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Allow a natural death.

I suppose I should preface this one with a disclaimer. These views are my own and do not reflect the organization I work for.  My views and perspective are shaped by what is probably over 20 years in the hospital setting.  The includes being a hospital volunteer, an ER Clerk , Med School, Residency and I'm completing my 9th year as an attending, a hospitalist. Since many of my patients look at me quizzically about what that means. It means I'm an internal medicine trained doctor practicing in the hospital setting taking care of acute admitted patients. So if someone has pneumonia, COPD , heart failure and they need to be in hospital, then I'm that rounding doctor.  --------- From admission, one of the first things explored as part of a patient's history and care approach is code status or advanced directives. There are all kinds of ways to approach this and I've heard from mentors , family friends, why even ask?  Shouldn't we do "everything?" Shouldn...
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Two Ears, One Mouth

  We have two ears and one mouth so that we can listen twice as much as we speak. Epictetus Read more at https://www.brainyquote.com/authors/epictetus-quotes I think it's a fairly common practice for doctors, at any level, intern, resident, attending to carry some kind of paper around. The more senior you are, the less you carry I find. This paper has patient names, perhaps jotted down conditions, and to do items. It might be folder hot dog style and tucked in a white coat pocked or event folder in four and tucked in a scrub pocket.  But let's think about the to-dos  When I'm on service, I definitely have a jotted list of to-dos or mental task list. Things like: narrow antibiotics, call pt's family, discuss goals of care I'd like the thing that my first meeting is more , personable. A hi, how are you going, how was your night?  But given time constraints and a constant sense of throughput, we have to move things along. Mr. Crag (not his real name) was an ICU downgra...
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Language of Love

 I've been playing around with the idea of getting back into blogging for many reasons. Therapy, sharing, decompressing, emptying my brain a little to make some room for other things. So let's look back, my last blog entry was under Scribe for Life (https://doctorscribe.blogspot.com/2015/11/im-sorry.html).   This blog took me through medical school , residency and first months as an attending with the last blog entry centered in large part around the passing of my maternal grandfather. My paternal grandfather would pass almost 4 years later. So why now , and why this title? The why now, well I'm approaching my 9th year as an attending, closing in on a decade which is wild to say. Since that last blog entry in 2015, I was married in 2018, moved in 2020, had my first born in 2020, COVID happened, changed jobs/left my home institution of 11 years (residency + attending) and then we had our twins in 2021 who are about to turn 2  in a matter of weeks. So the where I'm in ...
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