The Fight After the War

By Dr. Sudip Bose, MD, FACEP, FAAEM

According to the Substance Abuse and Mental Health Services Administration, 22.5 percent of American adults suffered from a mental illness in the past year. That’s almost 1 in 4 people. This means that almost all of us either know someone or are ourselves affected by a mental illness of some kind. These mental illnesses come with many different names: depression, anxiety, schizophrenia, and alcoholism to name a few. Those affected by mental illness must overcome one thing they all have in common: the stigma of the illness. They must battle that in addition to the universal challenges that anyone with an illness faces – managing symptoms, following up with a physician, keeping up with a treatment regimen.

What is stigma? It’s defined as a mark of disgrace associated with a particular circumstance, quality, or person. People can be stigmatized for many things, even such apparently benign things as race or gender. We have come up with words for these kinds of stigma – i.e., racism and sexism — and society has tried to move away from them as best it can. However, while we have come a long way in combating the stigma of mental illness, it is obvious that we still have a long way to go.

The stigma that someone experiences comes in two forms: external (from other people) and internal (from themselves). The impact of this stigma varies widely based on a person’s background, peer group, and personal identity. This means that some people can feel a greater impact of stigma than others. External stigma comes from the lack of support and understanding from others while internal stigma comes from our judgements of ourselves. Unfortunately, we all can be our own worst critics.

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KeepYour Inner Army Strong

Dr. Sudip Bose swimming

By Dr. Sudip Bose, MD, FACEP, FAAEM

First of all, what is our inner army?

I’ll review briefly from our last write up, Leadership Under Pressure:

  • We have an inner army in our brain.
  • We have an inner army that is our physical body.

We need to feed, care for and maintain those inner armies if we expect ourselves to be ready and clear-headed to lead and function effectively under pressure or in a crisis situation. When that grenade flies into your world and goes off— no matter what world you’re living in, whether it be corporate, small business, hospitality, medical, personal, whatever — you’ve got to be ready. You’ll only be ready if you keep your inner army strong.

Nutrition, exercise and sleep are key to keeping your inner army strong. But time is limited. We all have only 24 hours in a day to accomplish things. So how do you maintain your body to perform maximally under pressure? How do you maintain your peak performance?

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How Do You “Keep Your Inner Army Strong” and What, Exactly, Is Your “Inner Army?” — An Explainer

Dr. Sudip Bose swimming

By Dr. Sudip Bose, MD, FACEP, FAAEM

First of all, what is our inner army?

I’ll review briefly from our last write up, Leadership Under Pressure:

  • We have an inner army in our brain.
  • We have an inner army that is our physical body.

We need to feed, care for and maintain those inner armies if we expect ourselves to be ready and clear-headed to lead and function effectively under pressure or in a crisis situation. When that grenade flies into your world and goes off— no matter what world you’re living in, whether it be corporate, small business, hospitality, medical, personal, whatever — you’ve got to be ready. You’ll only be ready if you keep your inner army strong.

Nutrition, exercise and sleep are key to keeping your inner army strong. But time is limited. We all have only 24 hours in a day to accomplish things. So how do you maintain your body to perform maximally under pressure? How do you maintain your peak performance?

Continue reading “How Do You “Keep Your Inner Army Strong” and What, Exactly, Is Your “Inner Army?” — An Explainer”

Leadership Under Pressure, a k a, Emergency Leadership


By Dr. Sudip Bose, MD, FACEP, FAAEM

How do you make decisions under pressure?

Leadership under pressure is not analysis paralysis. How do you move from analysis to action? In emergency leadership, you have to act, and you have to remain composed under pressure to ensure you have a positive outcome, or at least to find the path to the best outcome a situation affords.

How do you fight and win? Three key points:

  • Fill the vacuum
  • Say something
  • Divorce emotion

These are three principles that will help you lead and perform under pressure. They’re things I learned while serving in the U.S. Army as a front-line combat physician for 15 months while in Iraq. My service in war was one of the longest continuous tours of combat by a physician since World War II. I treated thousands of our troops during that conflict and also provided medical care for Iraq’s deposed dictator, Saddam Hussein, after his capture.

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The Emerging State of Medical Care In Our Nation’s Emergency Rooms


By Dr. Sudip Bose, MD, FACEP, FAAEM

People who go to a hospital emergency room cannot be turned away regardless of how sick or injured they actually are or whether or not they have insurance. They must be seen and treated.

Hospitals are sagging under the weight of the uninsured coming in to emergency rooms to get routine medical treatment. I often say, somewhat jokingly, but with a solid basis in reality, that after 5 PM I become a primary care doctor. E.R.s have become primary care clinics, especially in the evenings and on weekends, where doctors treat sniffles, coughs, colds and other relatively minor health issues — and at a very high cost.

We are seeing, in effect, medical refugees.

Being seen in an E.R., as opposed to a primary care physician’s (PCP) office costs much more. One of the main goals of the Affordable Care Act, also known by its slang name, “Obamacare,” was to reduce dependency on E.R.s by providing affordable care to a wider range of people who, since they had insurance, would then stop going into the E.R.s and see their PCP.

That hasn’t happened. In fact, just the opposite has, according to a survey conducted by the American College of Emergency Physicians. In a 2015 survey of E.R. docs the American College of Emergency Physicians conducted, 28% of respondents, who were emergency room doctors, said the volume of patients using the E.R. increased greatly while 47% said the volume has gone up slightly. That’s 75% of respondents who said the volume has gone up, either greatly or slightly.

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An Open Letter to Presidential Candidates Hillary Clinton and Donald Trump on Veterans’ Health Care

By Dr. Sudip Bose, MD, FACEP, FAAEM

I’d like to take this opportunity before the first presidential debate to offer both candidates for office, Hillary Clinton and Donald Trump, some perspective related to our veterans’ health care.

Let me introduce myself. I served in the U.S. Army from 1995-2007 and as a front-line physician for 15 months while in Iraq. My service in war was one of the longest continuous tours of combat by a physician since World War II. I treated thousands of our troops and also provided medical care for Iraq’s deposed dictator, Saddam Hussein, after his capture. I’m founder of TheBattleContinues.org, a nonprofit charity serving injured veterans and speak on veteran health topics as well as what I call “emergency leadership.”

I’ve seen it all, from dealing with soldiers who would ultimately lose limbs from battle wounds to handling casualties of severe car accidents and shootings here in the U.S. as an emergency room physician in Odessa, Texas in the Medical Center Health System. Being an associate clinical professor of emergency medicine at the University of Illinois College of Medicine in Chicago, I’ve trained thousands of medical students using my textbook on emergency medical care that has been widely adopted at medical colleges throughout the country.

While you both have talked about taking care of our veterans, the need to continue care once they leave the service is immense. Our veterans deserve the best health care we can provide in America, and that absolutely must be a top priority.

I’d like to suggest a three-pronged approach to caring for our veterans:

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