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fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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GIVE THE GIFT OF PULSEGiveTHE GIFT OF Pulse

October 2008

Halloween Horrors

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Paul Gross

One October evening last year, I went to our local pharmacy to pick up a prescription for my daughter. I made sure to bring Cara’s insurance card because my employer had switched us to a new health plan.

I wasn’t sorry about the change. Our prior plan had been operated by incompetents–although they might only have been crooks, I couldn’t be sure–who also managed our flexible spending accounts. These accounts, you may recall, collect pre-tax income from your pay and then return it to you to pay for out-of-pocket medical expenses.

With that plan, nothing ever worked as advertised. I would submit a dental bill for reimbursement and the company would review it for three months before sending me a denial notice, stating that my health plan had no dental coverage.

“I know that I have no dental coverage,” I’d tell the representative on the phone. “That’s why I put a big X in the box labeled Flexible Spending Account.”

“You sure did!” she’d say cheerfully. “I don’t know why they did that. You’ll have to submit it again. This time, put my name on it….”

Or I’d submit a claim for a medical expense that was covered, » Continue Reading.

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In the Taxi to the MRI

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Rachel Hadas

I try to concentrate on the weather. Everything
deliquesces into simile.
Sleet ticks onto the windshield like a clock.
Truth blinks on/off like a stuck traffic signal.
It is better to live in the light but the light is flickering.
Anything more than the truth would have seemed too weak-
Poetic paradox understood too late
or maybe just in time. What time is it?
A small white poodle in a quilted coat
lifts a leg to pee against a hydrant
on Sixtieth Street, and we are nearly there,
early, of course. And since (she said) my heart
has been wrung out, no, broken, this is the …
this has to be … The sentence will not end.
The mind pulls, stretches, struggles, and returns
not to any absolute beginning
but a blank wall. Is there a door in it?
A future? How to get there? And once there
how to escape? When flickering stops and steady
light shines, that may be the worst of all.
Anything more than the truth would have seemed too weak,
but mercifully the blinking begins again.

About the poet:

Rachel Hadas is board of governors professor of English, Newark campus, Rutgers University. The

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Entry from an Intern’s Journal

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Jennifer Reckrey

Editor’s note: Over the next months we’ll be carrying occasional pieces by Jennifer Reckrey, a family medicine resident in New York City. Each week while she was an intern, Dr. Reckrey recorded some of her experiences as a brand-new resident. Today’s story is from week number six. 

How do you convince someone to do something they don’t really care about?

This week I took care of a 58-year-old woman who came to the hospital with one week of fevers, diarrhea, burning with urination, and abdominal pain. Though she probably had an infection, the CT scan she got in the ER didn’t reveal its source. It did, however, show that something was wrong with her uterus and ovaries. If the odd-looking mass was an abscess, it needed to be drained. If it was a cancer, she needed a very different sort of treatment plan. And to find out what was going on, she needed an MRI.

When I first asked her about it, she quickly agreed. She’d had MRIs scheduled in the past (her outpatient gynecologist was concerned about her too), but had always missed her appointments. She seemed glad for the chance to get this cumbersome test over

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Carmen’s Story

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Carmen Diaz

I used to be a shy woman who didn’t like the spotlight and never did any public speaking. Ovarian cancer has changed all that. Now I look for opportunities to tell my story. 

I am a 62-year-old, Puerto Rican-born, New York-raised mother of two. I was diagnosed with ovarian cancer in 2004. But for more than a year before that, my symptoms weren’t recognized. 

In January 2003, I started to suffer from abdominal discomfort, back pain, indigestion and heartburn. My primary-care physician told me to change my diet and prescribed medication for my indigestion. After weeks with no improvement, I went to a gastroenterologist, who diagnosed gallstones. In March, I had gallbladder surgery. 

Most people go back to work within ten days, but it took me a month. My fatigue, heartburn and stomach cramps, I was told, were probably a result of the surgery. Over the following months, I kept returning to my primary-care doctor, who prescribed antacids. Eventually, fearing that he’d brand me a hypochondriac, I stopped going.

That fall, during a routine gynecological check-up, I told my ob-gyn that I was feeling pelvic pressure and a burning sensation in my bladder. My pelvic exam and Pap

Carmen’s Story Read More »

Rx

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 Veneta Masson

Politicians…were quick to rise to the defense 

of a particularly vulnerable population. As a group, 
dual-eligibles [Medicare-Medicaid] have incomes below 
the poverty rate…and take an average of 15 medications a day.

 

Washington Post
January 14, 2006

 

This is how it works: 
as wealth trickles down 
to the poor and old 
it turns into pills.

 

So M and S, their slender portfolios 
long since depleted, can still
compete for bragging rights.
I take twenty a day, says M.
Ha! counters S, I take so many
they had to put in a port.

 

G presides over the corporate enterprise,
his specialty, mergers and acquisitions.
With combined assets (his own and his wife’s)
filling two cupboards, he allocates resources, 
tracks inventory, restocks 
from Canada and Wal-Mart.

 

K can still indulge herself.
I’ll start with one of the pale pink ones,
she tells the striped tabby, 
but I might decide I need two or three.
I’ll wait a while and see how I feel.
Maybe the purple would do me more good.

 

Honor is served.
Wealth is transferred.
The old have their pills.
And their health? 
That’s another story.

 

About the poet:

 

Veneta Masson is a nurse

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