The other day, our air-conditioner went out. We live in Austin, Texas, so the house quickly became an oven. Opening the windows and turning on fans didn’t help, since the outdoor temperature was over 100 degrees F. The situation was not just an inconvenience—it required urgent action. We were able to get the air conditioner fixed, but it was expensive. We have resources. Others do not.
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.
“Heat advisory in effect 11 a.m. to 7 p.m.” The text from the city emergency alert system lit up my phone screen. A little while later, I saw a Facebook post from Denis Phillips, chief meteorologist for ABC News, telling Floridians this was only the second time in over 20 years that a heat advisory had been issued. I was scheduled to be the preceptor on a street medicine shift that night. My first reaction was regret at having signed up for an August “street run,” as we called it. My second was remembering that the run would be canceled without a preceptor—so, heat advisory or not, I knew I had to keep my commitment.
In 2023, given the variety of bottled water(s) that are sold not only in grocery stores but also in hospital and medical school vending machines, it may be hard for some people to remember a time when water, packaged in plastic bottles, wasn’t a reality. Oh, there was Perrier, San Pellegrino, and a few other brands packaged in glass bottles. But it was only after the 1990-91 Persian Gulf War—the Middle East operations known as Desert Shield and Desert Storm—that water bottled in plastic found its place on supermarket shelves and began to be purchased by consumers worldwide.
My husband is an air-conditioning contractor based in southeast Florida, where A/C is needed almost the whole year round. This summer has been particularly hot—the temperatures pushing everyone’s A/C units to their limits. He comes home soaked in sweat and arrived on the border of a heat stroke one day.
When I was deciding what pediatric subspecialty to pursue, one mentor gave me this advice—think what common condition you wouldn’t mind seeing on a daily basis. As I considered various diagnoses, one stood out—iron-deficiency anemia, the backbone of pediatric primary hematology complaints. Indeed, during my fellowship in pediatric hematology-oncology, I’ve seen a plethora of patients with iron-deficiency anemia. The majority are adolescent females, iron deficient due to myriad causes, most often diet or abnormally heavy menstruation.
I am not a drinker—not of water, juice, coffee or tea, or alcohol. My children and physician constantly remind me of this unhealthy habit, stressing that my body needs fluids, especially water, to function properly. I hear them, but I do not listen. I have even ignored them these past several months when the temperatures have risen to the high eighties and often middle nineties.
As a new nurse, I practiced the “Five Rs” of medication administration with religious devotion: right patient, right medication, right route, right dose and right time. Over the next thirty years, I gave thousands of pills to patients.
Early one morning, my fellow RN called out from within a patient’s hospital room, “Getting ready for medical transport, need some help!”
Peeking into the room, “What can I do?”
Tanya replied, “Get Mrs. Smith’s meds.”
Dear Pulse readers,
Many years ago, while seeking employment as a musician, I spent part of a summer in Minneapolis, a town I associated with cold winters but which, it turned out, also endured hot summers. My quarters had no air conditioning and I was sweltering, so I purchased a fan, which didn’t help much. For some reason, my place just wouldn’t cool off, even at night, and there were moments when I felt I might suffocate from the heat.
My husband knew his body.
When he was diagnosed with atrial fibrillation in his 40s, despite the fact that he was a dedicated runner, every physician he ever saw recommended that he take some blood-thinner or other. Each of them gave as their rationale the fact that he had a five-percent chance of experiencing a stroke without such medication.
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.
I’ll be the first to admit that I only know a fraction of all there is to know about the wide variety of tablets, capsules, caplets, and other pills out there.
