A doctor puts his mind to mindfulness

A few summers ago during a week-long vacation, I started playing a mind game. In the mornings, I would sit outside on a comfortable deck chair, surrounded by the shrill call of cicadas, and gaze across the lawn into the trees. After getting settled, I would close my eyes and bring my body to complete […]

His wife is ill. He’s a doctor. Isn’t he supposed to know what to do? – Washington Post

Two weeks after my wife has a hysterectomy, she begins experiencing fevers that rise and spike each evening: 99.2, then 100.7, then 101.5. I am an infectious-disease doctor and a consultant for Medicare. And I am puzzled and a bit frightened. “What do we do?” asks my wife — also a physician. She is lying […]

What should doctors do to combat childhood obesity? – Washington Post

Lying in a hospital bed, my seriously obese patient could barely see her swollen and odorous right foot over her abdominal fat. The foot was soon to be amputated, the result of an untreatable infection exacerbated by diabetes and kidney failure, which developed in part because of obesity.Her two children, ages 6 and 12, hovered […]

Medical errors are hard for doctors to admit, but it’s wise to apologize to patients – Washington Post

In 2007, I published a story in my local paper in which I confessed to having made a medical error years earlier. I’d mistakenly prescribed an antibiotic for a patient whose chart indicated an allergy to the drug. Thankfully, the story had a happy ending. My patient recovered and took no legal action after I explained to […]

‘Lincoln’ rekindles equality – Washington Post

On Thanksgiving weekend, with family and friends, I watched Steven Spielberg’s masterpiece “Lincoln.” It was a history lesson on racial inequality. Abraham Lincoln championed the 13th Amendment, abolishing slavery, paving the way for the 15th Amendment in 1869, giving African Americans and other racial minorities the right to vote. The movie also hinted at gender inequality, when nearly all […]

Doctors in private practices are now joining hospital staffs – Washington Post

Fifteen years ago, I proudly hung a sign outside my office with my name followed by “MD.” I had started my own business. A small private medical practice is much like a mom-and-pop store, where the doctor has the autonomy to decide the hours, which insurance to accept, which patients to see and how much […]

When terminally ill patients ask how long they have, doctors find it hard to say – Washington Post

In January, when my close friend’s lymph node biopsy came back as a rare form of T-cell lymphoma, I scoured the scientific literature. What was his prognosis? He was 56, a little overweight but otherwise healthy. He had helped us move into our home more than a decade ago, and I was like an uncle […]

Diwali at the White House – Washington Post

Thursday evening my teenage daughter asked me to help her review for an AP U.S. Government exam on the Bill of Rights. That she was studying the first amendment and the freedom of religion seemed fortuitous: the following morning I was to board an early morning flight from our home in Memphis, Tennessee, to Washington […]

False positives show need to adjust expectations for cancer screening tests – Washington Post

Several years ago, during an annual mammogram, my wife, who is in her 40s, was told a mass had been found in one of her breasts. Anxious and uncertain, she had a biopsy, and we braced for the worst. My father-in-law, when in his 50s, went through a similarly harrowing experience when a prostate specific […]

Accepting death is difficult for patients and doctors, but it needs to be done – Washington Post

My 64-year-old patient with terminal cancer and less than six months to live wanted to go to Oregon. He was contemplating assisted suicide, which is legal there. “My life has been long and good,” he said. “I believe it is my right. I want the ability to say it’s too much, I can’t do it […]

Intensive care units grow more friendly to patients’ families at some hospitals – Washington Post

Not long ago, when my father was about to undergo a heart procedure, I hinted to the cardiologist, a colleague, that I wanted to be there, too, not just to offer comfort but also to be present for the play-by-play that would lead to a critical decision: whether to open his blocked arteries with a […]

Doctors often struggle to show compassion while dealing with patients – Washington Post

I was standing at my patient’s bedside. Mike Venata was having chills with a temperature of 103. Sweat covered his balding scalp like dew, then coalesced and rolled down past his staring eyes. Just 20 minutes earlier, a specialist had informed him that he had metastatic pancreatic cancer and could expect to live less than six […]

Medical tourism can pose problems, but savings are welcome – Washington Post

Medical tourism Re: “The future of American medicine may be offshore” [Apr. 5]: The interest in getting much less costly health care overseas is understandable. But what happens to a patient who has major surgery in India, for example, has immediate post-op care there and everthing is fine until they come back to the United States and […]

Letters to Medical Tourism Washington Post story

Over the week I am received numerous emails about how many of you have received low cost high quality care in Mexico, India, and South America. Also, there have been concerns about the follow up and quality of care. Market forces are powerful and the wind of medical tourism will be yet another force impacting […]

My homes – Memphis and Indore – quite similar

Little while ago I wrote about my trip to Indore, India and compared it with the problems and issues we face in Memphis. HERE IT IS: Memphis and Indore – my homes   I have been away — 8,500 miles away in India, where I was born and lived until age 10. I was vacationing […]

Medical tourism draws growing numbers of Americans to seek health care abroad

When my father had a toothache, he saw a dentist in Boston who recommended a root canal and dental crown costing about $2,000. He decided to wait until he was in India, his native land, for holidays and had the procedure done there for $200. Extremely satisfied with the service and the price, my mother […]

Hospitals’ focus on patient safety hasn’t eliminated preventable deaths – Washington Post

Published: December 20, 2010 Some years ago, I got a call at 3 a.m. from the hospital because a patient of mine had spiked a high fever. Suspecting an infection, I called in some antibiotics. A few hours later, a frantic nurse called to say my patient had turned red and was wheezing, likely from […]

Force that bonds us is stronger than what divides – Commercial Appeal

On an unusually quiet Sunday afternoon in the intensive care unit, Memphian Kristen Sharp lay in bed attached to a heart pump. Her tightly braided hair was pulled to the side of her thin, brown face. She gave me a beaming smile. It was Halloween day, and life had played many tricks on her, but […]

More rules are needed to curb drug firms’ attempts to influence physicians – Washington Post

Nearly a decade ago when I was newly settled into private practice in Memphis, a drug representative for a new and powerful antibiotic stood in my office and asked whether I would like to attend a consultants’ meeting about the drug in Washington. He said I was a “thought leader” in the field and had […]

Even with malpractice insurance, doctors opt for expensive, defensive medicine – Washington Post

Some months ago, the receptionist in my clinic handed me a registered letter. The name of the sender seemed familiar. “Dear Sir,” the letter read. “Please be advised that this letter serves as official notice that I am considering a potential claim against you in a medical Malpractice claim in regard to my husband. . […]

When a patient says she wants to sue me … – Washington Post

Even with malpractice insurance, doctors opt for expensive, defensive medicine Some months ago, the receptionist in my clinic handed me a registered letter. The name of the sender seemed familiar. “Dear Sir,” the letter read. “Please be advised that this letter serves as official notice that I am considering a potential claim against you in […]

Bundled payments might cut hospital costs without reducing quality of care – Washington Post

A decade and a half ago, when I started my solo practice, I would say to my routine HIV patients, “Let’s see you back in three months.” I was eager to fill clinic slots; also, because of my lack of experience, I felt safer seeing my patients more often. Nowadays, with my clinic overbooked for […]

With Swine Flu Returning, Families Can Reduce Risk of Transmission – Washington Post

Last winter, a few months before the first outbreak of H1N1 flu, my 13-year-old became ill, first with a cough and runny nose, and then with low-grade fever and nasal congestion. It was not severe enough to have her miss school, but we had her skip indoor soccer practice. A week later her older sister, […]

For Doctors, Rationing Care Is Standard Practice – Washington Post

Published: August 04, 2009 A seasoned pulmonologist shakes his head. “Let’s face it, we already ration care.” And, pausing ever so slightly, he begins his story. “This family of an 80-year-old gentleman came to me a few days after he was admitted into the ICU. He had end-stage emphysema. ‘We had a family conference last […]

Even ‘Snake Oil’ Can Help Patients Heal – Washington Post

Published: March 17, 2009 “Our conference was being held over lunch, but Pat, a middle-aged health-care consultant, did not touch a bite of her food. When I asked if something was wrong, she revealed her lifelong battle with Crohn’s disease, an inflammation of the bowels that causes diarrhea and abdominal pain. I asked what her […]

Want to Live a Bit Longer? Speak Up. – Washington Post

Published: February 17, 2009 “Did you know that women live longer than men?” I asked my wife. Of course she did — and not just because, like me, she is a physician. Anybody who walks into a nursing home can see the imbalance. Most people’s grandmothers outlive their grandfathers, and 85 percent of centenarians are […]

A Skeptic Becomes A True Believer – Washington Post

Published: February 10, 2009 I was skeptical when my hospital embarked several years ago on an initiative to reduce the number of hospital-acquired infections in our intensive care unit. These are infections that originate from the tubes and catheters inserted into the body — for example, ventilator-associated pneumonia, related to a tube lodged in the […]

Once Detected, HIV Can Be Manageable – Washington Post

Published: December 09, 2008 Ten years ago, an intelligent, reserved software engineer — a woman with the complexion of Halle Berry and the physique of a marathoner — came to my infectious-disease clinic, accompanied by her fiance. They’d been referred to me a few weeks after a rash and pneumonia prompted a clinic doctor to […]

Patients Can Join the Fight Against Flu Without Firing a Shot – Washington Post

Published: November 25, 2008 Last month at a luncheon marking International Infection Prevention Week at the National Press Club, some speakers reminded me of a shameful and frightening statistic: Almost 60 percent of American health-care workers do not receive the flu vaccine. Let me put that in context: Influenza, commonly called the flu, strikes 5 […]

Elective Surgery Is One Thing, Elective Politics Another – Washington Post

Why the Presidential Race Should Skirt The Doctor’s OfficePublished: October 28, 2008 A few weeks ago, as I was making rounds on the oncology floor, one of my patients asked, out of the blue, “Hey, Doc, who you gonna vote for?” I would have expected this patient to have other questions on his mind. He’s […]

Equal Treatment for the Uninsured? Don’t Count on It. – Washington Post

Lack of Compensation Can Tempt Doctors to Tailor Their Care to a Patient’s CoveragePublished: October 14, 2008 When I walked into the hospital room of a 19-year-old woman, a foul smell all but overwhelmed me. I called a nurse to assist me and saw her, too, catch her breath.When we examined the young woman we […]

Hospital Clash Puts Patients in the Middle

Published: September 16, 2008 From the patient’s point of view, doctors and hospital officials can seem to be a monolithic medical power structure. But in fact, physicians and administrators often do not see eye to eye.Read More

Some numbers to count on – Times of India

Published: September 14, 2008 Often at a family gathering or a social event the conversation moves to the issue of “how to live longer?” And I respond in no uncertain terms. “The elixir of long life is pretty simple — exercise, eat well, avoid stress, stop smoking and take preventive medication.” Read More 

Hand Washing: Time Well Spent – Washington Post

We Need Carrots and Sticks to Reduce Infection RatesPublished: August 05, 2008 One morning on hospital rounds, I saw a physician colleague enter the intensive care unit where a patient lay intubated and sedated. With his hands unwashed and ungloved, the physician palpated the patient’s abdomen, scratched his own head and then placed his stethoscope […]

Family Adjusts to Rules of the Road – Washington Post

Published: July 15, 2008 Last summer, my oldest daughter, Sapna, passed a multiple-choice driver’s exam, secured a learner’s permit and asked to sit in the driver’s seat. This was a source of concern for me. As an epidemiologist, it is my job to look at incidence and prevalence of disease in large populations and suggest […]

Doctors Can Be Doubters – Washington Post

My patient is an elderly man with end-stage congestive heart failure, kidney failure and now an infected dialysis line, and he is unlikely to live more than six months. The Bible lies on his bedside table next to his hospital breakfast tray and the morning newspaper. I wonder if I should pray with him. A […]

A Doctor’s Viewpoint Changes When the Patient Is His Father – Washington Post

Published: April 15, 2008 Each morning as I head for my morning rounds, I routinely hurry through the hallway alongside the cardiac catheterization lab not noticing what goes on inside. But, this morning it was different. On the table, under the x-ray beams, with a catheter tunneled into the arteries of his heart was my […]

Honestly, I Could Not Help Him – Washington Post

Patient’s Routine Visit Becomes An Ethical Challenge for a DoctorPublished: March 04, 2008 My patient had come for a routine doctor visit. He was a well-built, soft-spoken middle-aged man who was always polite, respectful and adhered meticulously to his HIV medication. He complained only if he was in a great deal of pain or discomfort. […]

How I Learned to Treat My Bias – Washington Post

Published: April 15, 2007 At our hospital in Tennessee not long ago, I saw my picture on the hallway message board alongside those of other doctors in a display thanking us for our service. My Asian-Indian complexion set me apart — it’s something that I am rarely conscious about in everyday life. It got me […]