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A doctor’s tips

Photo: Enric Moreu / Unsplash

Whenever someone learns I’m an emergency room physician, they reflexively ask ‘What’s the craziest thing you’ve ever seen?’ I get it — television shows like the eponymous ‘E.R.’ depict my job as full of lust, gore, and foreign objects in unexpected places.

I can humor you with stories all day long, but I’m not sure I want to. No one has ever asked me what I think is the most important question about my job: ‘What should I know about the ER if myself or my loved one is ever a patient? Any insider tips?’

There’s only one thing that…

Depression, burnout, and overwhelm have become status quo

Photo: Haris Mulaosmanovic/EyeEm/Getty Images

Dr. Lorna M. Breen was the medical director of the emergency department at a hospital in New York. While caring for patients, she contracted Covid-19. She recovered and returned to work caring for patients. Then, on a brief vacation in April at home, Breen took her own life. Her colleagues describe her as a fun-loving and energetic servant leader dedicated to her community. Now, Breen is another tragic victim of physician suicide.

Pediatric resident Dr. Poulami Saha suffered from depression. In May, She jumped off the 11th floor of her hospital in Calcutta. In March, Daniela Trezzi, an ICU nurse…

Six Months In

Whose advice should you follow to stay healthy and informed? The health and science experts on this list.

This story is part of “Six Months In,” a special weeklong Elemental series reflecting on where we’ve been, what we’ve learned, and what the future holds for the Covid-19 pandemic.

One of the most challenging aspects of the ongoing coronavirus pandemic is that even six months in so much is still unknown and uncertain. …

And we’re better off for it

Chairs taped off in a waiting area.
Chairs taped off in a waiting area.
A waiting area at Lenox Hill Hospital, New York City. Photo: Education Images/Getty Images

Since the onset of Covid-19, patients seeking any number of health care services have found an annoying, often frustrating hurdle inconspicuously absent: the waiting room. This dreaded area of contagion, paperwork, insurance verification, and awkward looks has been eradicated for the moment — becoming yet another possible relic of a pre-Covid past.

Before a few recent in-person visits to a medical and dental clinic, I received all relevant paperwork via email days before my appointment, was asked to submit my insurance information ahead of time, and was instructed to call or text the clinic shortly before arrival and wait outside…

Lessons from the Harvard Neurology residency

Photo: Jessica Rinaldi/Boston Globe/Getty Images

If you only have five minutes with a patient, what questions do you ask and what physical exam maneuvers do you perform? If you can only order one laboratory test, what should it be? If the MRI or CT scanner is unavailable, are you still confident in your diagnosis?

These are questions that we resident physicians ask ourselves daily as part of a critical thinking exercise. They help us stay grounded and able to practice medicine without relying on the luxuries of expensive or advanced testing.

Theory becomes reality

When Covid-19 engulfed our state and hospital, this critical thinking exercise took on new…

My story happened 20 years ago, but it’s still happening today

Photo: PixelCathers/Getty Images

I knew that I wanted to attend Brown University when I was a sophomore in high school. Our college counseling office had a database of schools that could be searched by keyword. I clicked on “Biology” and “Premedicine.” The list generated was alphabetical. Brown was first. The internet was just taking hold, and so I had to find the web address and type it directly into a browser window on a boxy Macintosh in our computer lab. There was a picture of an elegant brick building centered on a grassy green. The few, text-heavy pages talked about an “open” curriculum…

One ER physician recounts the stress of constant intubations and PPE shortages

Photo: Boston Globe/Getty Images

I couldn’t see. My face shield was blurred by a streaky haze. I tilted my neck back and forth in an effort to peer beyond it, beneath it, through it, whatever might work. Was it condensation? I started to raise my hands to my face to wipe it away before I remembered and yanked them back down: I cannot touch my face, can’t ever touch my face — neither inside this room nor outside it.

As I stood at the head of the patient’s bed in ER Room 3, her nurse, Kate, secured a mask over the patient’s face to…

I am at the house of God. But the angels are holding their breath.’

Photo: PhotoAlto/Odilon Dimier/Getty Images

The days have been long.

We have forgotten our avowed aversion to screen time. We have all learned to use Zoom. The irises are peeking out again. They mustn’t have heard. We anxiously scan the news — has exponential growth begun? Did I just touch my face? What will we run out of today? When I reuse my mask, are they still not plastered on the outside?

Market Basket, my local grocer, announced special hours for the elderly. How civilized. Like in Australia. My friends in California cannot leave home. Capone, in Union Square, posted a sign on its door…

An interview with San Francisco General Hospital Chief of Emergency Medicine

Doctors test hospital staff with flu-like symptoms for coronavirus (COVID-19) in set-up tents to triage possible COVID-19.
Doctors test hospital staff with flu-like symptoms for coronavirus (COVID-19) in set-up tents to triage possible COVID-19.
Photo: Misha Friedman/Getty Images

Elemental spoke with Christopher Colwell, MD, chief of emergency medicine at Zuckerberg San Francisco General Hospital, to get an inside perspective on what doctors are experiencing on the ground with the novel coronavirus outbreak and how they are preparing to handle the situation if and when it escalates.

The information reported here is from March 22. This interview has been lightly edited for length and clarity.

Elemental: Thank you so much for taking the time to chat with me. I know you must be incredibly busy right now, so I really appreciate it.

Christopher Colwell: It’s a remarkable time, no…

One physician’s advice on how to stay clean

Photo: PhotoAlto/Odilon Dimier/Getty Images

The doctor’s white coat. Some might imagine it pressed and sparkling, radiating confidence and demanding respect — the very symbol of a figure who heals your illness and makes you feel better.

But how clean, really, is a white coat or any of a doctor’s clothes for that matter? Why do doctors wear them? How often are they washed? And how many doctors in scrubs and white coats carry germs from person to person, unknowingly infecting patients with viral or bacterial illness?

The answer might surprise you.

The white coat was a staple of highly successful doctors many generations before…


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