Yet Another electronic health record
I have lost count of the number of different electronic health records I have used in my career. When I started it was only the paper record, the SOAP note, the numbered diagnoses and their associated plans written out in blue or black ink on lined white paper.
The US a war zone?
The Palestinian physician, who I mentored as a medical student, while I worked in Nablus during my Fulbright thinks so.
Preaching about Roe
Many sound frequencies and words in ink have been spilled on SCOTUS's action last week. I grit my teeth--today, what can I say that has not been said. As a physician I have seen the pain and anguish that comes with abortion decisions. I have seen the lack of support our society provides for mothers going it alone, trying to extricate themselves from an abusive relationship…
Mental health stigma (and more)
. . . is still present. A 9th grade student I am caring for in the school clinic was clearly depressed. Her PHQ-9 scored in the teens. She is sleeping on her aunt's couch as she attends a new school this year, having switched every year or two. Her mom who is homeless sees her routinely, but told her not to take the anti-depressant medication I prescribed…
Hope
Beneath the 6 inches of new snow in the Northeast, there is evidence of spring. The skunk cabbage spears could be seen at the edge of the steams, and small carpets of moss appeared greener. Birds are beginning to show their breeding colors and behaviors. The Omicron variant is receding and the CDC is altering guidelines. You can now search…
Dog Poop, the Social Contract, and Pandemic Behaviors
Dogs have been part of my extended family for most of my sixty-plus years. With a dog comes poop, even with the angelic 4-pawed fellow to the right.
On a farm it doesn't really matter, but in the city there is an expectation, a social contract of sorts. In the public parks and boulevards the dog owner is expected to scoop the poop.
While some dog walkers dutifully pick up their dog's poop, others don't bother, and before I know it I've stepped in it. Squish! Yuk! Stink!
School-Based Clinics in 2021
I first provided care in school-based clinics in the 1990s. My most memorable crisis was an early morning page from the clinic nurse who had a flare for the dramatic. We didn't have cell phones back then, so I found the coins to call her from a pay phone at the cafe where I was having breakfast with a colleague.
"I think I have a student in labor. Can you get in here fast?" Stacy's voice…
We muddle on . . .
Is it the 4th COVID surge? I am losing count. I walked up the stairs in the medical school this week with a physician I didn't know. He complained about his exhaustion from COVID. "It's the unvaccinated we are caring for in the hospital. Such a waste of resources. Nurses are quitting." I empathized and agreed, "These are hard times."
I went to the barn where I lease a horse and the owner…
Play it again
Twenty years ago, I was sitting on the concrete stairs outside the Shoulder to Shoulder apartments in Santa Lucia, Honduras, when I heard the announcer on a colleague’s short wave radio say that US troops were moving into Afghanistan. My compatriots (physicians, nurses, residents and medical students) on the medical mission out of the University of Cincinnati…
The Art of Improvisation
We are watching Ken Burn's Jazz Series on PBS. I enjoy music, but am not a musician and don't have much of an ear. My singing should be only in the shower. What has struck me about the series is the ongoing improvisation that is Jazz. It started with Louie Armstrong in New Orleans, Duke Ellington in NYC, and Count Basie and eventually Charlie Parker in Kansas City. It is a story of race--the creative and improvising black musicians inspiring the whites and then the black artists…
Gratitude and Bearing Witness
Now 11% of the US adult population is fully vaccinated and over 22% have at least one dose. My own family has done well thanks to their essential worker status (teachers and doctors) and being long term care residents. We’ve had our trauma with COVID, 2 members infected and recovered, and others on the front lines of bringing children back to school and in clinical care. But nevertheless we are privileged. Despite the chaos of President #45, the US…
Ground Hog Day
Remember the movie—Bill Murray trapped in an endless loop. February 2nd has come and gone and I can never remember if winter continues, or if spring will come sooner if the groundhog sees its shadow. Regardless, the Covid winter is here to stay.
There are reports of the four vaccine breakthrough cases in Oregon, and in New Zealand, which has been a model country in managing the pandemic, shows a rise in cases. The growing mutations of Covid-19 are worrisome, as is the current thought that the vaccine’s protection fade…