Doctors-in-training punished when sick →

We go to the doctor when we are sick. But what happens when doctors get sick? Who cares for them? All too often, physicians are threatened, harassed, even terminated for being ill. After reporting on a psychiatrist fired for having cancer and a pediatrician bullied for her brain tumor, I’ve heard from many more physicians who are now courageously stepping forward to tell the truth. In their own words . . .

Andrea Seiffertt DO

Andrea Seiffertt, D.O.  

I got a migraine with aura on NICU [Newborn ICU] call. I literally couldn’t read the orders and had to call over my resident, and tell her I had to lie down in the next 10 minutes before the pain hit or I’d be unable to work later. They left me alone for a few hours, grumbling. After I’d slept a half hour or so, they said, “examine this new one” and pulled me half asleep to a cold, turned-off open warmer with an unwrapped baby inside. He had gastroschisis [birth defect of abdominal wall in which baby’s intestines are outside of the body] , and I didn’t in the first moment realize he had already died, and wasn’t given any history or story, just handed the form. My impression was only of his perfect and sweet smaller-than-term face, his ruined middle, and how he was blue and cold and too stiff, with amniotic banding on one arm and leg. After that first second I realized what had been done to me, and was horrified and tried hard not to cry. That was the only moment of serious hazing I ever experienced.

Dario Lizarraga MD

Dario Lizarraga, M.D.

I’m a family medicine doc and during one of my OB/gyn rotations I came down with pneumonia. The OB attending refused to let me leave. I was running a fever of 104 so they just gave me Tylenol and put an IV in my left hand to keep me hydrated between deliveries. I would just double glove to protect myself. As the night wore on I became worse and my own family medicine attending saw me and proceeded to give me Phenergan IV and told the OB attending that I couldn’t work anymore. She called my wife to pick me up and take me home. If not for that one act of kindness I would have had to stay and deliver babies while sick and the go to gynecology clinic the next morning working a 30-hour shift. The next day, I saw my doc who prescribed antibiotics. My OB attending was so furious that I had extra work to do the rest of my rotation. 

Anna Hollenbeck

Anna Hollenbeck  

After my emergency C-section, when my son had gone into fetal distress after getting caught, and they ripped apart my abdominals, they had to carry me, bleeding, up and down 4 flights of stairs to attend school because I’d be failed if I didn’t show up. I shouldn’t complain, though. There was another student a few years back with an aortic dissection and half of his internal organs lost blood supply and had to be removed. The school was kind enough to allow him to continue his opiate pain medication while attending classes. Eventually, he ended up dying. All of these events seem almost surreal.  Medical education is cruel… 

Susan Haney MD

Susan Haney, M.D.

I had a meningitis (proved by spinal tap and hospitalized for 3 days during my second year of residency). Subsequently developed some depression, worsened by the fact that I initially complained about my residency program requiring me to “pay back” the 3 days of work I missed while hospitalized (to work 3 extra shifts on my days off). I complained because I was contractually entitled to sick leave. These were the only 3 days of work I missed over a total of 5 years of residency. In return for complaining, I was told a couple of months later that someone had noticed my attitude had changed (it had) and my knowledge base was deficient (it was not). I was asked to submit to a random urine drug test (which of course I passed). I told my residency director that yes, my attitude had changed—I was depressed about how the program was treating me—and that I agreed I would benefit from some counseling (which I arranged for privately, without further interference from my program). The following month, I tested in the 98th percentile nationwide on my residency in-service exam (higher, in fact, than any other resident in my program). It turns out that my perceived “knowledge gap” was real: I knew more about Emergency Medicine than some of my upperclassmen. When test results returned, their criticism stopped.

Lane B MD

Lane Baker, D.O.

In med school I had viral meningitis during a 4-week rotation at the place I wanted to do my residency. Week two I had a pounding headache, fever, intense neck pain. Tried to work through it with Tylenol. I may have mentioned it to some of the residents, but if I did I downplayed it. The start of the third week I was barely holding it together. I was a first assist on a C-section and had about a 102 fever and dripped sweat into the patients open belly. At this point they were concerned and also pissed. I was sent home until medically cleared. The disease got worse from there, BP 79/30 tachycardia. Well a spinal tap later some fluids and tampering with the bp machine I avoided their recommendation of ICU admission and went home. I took the remaining week and the next off but started the next rotation on time. Had to make up the two weeks at the first place over summer break. I felt the main “lack of support” is the whole environment of “do not seek help.” If you do you will be looked down on as weak and unworthy. My attending told me he worked until his appendix burst and he collapsed. This was given as an example of a “good work ethic.”  In residency I had Guillain-Barré. Not horrible I never had to be on a ventilator. I could not use my hands as they were nearly paralyzed. Walking I would have to lean to get momentum and even then it was difficult. Chief resident joked and “called” that he gets to intubate. They were trying to figure out how I could take call if I was any worse. I took no time off during that illness, again viewed as weak if you did. Damn I was just thinking I also had a mental health issue—depression mainly and anxiety. Here is the help I got for that: after morning rounds and lecture I was told to go into a room and make zero stops. I was met in the room by my superiors who said, “You have been acting different and have been reported by a nurse for acting not like yourself. We are going to follow the impaired physician protocol. You are to leave the premises now. Go from here to this address and do a urine drug screen. From there you will submit to a psych evaluation. If you refuse you will be suspended and sent home and possibly terminated.” I didn’t feel much support. By the way, no drugs. My diagnosis: depression and anxiety.

Michelle Catena MD

Michelle Catena, M.D. 

One of my classmates was dragged by a bus. A second was struck, flipped, left on the road in a hit and run when crossing the street. Our med school had people taking attendance by the number on the back of your chair. The first person had to be in her seat, scraped, bruised, bloodied, in pain. The second had to get special permission to be absent while admitted to the facility hospital. They wanted him in his seat to take tests and then return to the hospital. He was finally allowed to take his tests in the hospital.  Even my residency program director did not allow anyone to be absent for illness. It’s a disgrace. A severely ill student missed a few weeks. She was forced to repeat and ended up leaving. My tale of having severe food poisoning the night before a final and not being able to take the final at another time is trivial in comparison. I was pretty much passed out and delirious taking this final. But if you don’t show up, you are automatically failed.

 

Is this how our doctors should be treated?

Pamela Wible, M.D., reports on human rights violations in medicine. She is a practicing physician in Oregon where she hosts physician retreats to help doctors heal.

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Goat yoga for blood pressure? Doctors say yes. →

What if you could get off your blood pressure meds with a daily dose of goat yoga? New study released today confirms you just may be able to do that. Follow me on an investigation of the health benefits of this trendy exercise.

Goat Yoga 1

To study the effects of goat yoga on the human cardiovascular system, I headed down the road to meet Lainey Morse, the goat yoga lady who started it all. With 700+ people on a waiting list, she invited the first 25 to her field on this beautiful autumn day.  A reporter even stopped by to cover the event for The New York Times

Goat Yoga 2

Of the yoga students who were present, 6 chose to participate in our study. I measured blood pressure, pulse, and oxygen levels before and after one hour of goat yoga. Everyone was really happy to be there!

Goat Yoga 3

The goats welcomed us all to their pasture. Some nibbled on yoga mats and water bottles. Others snuggled with guests. One baby goat started nursing on our instructor’s mat. Be warned: you may have to wipe goat pellet poop off your yoga mat. 

Goat Yoga 4*

After a day at the office nothing beats stretching in a field of goats and breathing the crisp Oregon air.

Goat Yoga 5

Plus after class you get to hang out with your new furry friends and take selfies with goats!

Goat Yoga 5

I repeated blood pressure, heart rate, and oxygen levels. Even The New York Times reporter participated.

Goat Yoga 7

Results: though one student was diagnosed with hypertension, she and all the others benefited from the antihypertesive effects of goat yoga. Average systolic blood pressure reduction: 10 mmHg. Average diastolic blood pressure reduction: 7.5 mmHg. Average pulse reduction: 6.1 bpm. In fact, goat yoga offers more cardiovascular benefits than many prescription medications. Doctors may now recommend goat yoga as first-line therapy for hypertensive patients.

goatyogaresults

Got high blood pressure? Check with your doctor to see if goat yoga may be the right treatment for you.

Goat Yoga 8

Pamela Wible, M.D., is the author of Pet Goats & Pap Smears. She is a practicing family physician in Oregon where her patients actually bring their pet goats to medical appointments. 🙂

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Doctor-in-training forced to work during miscarriage →

Another doctor speaks out on the inhumanity of medical training. 

“We don’t get time to recover our own health issues and when I was in residency there were 2 separate [occasions], I remember the day in the ER. I actually had to tell my colleague, ‘I’m sorry if I’m a little emotional because I’m miscarrying today as I’m going through my shift.’ And that happened actually on 2 separate occasions and it was just kind of considered the norm. And that I guess is what I was just going to say. That it’s unusual that you don’t even get a moment to sit down or something. It’s just—you just deal with it.”

When asked for her call to action, she replied: “I want to say, ‘F*ck you. I need to rest of the day off!'”

Outraged? Have a similar experience? Please share your story below.

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Pamela Wible, M.D., reports on human rights violations in medicine. Struggling? Need help? Contact Dr. Wible. Filmed at Breitenbush Hot Springs physician retreat. Video by Geve.

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Dying med student forced to study with chest cracked open, no hair, no voice, in extreme pain—so he could get a residency →

Pamela, 

I just lost my study partner this morning to cancer. I love him too much to share everything he went through publicly. Maybe he can live on through your blog. 

He was diagnosed with cancer last summer. Had a softball-size tumor taken out of his lung, started chemo and went through hell. The pictures of him are horrifying. He came back to school because another leave of absence may have prevented him from getting a residency. He was beautiful and now he’s gone.

Our med school doesn’t let students recover from accidents or medical conditions without failing them for attendance or making them repeat the term—even though they have A’s. They are abusing the shit out of our class. One of the happiest guys in our class just told me he has been depressed all year. My lab partner, the sweetest human on the planet, tells me she cries in the shower every night.

Now an incredible human is lost. We are all in mourning. Instead of taking care of his body he came back to finish. Please do not share the name or picture, but please share his memory and love for healing. Medical school was more important than his own life. I’m so distraught, angry, and crushed that the system is run in such a way that we can’t get cancer.

After I read your article about a young surgeon who was dismissed from her program when she became ill, I realized you can’t get sick during medical training or this huge investment is taken away. It’s counterintuitive and heartbreaking. This story proves the pressures of residency. Great future doctors choose to continue school rather than fully recover in order to fulfill the timeline in which we must finish. 

It wasn’t a suicide but it kind of was. He should have been home getting treatment. 

I wish I could share more. But he wouldn’t want to be remembered as a victim or as being weak. That is the person he was. Don’t get sick in medical school.

He was here with his chest cracked open, no hair, no voice, and in 10/10 pain. Studying next year’s classes so he wasn’t behind.

~ Chris

P.S. He sent me this in January.

 

Medical student with cancer

 

Facts: A medical school diploma does not allow you to work as a doctor. A residency position is required. In 2016, 35,476 medical school graduates applied for the 30,750 residency positions. That means 4,726 did not match. What happens if you don’t get a residency? Here’s one doctor’s story: I’m a doctor. I’m on Medicaid. I work as a waitress.

Outraged? Here’s how you can help:

Sign this petition to support Dr. Svetlana Kleyman’s return to school.

Support Dr. Stephanie Waggel who was fired for having cancer.

Pamela Wible, M.D., reports on human right violations in medicine. She is a practicing physician in Oregon where she hosts biannual retreats for physicians and medical students to help them heal from their trauma so they can be the healers they were born to be.

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Do flight attendants treat heart attacks? 10 things to know before an airline emergency. →

Airline Emergency

Man collapses at 30,000 feet. Quick, who’s in charge? Hint: it’s not the doctor. Last month, Dr. Tamika Cross was told to sit down when she tried to help an unresponsive man. Why? Apparently the flight attendant was looking for an “actual” medical doctor, not a black woman. Turns out she’s not the only doc making headlines for being turned down in a medical crisis. What in the world is going on up there? I interviewed pilots, flight attendants, and physicians to find out. Here’s what I discovered:

1) A sick passenger can cost an airline $100,000—or more. Think transoceanic diversion to nearest city. Hundreds of grumpy people. All need hotels, meals, new flights. Plus there may be a dead guy on board, a legal investigation, and relatives to notify.

2) Medical kits may be unstocked. Should all FAA-approved flights have oxygen, epinephrine, a functioning defibrillator? Yes. Do they? Not always.

3) Flight attendants are underpaid. Guess how much these smiley greeters are paid to get you blankets, pillows, and help you to your seat. Nothing. They only get paid when the plane is moving. Average starting salary: $18 per flight hour. Yep, they eat airline food, get jet-lagged, and deal with rowdy passengers, terrorists, and medical emergencies—all for $18 per hour. Shocking fact #2: a couple of young pilots told me they also started at $18 per hour. Hauling hundreds of humans at 500 mph. For big bucks pilots fly FedEx cargo. Hauling envelopes.

4) There’s no place to put your body. No gurney. No exam room. No convenient spot to lie down. So you’ll be on the galley floor (like both people I treated on planes).

5) You will disrupt drink service. Not only will your medical crisis be viewed by a bunch of gawkers with cell phones, you may piss off the crew who can’t wheel the snack cart over your body. Trust me. You will be in the way.

6) Flight attendants have limited medical skills. With just a GED or high school diploma, 3-8 weeks of flight training, and some CPR, these folks are handling medical catastrophes in the air. So, yes, the gal who poured your Pepsi may be treating your heart attack.

7) The flight attendant picks your doctor. If three docs respond to the call for help, how do they choose? Pilots, physicians, and passengers agree—pick the most qualified. Can a flight attendant actually judge the skills of an ob/gyn chief resident, an infectious disease fellow, and a retired rheumatologist? Maybe that’s why 70% of flight attendants told me they take the first person who shows up. Unless implicit bias selects the white guy over the black woman who arrives first.

Pamela Wible Airline Emergency

8) The best doctor may be buzzed. Do we go with the sober rheumatologist or the chief resident post-Kahlua? Maybe the best doctor is a Muslim ICU nurse (they don’t drink).

9) Crew may obstruct care until doctor shows “credentials.” Docs don’t carry pocket-sized diplomas, yet crew must see credentials before accessing medical kits. Do you really want a doctor ruffling through her carry on for a hospital badge while you’re on the floor?

10) The doctor may still get sued. Liability varies by country. While the Good Samaritan law “should” protect you in the USA, nothing prevents a passenger (or next of kin) from calling an attorney. Some airlines offer indemnity but only if the crew initiates the call for help (not if doctor proactively offers). Given poor medical outcomes in the friendly skies, do you think the average doc wants to absorb all that liability

Frankly, I’m amazed anyone volunteers at all—and actually makes it to the passenger in time. How can two highly regulated industries intersect in such chaos? And what’s the fix?

Besides the obvious (stock medical kits), here’s my advice: 1) Mandate diversity training for crew—led by black female physicians. Contact Artemis Medical Society to schedule. 2) Prescreen for medical credentials. Lufthansa does this. Model what works. 3) Allow medical professionals to assemble themselves. Health care is a team sport.

One final request: please thank any doc who willingly stands up to implicit bias, grabs a half-empty medical kit, and risks personal liability (while on vacation) to save your butt—for no pay!

Now who thinks our medical professionals should board first along with active duty military?

Addendum: Thrilled to announce that as a result of these courageous docs stepping forward, Delta airlines has changed their policies.

Pamela Wible, M.D., is a physician who reports on human rights violations in medicine. Have a story? Contact Dr. Wible.

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