Category Archives: Practice of medicine

Do you know what ROSC means? This is the reason we work. It means Return Of Spontaneous Circulation. It means that someone was dead, without any circulation and came back to life. This is beautiful. A rare miracle that we got to enjoy on this Christmas day. For this to happen, one must have aContinue reading “The ER on Christmas evening or the magic of ROSC…”

A lady comes to see me in the emergency room with tears in her eyes. I have just hospitalized her mother in palliative care and I took the time to call her to tell her the news, her mother’s decision, her condition, her expected death soon. So she went to her bedside. She told me:Continue reading “How sometimes we touch other people’s life…”

Another busy shift in the ER brings another series of surprises.  Such is emergency medicine, filled with the unexpected…  This man i saw yesterday with abdominal pain, he feels much better this morning but i must tell him that his pain, it’s not his gallbladder stones, it’s cancer, terminal metastatic, inoperable cancer. He is inContinue reading “Another dance with death…”

It’s a regular day in the emergency room. I’m covering the resuscitation room again. In comes a frail 91 year old lady, brought in by ambulance. She is out of breath. She looks bad. Her oxygen saturation is in the low 80’s. That is usually an omnious sign. Impending death unless treated. In 15 yearsContinue reading “When caring means letting go…”

To be truly good in my job as an emergency physician, i must not deny the emotions, i must accept them. I must feel the pain and sadness of others. I can be fearful as i keep going because there is often no choice but to go on. When someone is dying, there is oftenContinue reading “In the face of pain and suffering…”

The other day, a 57 year old man with a temperature of 39.9 accompanied by severe breathing difficulties, coughing and sputum was brought into the resuscitation room. His saturation in the ambient air was 69%. His heart rate was 137. His blood pressure was 88/55. Diagnosis: sepsis on pneumonia. After a bolus, a good doseContinue reading “The pill pusher”

I met a patient who tells me he is into natural medicine. He takes a dozen different pills from his naturopath from echinacea to garlic with an added homeopathic drop. He thinks the pharmaceutical drugs are toxic. Big pharma are evil. Doctors are just pill prescribers. Those with long hair, 70’s hippie look who don’tContinue reading “On incoherence..”

I have been teaching medical students and residents for over 10 years. I love passing on my knowledge and sharing my expertise. I am an expert in my field. I have not received any training in pedagogy but I often think about the qualities needed to be a good teacher. An important question in thisContinue reading “Pedagogy or expertise?”

I am a man at the intersection of arts and science. An intellectual man can be great at passing tests and get through diplomation and become a doctor but he will never be a good doctor if he does not put care, warmth and empathy in his bedside manners and human relations. A good doctorContinue reading “At the intersection of arts and science…”

A story about the sacrifice health care workers make every day. Here is a powerful excerpt. I encourage you to read the entire article here. « 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, youContinue reading “When caring means burning out…”

(Nov 6th 2013) I faced death today. The death of a small baby. He was in respiratory distress. I’m an emergency physician and currently working in a very very remote area of Northern Quebec. We had to resuscitate him, intubate and ventilate, do CPR, give him resuscitation meds.I was in an hostile environment, without myContinue reading “On fear and courage …”

Lying on a stretcher in the resuscitation room. The emergency department is quiet. I have seen all patients. Trying to catch a few minutes of sleep before the next round. Unable to sleep. Thinking. Looking at the ceilings, monitors, defibrillators. Pondering about how it must feel to be lying here, not to sleep but toContinue reading “Resuscitation room at 4h00 am…”

I’m a privileged witness in the last moments of many people. Medicine is sometimes great at relieving suffering but it can also be great at causing unnecessary ones. There is a time to fight but there is also a time to let go. Almost every day, i talk about death with patients. Often i offerContinue reading “On the end of life moments…”

The night shift in the ER is always rewarding. While some sleep and others dream, we treat the sick, the dying, the crying febrile babies, the drug addicts, the crazy, the elderly. We replace broken bones, close wounds, remove foreign bodies from unsual places. We sometimes cure but we always struggle to alleviate pain. TheContinue reading “The night shift”

Recently, i had a patient die on me. This is often happens to me, almost daily. But this one was different, it was a fast inevitable death in an otherwise healthy looking lady. She was an elderly woman who came in with a deadly condition called septic shock. She died a few hours after beingContinue reading “Live and let die”