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

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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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March 2009

Heart to Heart

Janani Krishnaswami

I first met you in pre-op. It was my first week as a third-year medical student; my white coat was still white, the hidden interior pockets empty and the ten gel pens neatly tucked in my front pocket still leak-free. Stationed on a surgery rotation, I had officially spent twelve hours in the operating room–a frantic, exhausting blur of standing on tiptoe, gripping surgical retractors and struggling to avoid contaminating the sterile operating field where the surgeons neatly clipped and cut. You were the next case. From your chart I knew the barest facts: your name was Marie; you were forty-five years old, diagnosed with invasive breast cancer and scheduled for surgical removal of both cancer-ridden breasts

As I made my way to meet you, my supervising resident tapped me on the shoulder. “Just to let you know,” he said, “you probably won’t get much of a history. She only speaks French.”

Somewhere among my overworked brain cells lurked a few years’ worth of grade-school French, so I shook your hand and launched into what I hoped was a confident introduction. “Bonjour, Marie! Je suis étudiant en medicine.” Your eyes lit up, perhaps in recognition of a familiar » Continue Reading.

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Cure

Veneta Masson

In Latin it means care,
conjures priests and temples
the laying on of hands
sacred pilgrimage
sacrifice
the sickbed
invalid and
solemn attendants.

How far we have come.
Today’s English 
has neatly expunged 
these purely human elements.
Cure is impersonal, consequential
unequivocal, sometimes violent–
the annihilation 
of the thing that ails.

This nurse 
approaching the patient
has discarded temple garb
for practical scrubs. 
His gloved hands 
unsheathe the magic bullet,
shoot it through the central line
where it locks onto the target cells.

For the not-yet-cured,
there is still sacred pilgrimage–
that dogged slog
to the high tech shrine,
the health food store,
the finish line of the annual race
where, etched on each undaunted face, 
is a gritty tale of survival.

About the poet:

Veneta Masson RN is a nurse and poet living in Washington, DC. She has written three books of essays and poems, drawing on her experiences over twenty years as a family nurse practitioner and director of an inner-city clinic. Information about her poetry collection Clinician’s Guide to the Soul is available at sagefemmepress.com.

About the poem:

“What started me on the path toward this poem was my ambivalence about symbolic ribbons of all colors, the

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Hard Facts and Fiction

Brian T. Maurer

At Daniel’s first visit, it had been like pulling teeth to get this fourteen-year-old slip of a boy to talk. Despite my thirty years experience as a physician assistant, I hadn’t made much headway. I’d pose a question, and his mother would jump in to answer it. He’d slouched on the exam table, staring at the floor. Occasionally he’d lift his eyes to meet mine, then quickly look away.

Daniel’s mother had said she was concerned about him. He didn’t sleep at night; he couldn’t get up for school. He’d missed so much that he was in danger of failing his grade, and the year wasn’t even half over.

Daniel’s mother was not much taller than her petite, quiet son. She was dark, slender and attractive, with a blunt, sometimes brusque, manner.

“If you want to know what I think, I think he’s depressed–just like his father,” she’d said.

I had to agree: Daniel showed many signs of clinical depression.

“We separated last year, and I’ve filed for divorce,” his mother had said. “His dad’s a drinker, and he won’t get help. It seems like he’s powerless to do anything about it.”

I couldn’t help but wonder

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Miscarriage

Jessica Bloom-Foster

From the moment I walk into the room, she breaks my heart. She has just been sent to obstetrical triage from the ER, where an ultrasound has revealed a twenty-two-week pregnancy and a cervix dilated to four centimeters–halfway to delivery stage. She is moaning from her labor pains and moving restlessly on the narrow cot.

I am a second-year family medicine resident in a Midwestern hospital, and well past halfway through a busy call night. She is a thin, dusky-skinned woman, and she looks at me with wide, dark eyes full of sadness and pain. Her hair is pulled back with a nylon rag, and most of her front teeth are missing. Her face seems long and gaunt.

I take a rapid history before examining her, noting that she looks far older than her thirty-seven years. She tells me freely that she uses heroin and crack, is in a methadone program and smokes half a pack a day. She has not seen a doctor during this pregnancy. Her pains started at least twenty-four hours ago. This is her eighth child. She has only been using heroin for a few years. I ask her why she started using drugs,

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