"I don't just read Pulse, I adore it." --Donald Berwick MD
Dying for Change
On the Friday before Christmas, I received an unusual gift.
Like any job, being a primary-care physician has both challenges and rewards. The challenges are many, and the rewards are often fleeting--a smile or a "thank you" from a patient or coworker, for instance. And I've found that being a teacher of medical students and residents brings an additional layer of rewards and challenges.
One Friday before Christmas, these arrived in an especially potent mix.
Dr. Peterson, the radiation oncologist, gets right to the point.
"The medical center's tumor board has concluded that your cancer is inoperable, incurable and untreatable," he says flatly. "Any chemotherapy or radiation treatments would be palliative in nature."
He begins explaining the reasons behind the board's verdict, but everything he's saying washes out. My mind stopped working as soon as I heard the words "incurable" and "palliative." I am sliding into shock.
Dr. Peterson pauses.
Exhalations materialize in the dark as I walk
from the empty parking deck. I brew coffee,
then print a list--our census is up to thirty.
I grab my coat and start seeing patients:
the gastric bypasses, the nine ex-laps,
the psychotic panniculectomy patient,
and the bowel obstruction we are watching.
I page just before six to ask about his diet,
but you don't answer me, so I move on,
jotting ins and outs, celebrating flatus.
Knocking on the Whipple's door, I think
of you suddenly and my gut spasms,
smothered by the weight of living like this.
I page again from the ICU, staring at a phone,
wondering if it has finally gotten to you, torn flesh
with no one to hold pressure or throw a stitch.
a treasury of compelling stories and poems.
Includes The Resilient Heart , Babel: The Voices of a Medical Trauma and Confessions of a Seventy-Five-Year-Old Drug Addict. Foreword by Maureen Bisognano, President of the Institute for Healthcare Improvement.
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