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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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April 2009

Breaking Bad News

Paul Gross

Bad news is like a lump of red-hot coal that lands in your palm–and that you can’t let go of, no matter how badly you’d like to.

I was tossed the burning coal over twenty years ago, when I was thirty years old and fit as a fiddle. Or so I thought. I also happened to be a first-year medical student, having my head filled with facts large and small about the human body.

Then something started to go wrong.

The first inkling came when I had to excuse myself from a two-hour seminar because of a sudden urge to pee. No big deal…and yet something about its urgency bothered me. The next time the seminar met, I took the precaution of urinating beforehand.

It didn’t help. The same painless urgency interrupted the session once more. What was up?

Before long, I found myself using bathrooms a lot–in fact, more often than anyone I’d ever met. Within weeks, a one-hour class exceeded my endurance. So did the bus ride to school. And I certainly couldn’t make it through the night.

Then the thirst began. A raging, playground-in-the-summer thirst that had me running back and forth from my desk » Continue Reading.

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Coming Full Circle

Stacy Nigliazzo

Only thirty minutes into my evening ER nursing shift, and I was already behind. My first patient was a pregnant teenager with heavy vaginal bleeding. “About three months, I guess,” she flatly replied when asked about her last period. As we placed her legs in the stirrups for the pelvic exam, torrents of blood and water rolled into the kick bucket on the floor.

Dr. Parkman had barely opened the speculum when we saw it. I knew she couldn’t see the doctor’s face, but she could see mine. Shielding her from my expression, stunned and speechless, I cowered as best I could behind her left knee.

There it was. Tiny, pink and perfect. Her baby’s hand, so small that it would easily fit inside the shell of a walnut–outstretched as if reaching for us, for its very life.

The doctor and I both instantly knew there was no chance of survival. It just wasn’t time yet. He removed the speculum, and we watched as the tiny fingers slowly disappeared back inside.

Fifteen minutes later I exited the labor and delivery floor with an empty stretcher, having left my patient in a stark delivery room, pushing. The screeching fetal

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Mistaken Identity

Surgery finished,

I finally sleep

Pushing my shoulders,
the technician wakes me 

“Come now, we need 
a chest x-ray”

Smiling, she pulls me 
into position

The x-ray machine
tight against me

Finally getting a chance, 
I ask what she is doing 

“Oh,” she says “I have
the wrong one

You are not a 64
year old male”

Lying me down, 
she walks away

As I fall back to sleep,
I wonder, now bald

what I must 
look like

About the poet:

Kathleen Grieger has published poetry in many venues, including Free VerseCaduceusBlood and Thunder: Musings on the Art of Medicine, The Healing Muse and online in Yale Journal for Humanities in Medicine and Breath and Shadow. She has written hundreds of poems about her brain surgeries as well as her interactions with physicians and other healthcare professionals. Her poems are currently used at Froedtert Hospital in Milwaukee to teach that patients are people first. 

About the poem:

“Frustrated with the problems and errors that were hugely complicating my medical treatment after brain surgery, I realized that it was necessary for me to start writing again. Because I’d been so busy before, my poetry had been set aside; picking it up again was the best thing

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Brain Cutting

Emma Samelson-Jones

The page came to my resident, who grinned and looked over at me, his hovering medical student. “You should go to this.”

I looked down at the pager.

“Brain Cutting. 2:30 PM. Room B157.” 

Text pagers are the indifferent bearers of all news. Emergencies–“Smith, BP 60/30, Room L721”–appear in the same font as messages seemingly borrowed from a teenager’s cell phone: “OMG, the harpist in the hospital lobby is playing ‘My heart will go on’ from Titanic. WTF?”

I dutifully took the elevator down to the hospital basement and opened the door to the morgue. The medical examiner and a group of neurology residents and students were gathered around a steel table, its sides sloping gently down to a central drain.

As more people arrived, the residents repeated the patient’s history. Adrenoleukodystrophy–a rare genetic defect, marked by progressive brain damage. Same disease as in that movie Lorenzo’s Oil. A freak traffic accident involving a train had been followed by worsening weakness. Unsteady gait. Seizures. Personality changes. Death.

Most of the residents had cared for this patient over the previous year. We flipped through a pathology book with autopsy photos of another adrenoleukodystrophy case, then reviewed the brain MRIs that

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