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Showing posts from June, 2012

Have you lost the ability to be professional?

What does it mean to be a professional? And how do we maintain our professionalism at a time when things such as stress, burnout, and caregiver fatigue can degrade our motivation?

In medical school, you learn early that one of the best ways to remember important information is to attach an acronym or phrase to complex concepts. Thus, I came up with the Professionalism APGAR. You may be familiar with the APGAR scoring system if you have either trained in healthcare or have had a baby. Named after Virginia Apgar, it is an assessment of infant wellbeing performed one and five minutes after birth. I learned to remember the scoring system by applying the terms Appearance, Pulse, Grimace, Activity, and Respirations to the name. As you can guess, a wiggly, crying baby scores well on the APGAR, while a limp, hypoxic baby does not and thus immediately gets advanced resuscitative care.

I'll bet you think you would score perectly on my Professionalism APGAR, b…

Disability: Know when to hold 'em, know when to fold 'em

(Courtsey of While I have been feeling healthier and stronger than ever, I was reminded about disabilities recently... about my own and about how we all have them to some degree. I recently underwent an ACTH stimulation test to see if my body is doing any of its own signaling to cortisol, the important stress hormone. Although too much cortisol is bad, too little or no cortisol is life threatening. Remember the Hans Selye quote, "Stress is the spice of life. Complete freedom from stress comes only in death"?? Well, at this point I am still dependent on exogenous cortisol (in the form of hydrocortisone pills) to continue living life. It's a disability that, while very manageable and honestly not too... disabling, could be very important information for others to know in certain situations.

A medical student approached me after one of my talks to ask how to handle clinical rotations given a recent diagnosis of a degenerative disease. This question g…