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The Lord of Medicine

September 22, 2019
by Mark David Siegel

Hi everyone:

If I were Lord of Medicine, here’s what I’d command:

  1. Stop unnecessary oxygen. Start oxygen when patients are hypoxemic and turn it off when they’re not. Excess oxygen kills.
  2. Put your stethoscope on the patient’s skin. Only amateurs listen over gowns. Cotton and crackles sound alike.
  3. Don’t just do something, stand there. Think first. Effective medical care starts in your head.
  4. Proofread your notes. Chart errors can be deadly. Read before you sign.
  5. Document all patient encounters, however minor. Explain what happened overnight. Don’t make people guess why you gave fluids, ordered a CT, reversed the patient’s code status, etc.
  6. Talk to your consultants. They’re smart. If you disagree with what they say, call them. Better yet, invite them to rounds.
  7. Ask questions. You don’t know everything. I sure don’t. Learn from the brilliant people around you.
  8. Follow the Kantor rule. If something happens to a patient after you did something to them, it’s probably what you did to them that made it happen.
  9. Be concise. Meandering notes are unreadable. Medicine is complicated enough. Keep it simple.
  10. Be humane. Comfort your patients. Be a mensch. The rest is simple.

I could add more, but “10 Commandments” sounds about right…

Enjoy your Sunday, everyone. I’m off to the MICU for the last day of a spectacular rotation,


Submitted by Mark David Siegel on September 22, 2019