at home when I’m not working, I’m doing what I can to slow the spread of the pandemic”.

Insert any other positive thoughts here that may help you manage your anxiety, stress, and overwhelm.

Remind yourself of your professional values and interests

In this pandemic, it is hard to think about anything but the risks associated with working in health care and it may be hard to see beyond that. If you find yourself questioning everything and feel unsure of yourself in your role or position, it may be useful to keep in mind why you went into your field of practice in the first place.

Was it because you always knew you wanted to help people? Or because you wanted to make a difference in the world and contribute to society? Or perhaps you have a unique interest in a certain client population or area of expertise and this is your specialty now? What other reasons led you to do the meaningful work you do?
These reminders might ground you and help you feel refreshed in an unsettling and confusing time.

Know that you are doing the best you can

When you feel that you aren’t doing enough to make a difference, take a moment, stop, and look around you.

See the clients or patients in your line of sight that you have helped. Notice their smiles of thanks, the gratitude you hear in their voice, and the efforts they make as they try to follow your recommendations and guidelines.

These types of mindful moments will help you shift your focus away from your stress toward focusing on why you chose to do this valuable work in the first place — to provide excellent care to your clients and patients.

Talk to coworkers you confide in and trust

The people you work with are the people you often spend the most time with as so much of our days are spent working. In your group of colleagues, hopefully, there is at least one person you really connect with and who you feel you can talk to. Reach out to them if you need a moment to vent, to share a funny story, or discuss how you are feeling. This helps foster a sense of trust, community, and shared experiences.

Connect with loved ones

Calling and video calling your close family and friends and spending time with your spouse or partner or children during this time of uncertainty can help manage feelings of stress and burnout.

Talking with important others about things that are not related to the pandemic can help get your mind off of it. This allows you to focus on other topics that interest you and make you happy while also investing in key relationships in your life.

Limit media

Watching the news or reading articles on your phone or computer constantly can add to your anxiety, stress, worry, and overwhelm. You may already be supporting patients who are COVID-positive daily, you may be concerned about eventually working with COVID patients, or perhaps you are worried about passing it on to or getting it from others. Constant consumption of media further feeds into this stress and exacerbates it. This cycle of thoughts can continue to spiral if they are not kept in check.

A mental break from all things COVID at points throughout your day can be just what is needed to help you refocus. Permit yourself to turn off your phone and computer when you need to.

Focus on the basics

Eat. Drink water. Sleep. Exercise. No need to follow a perfect and ideal routine here, but try to do what you can, when you can. Do activities that help refuel and relax you, such as deep breathing, yoga, meditation, mindfulness-based activities, or anything that rejuvenates you, such as losing yourself in a hobby that you are passionate about. Building in positive habits and routines, especially when you feel stressed and overwhelmed, can go a long way toward helping you feel better.

Focusing on these basics can motivate you, re-energize you, and keep you going through those long and tiring workdays.

This is a very challenging time for everyone. Your health is number one and needs to be stable before you can fully help others. Take care of yourself and be well so that you can continue to do the important work you do to support patients and clients every day.

The post Working in Healthcare During COVID-19? Tips for Reducing Burnout and Overwhelm appeared first on Medika Life.

He became so much worse: he couldn’t breathe. He was restless. He became increasingly agitated.

Then, his heart just stopped. We called a CODE BLUE. We started CPR, and I placed a breathing tube into his lungs. His heart came back, but it was not to last.

I placed him on every medicine I had to try to help his heart beat more forcefully. Nothing was working. When I did an ultrasound of the heart, it was barely beating — even though he was on rocket fuel for the heart. In spite of everything we were doing, we could not save him. He died within hours of coming to the ICU.

It was sad, and I really felt for the family at the bedside. At the same time, I didn’t have the same feeling I had when I took care of a Covid patient who suffered the same fate. I’ve faced death so many times in the ICU. But with Covid it was different, and I’ve figured out why.

Fear.

I didn’t have the fear and dread that I had taking care of Covid patients. You see, I wasn’t scared of catching cardiogenic shock from the patient. I am not scared of catching diabetic ketoacidosis. I am not scared, even, to catch someone’s septic shock, even though it is possible to catch some infections like C. difficile or tuberculosis.

I am scared of catching SARS CoV-2. I am deathly scared of getting Covid and then bringing it home to my family. This disease is so horrific and so new, and we still don’t know what are the long-term effects from this disease. This unknown, this uncertainty, leads to a great amount of fear. And that fear permeates everything when caring for patients who are suffering from Covid-19.

Never before have we had a disease like Covid-19. Sure, we’ve had influenza, and even very bad influenza pandemics like H1N1. We have never had something as bad as Covid-19; something as horrific as Covid-19; something as deadly as Covid-19.

And it’s “transmitted through the air,” as someone famously said recently. It’s so contagious, and that fact adds to the menace of the disease. And when you have dozens of these patients at the same time — all on ventilators, all super sick — the fear and dread can be overwhelming. It was overwhelming.

Yes, we had PPE, and I was and still am extremely grateful for it. The PPE works, too. And we have some treatments now that seem to be effective for Covid. Still, it’s hard to shake the fear, especially when you see firsthand what horror this disease can cause on its victims.

On the one hand, a little bit of fear can be productive. It ensures vigilance: vigilance for hand washing, vigilance for wearing PPE, vigilance for making sure I don’t catch or transit this disease to others.

On the other hand, too much fear can be paralyzing, and I must also be vigilant against letting the very natural fear I have of Covid-19 from taking over. While several thousand of my healthcare colleagues have indeed gotten Covid, and some have even died, the vast majority of us in healthcare have remained safe from this disease. And I thank God for that.

I’ve faced death many times over as a critical care physician, but I’ve never been as affected as I have been with Covid-19. Fear has a lot to do with that. Going forward, I must remain vigilant: vigilant against catching this disease, and also vigilant against letting my fear get the best of me.

The post What is it About Covid That Makes it Worse appeared first on Medika Life.

I won’t lie, during the height of the pandemic, leaving bedside clinical practice crossed my mind. As the darkness of Covid-19 surrounded me, as the death and destruction suffocated me, I also asked myself whether I should close up shop and do something else.

Indeed, there are other things I can do in healthcare that don’t involve risking my life day in and day out with Covid-19. Yet, I never went through with it. The call to the bedside was just too strong.

Ever since I was a young boy, I’ve only ever wanted to be a doctor. It’s all of which I’ve ever dreamed. When I applied to medical school, all the odds were working against me, and when I got the notification of my acceptance (off the waiting list, I might add), it was one of the happiest moments of my life.

And so I’ve tried to never take my being a doctor for granted. I try to live a life of gratitude for being chosen for this profession each and every day. And when the thought of leaving did enter my mind, it was quickly eliminated because, I just can’t see myself doing anything else.

I enjoy taking care of patients too much. I enjoy battling the pathophysiology of critical illness too much. I enjoy being able to watch patients come near death and make it out alive and well too much.

Now, it’s not like I haven’t seen death before. I’m an ICU doctor. I see death all the time. With Covid, it’s different.

Covid has brought a scale of death and destruction I’ve never seen before. Never before have I taken care of patients with such a contagious illness that has made me terrified of getting it or — much worse — bringing it home to my family. Never before have I seen an illness that literally tortures its victims to a painful and horrible death. Covid has changed me as a Physician forever.

But Covid has not beaten me down to the point of actually leaving the bedside. The call is just too strong.

No doubt, as the Summer comes to an end, and the Fall and Winter set in, I am scared of a resurgence. I am scared that we will get overwhelmed once again with patient after patient after patient with frightening illness. I am scared that we will, once again, face the darkness we faced in the Spring. That fear is constant, and it’s a menace that pervades everything I do.

But the call to the bedside is just too strong. The call to care for the sick is just too strong. The call to witness the Healing of the Lord is just too powerful to ignore.

Perhaps one day, things may change and I will leave the bedside once and for all. Perhaps one day, I will hang up my scrubs once and for all. Today is not that day. That’s because, the call to the bedside is just too strong.

The post Covid Made Me Think About Leaving Medicine appeared first on Medika Life.

She left with life-changing news.

Exam, mammogram, and biopsy

Her breast cancer was confirmed, and she disappeared. We made phone calls, left messages, and sent certified letters to no avail. In medical terminology, we call this “lost to follow up.” She ghosted us.

We continued our pursuit. Months later she returned. She did not follow up with the breast surgeon or Oncologist. She didn’t like them. Her family had other opinions.

She was angry.

I could feel it.

This was life or death

I would like to say I encouraged her to seek treatment, but I didn’t. I pushed her to get help. Not a gentle nudge but a shove. It was intervention time. I spoke the cold, hard truth. The goal was to break the dangerous cycle of denial. After relentless encouragement, she promised to go.

The resentful look in her eyes told a different story.

She was not ready.

She just wanted to leave.

Surgery, chemotherapy, and radiation

I saw her a few months later. My intervention worked. She had bilateral mastectomies and removal of the lymph nodes. She was undergoing chemotherapy and radiation. She was still angry.

She resented me.

I knew it.

I reminded myself her care was all about her. This moment was not about me. My job was not to be liked but rather to help her get well. In desperate times, patients focus their frustration on what they can control. Patients need a place to channel their feelings and rage. My job that day was to be the target.

Fear manifests as anger. She was furious and frustrated.

But she was alive.

Three years later we meet again

She came to see me yesterday. With a huge smile on her face, she embraced me in a giant bear hug. She held the hug a little too long. She grabbed both my hands and squeezed them tight. We locked eyes. She said, “thank you.” She appreciated my fight to get her treatment.

Then, with a beaming smile, she told me her cancer was back.

My heart sinks

After three years of remission, her breast cancer came back. The metastatic disease has spread to the chest, lungs, and brain. It is inoperable. She is restarting chemotherapy. She qualified for an experimental protocol with a 2–3% survival rate over three years.

I am rarely speechless. I can not talk. Tears fill my eyes. I try to fight it.

I am the doctor she trusts to take care of her. I am losing it.

What? No? Not possible. That can’t be true. She has a teenage son.

Quickly, I process her reveal. Inoperable metastatic cancer. Experimental protocol. 2% survival rate.

I stop fighting my emotions. I cry. I manage to say, “I am so sorry.”

She looked me in the eye and said “But I am ok”

She explains she came today just to see me. She wants me to know she “is good.” Her spirits are great. This was the best she felt in years. It took a long time for her to get to this place of acceptance.

She has found joy in living.

She shares her story. In the past, she blamed me for finding her cancer. She was frustrated every office ended in bad news. She resented me for forcing her into treatment. She was furious she had cancer.

Now, she is at peace. She is thankful. She appreciates all that I did. She needs me to know she is no longer angry. She has accepted her fate. She has found a happy place. She is loved.

My eyes glisten with tears. Her eyes glimmer with joy.

I am in awe of her strength, her will, and her compassion. We finish our visit with another hug.

It was my turn to hold the hug too long.

Afterthoughts

I think about her often. I try to shake the memory. I can’t. She was closing the open loops. Seeking resolution.

When I think about her, I smile.

My heart fills with admiration and gratitude. I am thankful she blessed my life. I am thankful she came to see me. For 15 years, I had the honor of being her doctor.

She found her happy place.

I will find mine knowing the true reason for her visit was to say “Goodbye.”

The post How a Breast Cancer Patient’s Strength Inspires Her Doctor appeared first on Medika Life.

What is motivating you to make this change?

Take a close look at and put deep thought into where your desire to make a career change is coming from. Are you unhappy in your position? Do you feel stagnant in your role? Are you looking for a challenge? Does it seem that there are no further opportunities for career advancement in your workplace? Do you yearn for a change in responsibilities, environment, industry, or area of focus?

What could be the benefits of this change?

Consider the possible financial gain that could come from a change. Could you receive a potential increase in income or benefits? What about workplace dynamics? Are you in a toxic environment and would changing companies have a positive effect on your mood, mental health, and overall coping, while recognizing there is no guarantee that things will go perfectly in a different setting? What possible opportunities for professional development, growth, and learning could a new position or career bring?

Carefully think about all of the positives that could come from taking this leap.

For what reasons would you stay in your job?

There is also the flip side about all of the reasons why you may want to stay in your job for now. This doesn’t necessarily mean forever – it could just be for some time longer until you feel more ready to make a shift.

For example, are there familial or parental reasons why you may need to stay in your role for now (e.g. job security, pension/benefits, proximity to your child’s school or your elderly parent who you are caring for, dealing with a separation or divorce, or managing your health issues or the health issues of your family)?

Are there logistical or practical reasons for remaining in your job? Some ideas may include access to transportation, recently moving into the area near your job, being close to retirement, and having concerns about making a change at this time from a financial and resource perspective).

Could there be personal reasons, such as the close bonds you have developed with your colleagues that make it hard to imagine leaving at this time, or your immense job satisfaction or pride and joy in the work that you do every day?

Weighing the benefits of making a change versus the reasons for remaining in your current job will be an important process for helping you figure out your next steps.

Where would you like to be in 5 or 10 years?

This is a common question that everyone probably hears often although it is an important one in this predicament of making career choices.

Sometimes we get stuck dealing with the present and we forget to think about how the decisions we make now can affect us in the short term and long term future. Try to expand beyond the current time and consider how the career changes you make – or don’t make – could impact your life down the road.

For example, do you want to go back to school to learn about a new subject area or explore more in-depth training or professional development in your field to increase your chances of finding a new job in the future? Do you envision being in a different industry or running your own business? What would you like your daily work life to look like? What are you passionate about and what could you see yourself doing and not getting tired of quickly?

If you are close to retirement, are you content with continuing your current role or would you like to try something different before you retire? If you are seeking change, could that new role possibly become a part-time job or a volunteer position post-retirement?

The choices you make will of course depend on your life stage, personal and professional goals, and interests and desire for change. Do what you think is best for your present and future self.

What will help you make a career decision?

What practices do you engage in that helps with reflection? Is it meditation, journaling, taking some quiet time to reflect in silence, talking out your thoughts and feelings with loved ones? Whatever it takes to help you make a decision, do that and see where it leads you.

If you do decide to make a career move or a job change, what’s your first step? Second step? Make a plan.

Before you make any changes, you need an action plan. A solid action plan will outline some of the initial steps you need to make now, a week from now, a month from now, and so on. Planning out these steps will help make your career or job transition as successful as it can be.

Consider such action plan ideas as: do you want to devote some time to updating your resume or getting someone you trust to review it and share constructive feedback? Is there a course you’ve been meaning to register for and are now committed to taking? Would it help to sign up for job alerts in your field or industry – or new fields or industries you are interested in breaking into – so that you get a sense of what is out there and what the expectations and requirements are? What skills would you like to brush up on or develop to get you that much closer to your goal?

How will you know that you are making progress in your career development? What will you observe in terms of certificates attained, interview requests, and job offers? How will you know that the job or career change is working well for you? How will you feel, what will you think, and what will you notice around you?

Your career path is fluid and ever-changing. It’s ok to stay where you are if you don’t want to make a change. Or, you can take that leap if you feel ready to jump in and if that’s what you want.

Reflect regularly, assess where you are at, weigh all the factors so you are making an informed decision, choose what’s best for you, and re-evaluate over time as you continue your journey down your career path.

The post Thinking About Making a Career Move or Job Change? appeared first on Medika Life.

Nutritional science, aging, and the laws of physics inhibit my ability to get what I want.

Science is very inconvenient.

Everyone has opinions about science these days. Our social media feeds are full of vitriolic opinions. I miss the days of puppy dogs, nostalgic high school photos, and our children’s latest achievement pics. Now we have neighbors screaming at each other about masks and school re-openings.

When it comes to COVID-19, everyone has an opinion.

But here is the deal.

COVID-19 does not care about our opinions. It is a virus.

Specifically, SARS-CoV-2 is an 80 nanometer enveloped, non-segmented, RNA virus containing single strands of RNA with crown-like spikes on the outer surface.

SARS-CoV-2 has no brain or thoughts. It does not think about anything at all. The virus is a random bit of fragmented RNA that attaches itself to a respiratory droplet and spreads from one person to another… and kills people.

The virus has no motivations. It is programmed to replicate. That is it. SARS-CoV-2 has no desires, intentions, or strategies. The only purpose of this small bit of genetic code is to reproduce itself as efficiently as possible.

We are entitled to our opinions

Everyone has a right to their own opinions. Adults may choose to believe anything they want.

Many Americans do not agree on the value of facemasks…except for scientists, epidemiologists, hospitals, The Center for Disease Control, The World Health Organization, The Joint Commission,The American Medical Association, and The National Institute of Health.

Some endorse the idea masks do not work, the virus is a hoax, and COVID-19 is no worse than the flu.

The thing is, science does not care what we think.

When we read a coronavirus story and react with emotions and feelings, SARS-CoV-2 pays no attention. The viral proliferation pathway is unswayed by our well-thought-out responses.

I have many personal feelings about the pandemic.

• I wish COVID-19 would magically disappear.
• I would like the simple act of coming home from work to stop being a potential threat to my family.
• I want my kids to go back to school and to live a normal life.
• I would like teachers to be safe to return to the classroom.
• I want to eat inside a restaurant, hop on a plane, and enjoy a weekend in Las Vegas.
• I do not enjoy wearing a grimy, sweaty mask all day at work.
• I wish everyone would wear a mask and stop the spread of the virus.
• I desperately do not want any of my pregnant patients to catch COVID-19, get sick, or die.

My wants, desires, and preferences do nothing to change the scientific reality. Astrophysicist Neil deGrasse Tyson once said, “The thing about science is that it’s true whether or not you believe in it.”

We can not be dismissive of scientific evidence

The tension between opinions and science are on full display in the #reopenschools debate. There is a bipartisan agreement to find a way to get kids back in the classroom. The open question is how to do it safely.

White House Press Secretary Kayleigh McEnany said, “The science should not stand in the way” of reopening schools.

But if science is not going to guide decision making regarding the US Education system, how will we decide? Gut-instinct, coin toss, fortune tellers, or tarot cards? Or should we reopen schools based on intuition, faith, polling data, or political party?

Bending the science to match our desires will not work. The virus does not care whether we open schools or not. SARS-CoV-2 has no opinion.

The virus is not liberal or conservative. It is not a Republican or a Democrat. SARS-CoV-2 does not watch Sean Hannity or Rachel Maddow.

The virus will simply hop on board a respiratory particle and pass indiscriminately from one person to another. The virus’s spike proteins attach to cell surface ACE2 receptors, hijack the cell, and reproduce thousands of copies of itself.

Our political beliefs have no impact on viral function.

Scientists do not decide what we want the truth to be and then search for evidence to support our beliefs. Instead, we use the scientific method to answer the unknown. We generate a hypothesis, runs tests, and then prove or disprove the theory

Science is a search for the truth, not an effort to bolster our belief system.

SARS-CoV-2 is a bipartisan killer

Planet Earth has been exposed to a novel virus. No human is immune to COVID-19. Until a vaccine or an effective treatment is available, the safest course of action is for every American to live as though we are all asymptomatic carriers.

The current scientific evidence demonstrates the coronavirus pandemic is not a hoax or a left-wing conspiracy.

COVID-19 is a bipartisan killer.

Our Fox News, CNN, and MSNBC friends, families, and coworkers are catching COVID-19. Many will be hospitalized. Others will die. Each day the chances are increasing; each of us will be exposed to or know someone with coronavirus.

The evidence-based data shows the best way to fight the pandemic is to cover our face, respect social distancing, and wash our hands.

My strong opinions wanting the virus to go away will not change reality.

In the meantime, perhaps my life-saving mask will deter me from eating another Tiff’s Treat cookie.

The post SARS CoV-2: A Virus That Does Not Care About Your Opinion appeared first on Medika Life.