"I don't just read Pulse, I adore it." --Donald Berwick MD
Through Our Eyes #3 (clear and peaceful)
I first met Marie five years ago. A petite, soft-spoken woman in her thirties, she was the patient of one of the residents whom I supervise at our community hospital. Marie worked in housekeeping for a large corporation; she and her husband, a bus driver, had a six-year-old son. Now she was twenty-six weeks (six months) pregnant with their second child.
Marie's blood pressure was markedly elevated (168/120), she had fairly high amounts of protein in her urine, and her baby measured small on the ultrasound. These pointed to severe preeclampsia--a serious complication that can quickly worsen, leading to kidney damage, seizures or even death for mother and child, and that can only be cured by delivering the baby.
The resident and I reached a swift, unanimous decision: Marie's pregnancy was far too high-risk for our hospital. She needed to be transferred to the University Hospital across town--"the U," as it's known. And the baby would need to be delivered soon.
Carl V. Tyler
In my clinic and in the nursing home
Every week I see it
That depthless hollow look behind the eyes
But this time it was your eyes
Sitting across the table
At a TGI Friday's outside of DC.
And that all-too-familiar look to your face
Of knowing and not knowing
Of barely contained panic
Of quizzically furrowed brow
Yesterday my friend Sophie asked me to accompany her to a Miami hospital intensive-care unit to see her older brother, Guillermo. He'd been admitted the previous night with seizures and cardiac arrhythmia.
Joined by my husband, we made our way to the ICU. When she saw Guillermo lying immobile, swollen and unresponsive, with a breathing tube in his mouth and other tubes snaking into his chest from IV poles, Sophie broke down sobbing.
Seeing her reaction, I felt a little ashamed at my own calm, although I knew it was hard-earned. During my years as a family doctor working in Miami-Dade County's community clinics, I'd witnessed countless scenes like this one. Where Sophie saw a beloved brother utterly vulnerable and present only physically, I saw a fluid-overloaded patient hooked up to a ventilator, with the appropriate drugs being administered and a dialysis machine cooling and filtering his blood to treat his seizures.
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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