Goals Of Care, Family Meetings, And The 80/20 Rule

Surprisingly, in my past month in the intensive care unit (ICU), I spent more than half the time talking to family members about goals of care. In a previous post, my attending had a great quote about survival in the ICU. If one-third of your patients survive the ICU stay, you’re doing hall of fame work. So if only one-third of patients are surviving on a good day, then why am I spending most of my time speaking to families about goals of care? Shouldn’t I be spending more time treating the patients?



“20% of our efforts leads to 80% of our results.”


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Too Much Xanax, Depression, And What To Do About It

The other week, I had an 18-year-old guy who came in unresponsive after overdosing on Xanax and Tylenol. We stabilized the patient, and when he woke up, I asked him why he did it. He told me that he was just doing some dumb stuff with friends. However, when I asked the father later, he told me his son has been more depressed lately and attempted suicide just last month by cutting his wrists. They didn’t seek help at the time for a variety of personal reasons, and it’s fortunate that the patient’s suicide attempt failed the second time. Fortunately, I haven’t seen a lot cases like this at my hospital, but still, he was so young. The patient had so much to live for.

Sunset in 2012 from my medical school campus, St. George’s University.

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Look Down A Trachea And Succeed With A Growth Mindset

In the ICU, we had to perform a bronchoscopy on a patient to rule out excessive bleeding in the lung. It might have been my attending who was in a good mood or the fact that I was just sitting at the computer responding to WordPress comments, but whatever it was, he asked me to do the bronchoscopy. For those of you who don’t know, a bronchoscopy is a procedure where you take this thin tube with a camera at the end of it to visualize the inside of someone’s airways. The procedure looks like this. Gross, I know. I’m not much of a procedure person, but as I was standing there holding the scope in my hand and looking down this guy’s trachea, I came to a realization. Bronchoscopy is a type of endoscopy, and endoscopy means to look inside.


Bronchoscopy (Courtesy of WebMD)

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Chronic Disease and How to Influence Others

One of the greatest assets of the human race as a whole is our ability to communicate with each other. This ability allows us to exchange great ideas, solve difficult problems, and express various amounts of emotion. In this post, I’m going to talk about how to communicate and a 5 step formula on how to win others to your way of thinking.


Misha convincing me to walk her more.

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Hemodynamic stability and my Top 3 Strategies for dealing with emotions

I just got into an argument with Kari last night. It was over cleaning the house for our Airbnb guests coming in for Coachella weekend. After the fight, I just sat there at the dining table fixated on why she wouldn’t clean the room. A couple of hours later I finally got up from where I was sitting and started cleaning the place.


We all know that petty arguments are often unnecessary and unwarranted. Not only do we end up sleeping on the couch after arguing, we lose time, productivity, and energy! Today, I’m going to talk about separating emotion from the problem and my top 3 strategies on how to deal with our emotions.

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