The Coronavirus Crisis is over. The justification for its existence has evaporated. Ignorance and fear have been replaced by data and reason. All that was left was for someone to declare it dead. And on this episode I do just that.
As Americans struggle to return to normalcy, we are constantly told what we must do to be safe. These instructions come at us from all directions and are numerous, wide-ranging, and inconsistent. In this episode I reveal the secret to safety from Covid 19 (and everything else).
The media continues to sow fear by distorting the truth. As the coronavirus pandemic predictably and inevitably spreads, the misconceptions resulting from these lies poisons rational decision making both in individuals and society as a whole. Emerging evidence supports an understanding of the pandemic contrary to the doomsday scenarios popularized by the TV and internet.
As an old white guy , I haven't had to consider how racism has shaped me. But an odd thing happened as I became agitated watching the recent unrest....I started to sense that the protesters might be right. They compelled me to revisit my beliefs, and on this episode I discuss some that have crumbled under the scrutiny.
Despite significant concerns, our nation is reopening. Now is the time to employ the "doctors best test" as we share the environment with corona virus. There will be rough water ahead, not simply a second wave. But by allowing ourselves not to be certain we can adjust our course frequently and keep our heads above water.
Americans are asking "when is enough enough"? If we are to successfully unlock our national lockdown , we must first unravel the twisted truths used to convince us to support this policy. In this episode I illuminate the "little white lies" that became the wrong reasons for doing the right (and ultimately successful) thing.
We see them on the newscasts, our emotionally distraught politicians, pleading for ventilators - our "missiles in the war against Coronavirus". Without expanding our supply people will die. So with enough of them people will live, right? On this episode I reveal how this lie, that is being fed by the media to a public hungry to trust its leaders, is only likely to worsen outcomes.
The internet and TV report that corona virus tests are crucial but also scarce - so they must give an advantage to individuals trying to survive the pandemic, right? (kind of like having lots of toilet paper). Testing is important but not for the reasons that the media implies and misconceptions about testing continue to abound. So here is a reality check.
Whether or not it is the medias's intent to distort the truth, the fact that it does has left most Americans encumbered with misconceptions that block an effective understanding of all things Corona. In this episode I discuss the lockdowns enforcing social isolation, that are necessary for now, but not for the reason that people have been led to believe. And why understanding the real reason is essential for moving forward.
If your window on the world is provided by popular media, then the chances are great that your initial contact with the Corona Crisis has left you infected with misconceptions about the pandemic. In this presentation I discuss how this happens and why being burdened with these misconceptions is harmful.
The Corona virus crisis has gripped, perhaps strangled our society. Is this event the unprecedented medical apocalypse that the evening news and our political leaders are portraying? It is a big deal but some historical perspective is necessary to balance our understanding of this pandemic. I present observations from the trenches we are preparing as we face this unknown .
I have argued that high blood pressure is not a disease but a sign - so a sign of what , exactly? In this entry I explain why it is difficult to convince my colleagues to abandon the idea that high blood pressure is an imminent threat and how I reshape my patient's thinking regarding this vital sign .
It widely acceppted that high blood pressure is bad and causes heart attacks, strokes and and host of other maladies. Although this idea has intuitive appeal and is so widely held as to have become "common knowledge", the problem is that this belief is wrong. In this podcast I discuss how this fallacious idea distorts our understanding and ultimately harms our patients.
To understand the mysteries of medicine we are taught basic concepts we then use construct cognitive frameworks that allows us to interpret information, make predictions and formulate interventions. But what if the original concepts are wrong? Experience has proven to me that many dogmatically held beliefs in medicine are flawed and negatively impact patient care. In this episode I begin an analysis of this important problem.
Can a non critically ill patient's physical exam yield information that is not more precisely derived from laboratory testing, imaging, or other technology? Certainly. In this episode, I discuss aspects of the physical exam that remain not only clinically relevant, but essential to understanding a patients pathology.
If we are being honest, most emergency physicians will admit that our physical exams have become subservient to technology as we evaluate our patients. Does this mean that the physical exam is now just an archaic ritual? Not so fast, my friends. In this episode I describe those aspects of my physical examination I still fine crucial as I care for critically ill patents.
The big reveal! The top two negative changes to befall the practice of emergency medicine are finally unveiled. How these have evolved and why they constitute a powerful malignant influence is examined.
I move on to discussion of the "big ticket item" changes that have impacted the practice of emergency medicine one the last four decades. I outline what drives these changes and how they errode the quality of care provided in our emergency departments .
Forty years of experience have allowed me to develop skills and acquire knowledge that make the practice of Emergency Medicine a bit easier. Thank goodness for that, since many other factors have appeared through the years that have had the opposite effect. So with this episode, let the bitchin' begin!
During four decades of emergency medicine practice much has changed. In this podcast I describe what my experience has taught are some of the most beneficial changes that have improved the day-to-day practice of emergency medicine.
The boogey man's voice that is forever urging us to tread cautiously is a part of us, so how can we escape his influence? We can't. But we can balance it, making it less oppressive and allowing us to practice more confidently and less defensively. I present several strategies that experience has taught me to accomplish this.
We go to work each day accompanied by a boogie man whose ceaseless demands that we be cautious can become overbearing. His influence sows seeds of doubt and nurtures within us a paralyzing anxiety that interferes with our decision-making and can expose our patients to harm. In this episode I discuss his genesis.
How did we get to a point where emergency specialist's are having to choose between providing patient care or being sanctioned by their employers and hospitals? In this episode I conclude my discussion of the hijacking of the management sepsis by the surviving sepsis campaign and how this harms unsuspecting patients.
In the early 2000's a pharmaceutical giant began a marketing campaign that re-defined sepsis and its management. In this episode are review this sordid interaction between money and medicine.
During my 30 year practice of emergency medicine, sepsis has transitioned from being a descriptive term for a patient being overwhelmed by infection into a distinct disease process. Unfortunately this has lead to serious problems. In this episode I discuss my experience witnessing this transition and how is this change evolved.
Many patients present to our emergency departments with worrisome symptoms, but we physicians can find no objective evidence that they have disease. In this episode, I present a hypothesis to explain what is causing this confusing situation. By offering our patients an understandable explanation for what is happening to them we can more effectively reassure them and begin the journey toward relief.
Each day emergency physicians see patients whose potentially serious symptoms cannot be explained after comprehensive evaluations. These patients seemingly have invisible disease. Many such patients return repeatedly convinced they have, as yet, undiagnosed dire medical conditions. Just what is going on?
We must extract critical information from those who come to us despite difficult circumstances. In this episode I discuss lessons derived from taking 200,000 histories from patients and identify several questions that have helped me clarify confusing patient encounters.
Wouldn't it be great if there were a test available that could reliably tell the emergency physician how far down the slippery slope toward death the unstable patient before him/her had progressed? Oh wait, we have one. Why are we are being told not to use it?
Our specialty faces threats from without and from within. In this episode these threats are further examined and methods of defending our specialty and ourselves are discussed.
