Fourteen Days of Frontline Pandemic Life

Fourteen days of social distancing have passed. Emotions are high all around. The wicked foreboding of the mysteriously menacing novel Coronavirus has spared no one. Everyone is scared. The cleaning staff, scrubbing and wiping just one more time. The techs, maintaining stoicism behind masked faces. The patients, eyes darting with fear. The nurses, bravely caring for their patients. The reality is that the physicians are scared too. We are all clouded in the worry that either we will get sick or compromise the health of a loved one at home.
Human beings are social creatures. The dinners or parties bursting with the melody of bustle and chitter-chatter are enticing to us all. Unfortunately these very events that connect us have the potential to kill us today. Breathe the air of an infected person less than six feet away and Coronavirus settles in, like a fine dust. It will inveigle its entry into the lungs and ultimately result in insidious cytokinetic demise. 
Despite the social distanci…

Ode to Female Physicians

The highlight of my week was an evening out with my fellow female physicians. We are a group of Pediatricians, Internists, Obstetricians & Gynecologists, Anesthesiologists, Cardiologists, Psychiatrists and Ophthalmologists. 
We are also writers, book authors, speakers, researchers, fashionistas, leaders, globetrotters, home chefs, charity organizers, foodies, entrepreneurs, family members and friends.
We talked and shared stories.
We have saved lives yet also lost lives. We have delivered good news and delivered bad news. We were called to serve in Medicine yet also sustain its burden.
We face sexism and misogyny daily. We are overlooked professionally because we are women. We are held to conflicting double standards.
My own personal story: I declined to see a patient who showed up late beyond the grace period. It was the last patient of the day. I was asked to stay late to see this person. Then I was told that I did not accept the feedback in a positive way because I wasn’t “bubbly.”
Are m…

Speaking Of Viruses, I Got Sick Last Weekend...

Influenza is no joke. I unfortunately fell victim to this vicious virus a week ago. It started with an annoying dry cough. The next day, I had full-blown fevers with shaking chills and body aches for two days. Then I had a 10/10 dull headache with pressure over my eyes and light sensitivity for three whole days. I don’t suffer from migraines and this was honestly the worst headache of my life.
After forty-eight hours of 10/10 headache, I recognized that I needed help. I checked into Urgent Care. While I was waiting, I curbsided one of the Infectious Disease doctors. He advised me to start Oseltamivir immediately. (I had held off because my fevers and chills had resolved in two days.) He told me if I wasn’t better in two days, I might need a CT scan of my head and/or spinal tap. I relayed this information to the Urgent Care physician and she ordered Oseltamivir and, just in case I didn’t get better, Amoxicillin for possible sinusitis.
I see patients with colds and flu all the time. I ord…

Do No Harm

I was assigned to care for a patient who had been newly diagnosed with cancer. A midline IV line had been inserted with plans to start chemotherapy. Unfortunately a blood clot had developed at the midline IV site (a common occurrence in patients with cancer). The midline IV line was pulled out. She needed some sort of access for chemotherapy. She had also complained of chest pain. A CT scan, EKG and blood tests didn’t show the heart or lungs to be the source of her chest pain.
I came to the patient’s bedside to introduce myself. She smiled at me. I had barely started my introduction when her father stormed in and started shouting. (At me, in case there was any doubt.)
He had multiple complaints.
He blamed “you people” for the blood clot.
He was angry at me that the patient’s Oncologist hadn’t run to the patient’s bedside already.
He was angry that I hadn’t figured out what was causing her chest pain. I reviewed all the results with them and advised them that the pain was not cardiac or pul…

Trump’s Not the Only One With Legal Troubles

Well, Trump is not the only one with legal battles today. I, too, was in court to clear my good name. I was accused of running a red light and being in the intersection at the red light. I had turned left on a yellow, which was very short, and ultimately turned red when I was in the intersection. 
My defense team (aka me, Google and my attorney brother) researched the case and came up with talking points and precedent cases. (Law is super fascinating, by the way!) The short version of my statement is that this particular yellow light was set shorter than the guidelines recommended by the CA Manual on Traffic Control Devices. 
I pleaded “not guilty” via Trial by Declaration. I was unfortunately informed that I was still guilty and I can choose to do traffic school. I requested a Trial de Novo and prepared my defense.
Being a “legal deviant” is new territory for me, so the amount of anxiety leading up to this court date was at an all-time high. In anticipation of getting lost, directions, …

All About Sleep

Halfway through January and I’m getting so many complaints of poor sleep. . 💡Why do we sleep? Research is ongoing but from what we do know — restoration of body and mind. This includes musculoskeletal, nervous, endocrine, immune and cognitive/memory functions. There may be a link with poor sleep and dementia. . 💡Phases of sleep: NonREM and REM sleep: stage 1 nonREM—> stage 2 nonREM —> stage 3 nonREM (“deep”) —> stage 2 nonREM—> REM. REM largely occurs the two cycles before waking, which is why you wake up thinking “I had the strangest dream...” . 💡How much sleep is recommended? Per National Sleep Foundation guidelines, adults should get 7-9 hours of sleep per night. You know you got enough when you don’t experience daytime sleepiness. . 💡Factors that can affect impact sleep quality (incomplete list): Sleep apnea, heart failure, asthma or emphysema, restless legs syndrome, shift work disorder, depression, anxiety, stress, caffeine, alcohol, drugs (especially cocaine and amphetamines…

When Less Is More: Weighing the Consequences of Actions

I was supposed to see a 99 year old man on my schedule. He had been sick for a few weeks with intestinal issues. Initially the doctors tried to treat him conservatively. He did not get better.
His family decided he should have surgery. He was taken to the operating room and made it through the surgery but in critical condition. He ended up in the ICU after the surgery. He was given fluids, pressers and multiple blood transfusions. Ultimately his body gave out and he died the night before I was supposed to see him.
Modern medicine affords so much technology and intervention. But is it always the right thing to do?
This man could have spent his remaining time comfortable and surrounded by family. Instead he rounded out his 99 years in a freezing operating room and ICU probably in pain and surrounded by strangers. 
Sometimes less is more and allowing people dignity is the humane treatment.