Cool Under Pressure

March 8, 2016

Cool under pressure. The best emergency physicians are cool under pressure. That was me – or so I thought.

One day this past winter, while stepping out of a shower, I noticed a small cadre of ants on the bathroom floor. These were not the big black carpenter ants from the back yard that were common in summer. No. These were those tiny brown ants. There were perhaps thirty of them reconnoitering below as I toweled off.

Kill ’em. A few minutes later I had laid out two bait stations that came from a bright orange box claiming that the poison inside would “kill the queen.” Beyond question, it must have been potent stuff if it could wipe out a whole monarchy. My war against the ants was on. Read the rest of this entry »


Practicing Medicine by Ear

December 15, 2015

My grandmother was an aspiring mezzo-soprano opera singer in Italy before World War II. After the German Army was driven out of Naples, she met and later married an American GI, settling down in central Maine, where they started a family. Like many of the immigrants in the area, my grandparents worked in the local mills making everything from shoes to blankets. My grandmother never gave up singing and was renowned for stunning her coworkers with renditions of classic arias that rose above the rhythmic chatter of sewing machines and looms. I have rich memories from my childhood of Sundays with my Nonna. We would make fresh pasta and sauce together and her booming voice would saturate the kitchen with the melodies of her youth.

By comparison, my own musical career got off to a less impressive start. At times I “played” the piano, violin and even the recorder, all with little success. Then, quite by accident, I discovered vocal music. I had always liked theater, and when they needed singers for the school musical, I was cast in the show. From then on I was a singer, eventually landing a coveted spot in a summer supergroup of some of the best college a cappella singers in country. I accomplished all of this without formal vocal training or expertise in music theory. A childhood surrounded by musicians resulted in my learning to sing by ear. Without being able to read music, I could tell you what the next note would be because I knew which note “fit” the chord.

Looking back, my approach to clinical medicine in the emergency department, mirrored my early days in music: I practiced medicine by Read the rest of this entry »


It’s Time for a Tune-Up

May 19, 2015

If I’m to take fashion advice from Maureen Dowd’s March 3 column, “Stroke of Fate,” a take-down of emergency medicine disguised as a recovery narrative of her niece, then I should exchange my white coat for grease-stained overalls.

In her column, a Harvard neurology professor who specializes in stroke describes the brain as the Rolls-Royce of the human body. When it comes to acute stroke care, he is quoted as saying, “would you run your Rolls-Royce into the local gas station?”

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The leaf blower/CT scan quandary

December 14, 2014

To critics who admonish emergency physicians like myself for our excessive use of CT scans, I’ll ask them to consider the leaf blower. I’m sipping my morning coffee on our front porch, a bright, idyllic autumn day in New England, the tranquility ripped apart by the landscapers across the street. For many jobs, a powerful leaf blower might prove superior to a rake or broom. But in my neighborhood known for smaller yards, the humble rake and broom would work as well, if not better.

I’m not a leaf blower person. Raking my yard takes hours. It leaves my muscles knotted and hands calloused. Not so the speedy landscapers, nonchalant with technology strapped to their backs. Laughing and screaming over noise that assaults my eardrums, they bully grass clippings and leaves into a dancing cloud that swirls onto the street, often finding refuge on my lawn.

Why should the status of lawn detritus, or my serene coffee moment, concern them? They’re responsible for my neighbor’s lawn, not the yards nearby. And if leaf blowers improve the speed and perhaps the quality of their work, why wouldn’t they take advantage of the opportunity? Imagine the following argument from a landscaper-philosopher: “What is a leaf blower anyway but a push of air, like a strong wind? You have a problem with the wind?”

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