Global Health

My Interview with Atul Gawande

Atul Gawande is the preeminent physician-writer of this generation. His new book, Being Mortal, is a runaway bestseller, as have been his three prior books, Complications, Better, and The Checklist Manifesto. One of the joys of my recent sabbatical in Boston was the opportunity to spend some time with Atul, getting to see what an inspirational leader and superb mentor he is, along with being a warm and menschy human being. In my continued series of interviews I conducted for The Digital Doctor, my forthcoming book on health IT, here are excerpts from my conversation with Atul Gawande on July 28, 2014 in Boston. I began by asking him about his innovation incubator, Ariadne Labs, and how he decides which issues to focus on. Gawande: Yeah, I'm in the innovation space, but in a funny way. Our goal is to create the most basic systems required for people to get…

Ethics and Ebola

by Dr. Bartho Caponi MD, FHM The Ebola panic has died down; while many are under monitoring, there have been no further de novo U.S. cases since October 15, and only two more "imported" cases. Travelers are being screened and resources are heading to areas where they are needed. At my institution, Hospitalists have led the way; over half my division volunteered up-front to provide necessary care. I ended up in a lot of planning and policy meetings, where we internally crafted a comprehensive plan to deal with any Ebola-related eventuality. Nationally, the Centers for Disease Control and Prevention (CDC) have created many useful resources for people and institutions needing them. We now have guidelines for speaking to our children about Ebola and for taking care of Ebola-exposed pets, in addition to more trenchant issues. We now have "Ebola centers," hospitals capable of caring for suspected or confirmed Ebola patients…

Panic and Preparation

Things move fast in an outbreak – whether an outbreak of disease, panic, or both. A lot has happened since my last blog post. I wrote the last post just after Thomas Duncan became the first person to die of Ebola on U.S. soil, and nurse Nina Pham was infected while caring for him. In the past month, we have seen one additional nurse infected with Ebola, and both Amber Vinson and Ms. Pham have been discharged from the hospitals after clearing their infection. Some have cheered and others jeered as nurse Kaci Hickox has clashed with the governor of Maine over an imposed quarantine after she returned from Sierra Leone.  The number of cases has also crossed the 10,000 mark, with many more to come. Discussions continue about many facets of the outbreak: Where were mistakes made? How should we prevent the spread to healthcare workers? How should we…

Global Health Hospitalists: Strange but Noble Bedfellows

As my Division of Hospital Medicine has grown – now to about 60 faculty – I spend part of my time figuring out what direction we should go in. At times, the path is obvious. It didn’t take Wayne Gretsky to recognize that we needed expertise in healthcare IT a decade ago, or in cost reduction more recently. The story of how we became the nation’s leading program for “global health hospitalists” is a very different tale. I’ve just returned from visiting our program in Haiti with three of our faculty members and two fellows, and so it seems like a good time to tell this story. Since we created our hospitalist program nearly two decades ago, we’ve pushed our faculty to find an area of interest beyond their clinical work. (Our former chair Lee Goldman, a cardiologist, dubbed these areas “diastole” and the name has stuck.) This has been…