There’s a strange phenomenon that appears when building safety-critical AI systems. Ask an AI to report information only from a verified database, and it may sometimes fabricate a source—not to deceive, but to protect. This is the “Helpful Liar” problem. And it reveals something important about how modern AI actually works. A dilemma with noContinue reading “The Helpful Liar: What AI Teaches Us About Conflicting Values”
Category Archives: Practice of medicine
The Future of Medicine: Why Human Connection Will Define Medical Excellence
It’s inevitable that patients will increasingly turn to AI tools like ChatGPT to research their symptoms before visiting their doctor. This shift represents more than convenience—it’s fundamentally leveling the playing field between medical experts and patients. With AI effectively putting advanced medical knowledge in everyone’s pocket, patients are arriving at appointments more informed than everContinue reading “The Future of Medicine: Why Human Connection Will Define Medical Excellence”
La médecine d’urgence, le traumatisme indicible…
J’ai commencé à pratiquer la médecine d’urgence le 1er juillet 2000. Je sortais tout juste de ma résidence en médecine familiale. Rempli d’optimisme, alimenté par la passion, mû par la compassion, j’aimais vraiment ce travail. J’aimais tellement mon travail que je me souviens avoir regardé la série télévisée ER pendant mes jours de congé. JeContinue reading “La médecine d’urgence, le traumatisme indicible…”
Emergency medicine, the untold trauma…
I started practicing emergency medicine on July 1st, 2000. I was freshly out of my family medicine residency. Filled with optimism, fueled by passion, driven by compassion, I truly enjoyed this work. I loved my work so much that I remember watching the TV series ER during my days off. I became my work, andContinue reading “Emergency medicine, the untold trauma…”
Why I did not go into psychiatry 25 years ago…
“The problem with modern psychiatry… You’re sad, you fit the DMS-V criteria for depression, let me prescribe you an anti-depressant, I’ll see you again in 5 weeks and we’ll make eye contact”. – Paul Conti This morning, I listened to Paul Conti and Peter Attia’s discussion on trauma “How to heal from trauma andContinue reading “Why I did not go into psychiatry 25 years ago…”
On being an inspirational teacher
Having the privilege to teach clinical communication to doctors, I spend a lot of time thinking and reflecting on what makes a good teacher. In meetings with my group, we spend a lot of time polishing our powerpoints and presentation skills. I get how important it is. Good content delivered by a good presenter willContinue reading “On being an inspirational teacher”
COVID Omicron and our healthcare system…
I was in the hospital elevator this morning with my little surgical mask and three people. I realized that the network will struggle with an aerosolised virus that passes through masks without difficulty, infects vaccinees without problems and is frequently transmitted from an asymptomatic person. The crisis in the network will be, in part, aContinue reading “COVID Omicron and our healthcare system…”
On saving healthcare…
Every day, I read, see and hear news about our healthcare system. Every day, I talk to patients and doctors. I have come to see that we all want the same thing: better care. And yes, when I say “we,” I did not forget the other people too… nurses, therapists, social workers, managers, clerks, cleaningContinue reading “On saving healthcare…”
Our values embodied in a morning meeting at the office…
Once in a while, I invite people who make my work possible to share a meal and discuss issues that come up in our work. The pandemic forced us to take a two-year break from this habit and I am happy that we are starting to resume what is looking like to a new normality.Continue reading “Our values embodied in a morning meeting at the office…”
17 years of emergency medicine…
After discussing this morning with a colleague, I feel the need to share this text that was published in December 2017 because it is still relevant. It was originally written in French and translated using Deepl so there might be a few mistakes.. “To all my colleagues, I’ve been working in the emergency room forContinue reading “17 years of emergency medicine…”
On self-care in healthcare…
Self-care is not selfish. Let me explain why. Self-care is a means to ensure that one gives from a place of abundance so that our work is sustainable long-term. When our physical, cognitive, emotive and social batteries are full, giving our time feels right, and we resonate positively with the work we do, making ourContinue reading “On self-care in healthcare…”
Jillian Horton’s We are perfectly fine… a short review
Horton offers an inside look at the life of a Canadian doctor, filled with the struggles, the doubts, the occasional guilt… I appreciate her dark humour. In the end, she is a lot of what medicine lacks: open honesty. We, doctors, are good at treating diseases, alleviating suffering, listening and holding hands… but, sadly, weContinue reading “Jillian Horton’s We are perfectly fine… a short review”
On positive business practices…
There is a lot to learn from big companies embracing the “wellness mindset.” Watch this great 3 min video: Stamps.com promoting positive business. There is a lot of literature supporting the idea that happy employees make happy customers, which is good for the bottom line. When we care about human beings’ needs and treat peopleContinue reading “On positive business practices…”
Peter Attia on Covid vaccine…
I love this guy. He’s intelligent, rational and he explains well. If you want the short version, skip to 43:20 where he explains that if we vaccinate 1,000,000 people with the AstraZeneca vaccine, 1 person will die from the vaccine whereas 2000 people will avoid death from Covid. Impressive results. Listen on Spotify here
On real vs perceived danger…
Most of my family and friends have or will soon receive their Covid-19 vaccine. Most of them got a shot of Astra Zeneca’s vaccine. Everyone is well and healthy. I am relieved. Rationally, this image explains well the odds and helps us make a decision. Unfortunately, this image does not speak to our emotions, toContinue reading “On real vs perceived danger…”
When caring means burning out…
A story about the sacrifice health care workers make every day. Here is a powerful excerpt. I encourage you to read the entire article. « For many health-care workers, the toll of the pandemic goes beyond physical exhaustion. COVID-19 has eaten away at the emotional core of their work. “To be a nurse, you reallyContinue reading “When caring means burning out…”
On doubt and intelligence…
“A fundamental cause of the trouble is that in the modern world the stupid are cocksure while the intelligent are full of doubt.” —Bertrand Russell
Be fast…
“Be fast. Have no regrets. Be coordinated. Be coherent. Be the first mover. Be prepared. One of the great things in emergency response : if you need to be right before you move you will never win. Perfection is the enemy of the good when it comes to emergency management. Speed trumps perfection. One ofContinue reading “Be fast…”
One last word…
Some evenings are like this in the emergency room, filled with so many stories, so much pain that time flies and I forget to eat. Tonight is not busy, it’s hectic. I barely have time to think. I flow from one patient to another, hearing stories, listening to heart and lungs, ordering tests, prescribing treatmentsContinue reading “One last word…”
The time to live, the time to breathe…
I just woke up from a post night shift nap. I worked 2 evening shifts in the emergency room. Although being an emergency doc is not my primary work now, i still love the unique atmosphere created in the resuscitation room. The people who work in the emergency room, i love even more. They areContinue reading “The time to live, the time to breathe…”
A time to live, a time to breathe…
I just woke up from a post night shift nap. I worked 2 evening shifts in the emergency room. Although being an emergency doc is not my primary work now, i still love the unique atmosphere created in the resuscitation room. The people who work in the emergency room, i love even more. They areContinue reading “A time to live, a time to breathe…”
Being mortal
Medicine and what matters in the end. Great book. There is nothing more to say.
Sleepless nights in Puvi…
Yesterday at 9:00, I enter Puvi hospital I start doing rounds on the department. It’s a quiet morning, i know the patients well. I assess a few new patients during the afternoon. I receive a call for the transfer of a young man in respiratory distress from a village. I accept the transfer but theContinue reading “Sleepless nights in Puvi…”
Emergency room stories of life and death…
Working in the emergency room is sometimes like dancing with life on the edge of a precipice. Our work is hard. We deal with the suffering, the pain, the cries and the tears every day. But this work is also full of rewards. It gives us an uncommon resilience and an understanding of life. IContinue reading “Emergency room stories of life and death…”
Another emergency room story…
It’s a quiet friday night and i am covering the resuscitation room. We get a paramedic pre-alert advising us that they are en route with a 38 year old man in acute respiratory distress. When we hear his vital signs, i tell the nurse to get ready, call the inhalotherapist and prepare the intubation drugs.Continue reading “Another emergency room story…”
Martin Pham Dinh 