"I don't just read Pulse, I adore it." --Donald Berwick MD
It was my first day at my new job, practicing a new specialty. Having spent fourteen years as an ICU physician--including a four-year pulmonary/critical-care fellowship in this very hospital--I had just completed a palliative-care fellowship. Now I was the hospital's palliative-care consult attending.
When I set eyes on the patient in room 1407, my first thought was: THIS LADY NEEDS TO BE INTUBATED--STAT!
The only trouble was that my job was to ease this patient's passing, not to prolong her life.
The team had told me that Mrs. Zelnick, an eighty-two-year-old widow, was dying from pneumonia and didn’t want to be put on life support.
Reflections from the anatomy lab
overlooking Central Park
Reluctant, the same green
light over that copse of trees
and sheet of lawn glares and
bends through the lifted-open
cage of ribs, branched veins,
and cragged spine. Exposed,
my hands appear on the gurney
as a child's. The one across
needled grass applauds small
palms, not distant, but sound
mutes here. Joy does not carry
heft like limbs of the corpse
before me. In layers of blue
latex, the uniform tint of a pond
rendered from afar--its depth
imprecise--I glove and delve
into the viscera, leaving this
abdomen a cavity. I wonder
what hands have touched you.
Many healers, teachers and parents have them.
At one point, I did, too. I had delusions. I thought I was a hero, a rescuer clad in a shiny white coat and wielding the sword of clinical wisdom.
I look back on those days with nostalgia and regret. I wish they'd lasted a little longer--my belief in my own medical grandeur and invincibility.
My most memorable patient changed that for me.
I remember how her mother, Gigi, first brought Serenity to see me when she was a newborn. Gigi was fifteen; I was annoyed. Too much work for a pediatrician to make sure all the education gets through--after all, she was still a pediatric patient herself.
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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