Omicron. It is really changing everything about the not-so-roaring 20’s COVID experience. With this new variant, we now live in a different world than we did only a few months ago. However, we still haven’t allowed ourselves to really believe it. We are still talking about the need to test more, quarantine more, and even continue to go remote with some schools and work. Pessimistic pundits are predicting a large number of future deaths. Sure, people are still getting sick, and hospitals are busy, but we can also reliably predict that virus prevalence is soon going to drop precipitously and the ..read more

I have heard more than one person in the hospital comment that maybe it wouldn’t be so bad if people who actively oppose getting vaccinated from COVID-19 just get sick and die. Then no one would have to listen to them anymore. Those are pretty harsh words and obviously not meant to be interpreted literally, but it’s clear the COVID-19 sympathy train has left the station. Becoming critically ill from COVID-19 is now officially a preventable disease. The mRNA vaccines are one of the great achievements in medicine of the last century. Their effectiveness is tremendous. Are they perfect? No. Peopl ..read more

The other day, I received my vaccine against COVID-19 – a novel mRNA vaccine that will without hyperbole likely someday prove to be one of the greatest achievements in human history. As I look at social media, I see a deluge of my colleagues posting selfies or photos of themselves receiving the vaccine. Many of them describe the relief, the liberation of burden, and the tears of joy they felt as they got injected with liquid hope. A few hours after my shot, I felt a noticeable muscle pain in my arm. But I can tell you, the pain felt good. I actually relished the pain. It represented the beginn ..read more

So let’s get one thing out of the way: I am no expert on anything related to the African American experience. I am not even well read on the history of race relations in the United States. I am a white male. The closest I am to “ethnic” is sometimes people mistake my name as having Argentinian roots instead of Italian. When I was in medical school, almost from day one, patients would assume I was the guy in charge. Someone told me my first day on the wards that I looked “young for someone who has accrued so much knowledge.” In the hospital and frankly in most areas of life, my race offers me t ..read more

I want so badly to write something hopeful. I wish I had some inspiring words that could make us feel like everything is going to be ok. I see the trepidation slowly enveloping my heath care colleagues- fear of the storm that is about to hit in Los Angeles. I want to rant about the ridiculous fact that we don’t have enough masks or gowns, or COVID tests, or ventilators. I want to rage about the lack of political will to pay the draconian price it will cost to arrest this viral attack. I could go on about the United States cultural valuation of individual exceptionalism and how this worldview h ..read more

So yesterday I went to an ICU meeting about the impending COVID-19 explosion sure to hit the hospitals en force in Los Angeles in the next week or so. I think I now know what it must be like to be told you are about to be deployed to a war zone. It is without a doubt going to be the worst medical disaster I will see in my medical career. I have no doubt we will be overwhelmed, our standard of care for our patients will drop, and people will die in the next few weeks who may not have died a month ago. Many of those will be people who do not actually have the coronavirus, but fall through the cr ..read more

So the first thing to understand is that the novel COVID-19 coronavirus is not the zombie apocalypse. The fate of the human race will not be left in the hands of an elite team of exceptionally good looking epidemiologists who traverse the globe in search of life saving antibodies residing in the blood of a specific Wuhanese bat. The novel coronavirus is probably more comparable to a very bad flu…and unfortunately, whether you realize it or not, that means it is very serious. Generally our ability to assess risk kinda sucks. It is why we tend to spend our days worrying about our children gettin ..read more

It was my first day of my first rotation of my third year of medical school. I was starting a month of inpatient pulmonary medicine. One thing was certain- I had absolutely no idea what I was doing. I arrived in the morning with a squeaky clean, perfectly pressed short white coat- its multiple pockets overflowing with pharmaceutical branded pens compiled from drug company sponsored lunches, a library of miniature medical reference handbooks, and even a tuning fork- a diagnostic tool used so infrequently in internal medicine, I was instantly mocked by the intern on service for even bringing it ..read more

Sometimes in an ICU, a patient transforms in front of your eyes from a human being undergoing aggressive treatment with hope for recovery, to a human body kept marginally alive by machines and medications in a futile prolongation of the death process. As a critical care doctor, my role is to judge when that transition has taken place and explain this morbid situation to the patient’s family and loved ones. These conversations, for me, are the most difficult part of practicing medicine- not because I have difficulty explaining or talking with families. I don’t. But because with each one of ..read more

One day, you may find yourself at a Friday evening dinner party with a group of random acquaintances and the seemingly never ending humdrum of polite boring conversation slowly starts to overwhelm you with apathy for your fellow dining companions. You dig deep to muster the strength to sip your appletini and snack on your carmelized brussel sprouts, diligently counting the seconds until you can go home and watch reruns of CSI Miami.  You then find yourself inspired with a crazy thought: Instead of acquiescing to a wasted night out, filled with uncontroversial soporific banter, you conside ..read more