I have always been aware that I am Jewish. In the antisemitic neighborhood where I was raised, my unique religious identity was central to all interactions. I was perpetually othered. Supposedly I was smart because I was Jewish. My (ugly) appearance was Jewish. My (weird) last name was Jewish. I was different. Undesirable.
If you have ever been in therapy, you likely discovered that while you share personal details about your life, the therapist reveals little information about theirs. From my understanding, when and what to disclose is part of a therapist’s training. In contrast, in medicine, relatively little about self-disclosure is taught. Instead, it is up to the individual to figure it out on their own.
Being a child of medical parents brings special challenges. For example, such children grow up with a unique idea of appropriate dinner conversation. When I exclaim, “Guess what I saw at work today!” my children interrupt to inquire if my story has blood or something “gross” in it. And they regularly yell, “HIPAA!”—a reference to the federal patient privacy regulations—even though I always deidentify patients.
During a busy clinic, my eighteen-year-old texted concerns of sudden torrential rains causing flash flooding in our yard, with potential basement flooding. Centuries ago, our backyard was swampland. Now it is developed land and a flood plain.
Two dreaded words for medical providers and patients: Prior Authorization (PA). For the fortunate few who have not needed to engage in this process, here’s a definition from the American Medical Association website: Prior authorization is a health plan cost-control process by which health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.
Having a purpose in life is as critical to one’s well-being as food and shelter. I’ve learned, over my 25 years of doctoring, that a sense of purpose both helps us develop our identity—our sense of self—and connects us to something greater than ourselves.
Finding New Purpose Read More »
My routine clinic day was interrupted by a startling message. During a moment of extreme stress, a long-term patient of mine left a threatening voicemail on my colleague’s phone. The target of her anger was me. It was difficult to discern her garbled speech in the recording of her screaming, but I heard loud and clear that she intended to find me at my clinic and physically hurt me – or worse.
Giving ninety days’ notice to leave a job as a family physician at a community health center provided ample opportunity for me to say goodbye to patients. I listened carefully at farewell visits. A Black patient minced no words as she proclaimed to me, a White woman, “I will tell you what I like most about you. You listen and you don’t act like you know more about my body just because you’re a doctor.” Her words made a profound impact on me.
The voice of a dear yoga teacher echoes in my head: “It is easy to maintain your balance in the pose. The hard part is to stay balanced when moving from one pose to another.” Real life often evidences itself on the yoga mat, and life transitions are not my favorite events. Thus, unsurprisingly, I frequently rushed the transitions between poses in yoga class. As my legs, torso, and arms whipped about, my teacher would call out my name to remind me to pay attention and find my balance in between poses.
Balance in the In-Between Read More »
We medical providers care for countless patients who feel depressed. For those folks, sometimes life feels so difficult and terrible, that they have thoughts of wishing they didn’t exist, or that the world would be better if they didn’t exist. Sometimes these patients have a plan to end their lives. The more concrete the plan, the more we worry.
What do you do when you hear about a sex assault that happened years ago, and you currently interact with the perpetrator in your daily life? What if that perpetrator is seemingly a nice person, and you are friends with his female partner and his family?
What if the perpetrator is a patient of yours, and you are also the primary care provider for his family?
What if the perpetrator is a coworker or a supervisor at your workplace, and you spend time together in meetings and engaged in work tasks?
Statute of Limitations? Read More »
For the fifteen years that I have been at my current job, I have held onto my patients’ stories. Tucked into special pockets in my heart, they would be brought out whenever their “owner” came in for an appointment, where the story would take on a new form, then be stored away again. There were stories of shame and heartbreak, stories of joy and triumph. People confessed their deepest fears, shared events never revealed, and confided fledgling hopes and dreams. These stories are signs of patient-physician trust and of sacred human-to-human connections.
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