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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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October 2009

The Resilient Heart

Paula Lyons

He was applying for a job on a refuse truck working for the City. This is a very good job for someone whose hiring prospects are otherwise limited. Excellent benefits, all state and federal holidays off, health insurance for oneself and one’s family, physical exercise in the fresh air. (All right, this was Camden, New Jersey, so exercise in some kind of air.) And one more plus: If the team is efficient and hardworking and get through their rounds by 11:30 am or noon, they can take the rest of the day off, yet get paid as if they’d worked the whole 5 am-to-1 pm shift.

I was the doctor doing his pre-placement physical exam–designed to determine if the potential employee has medical conditions or takes medicines (or recreational drugs) that might interfere with the employee “performing essential job functions in a safe, regular, and reliable fashion.”

He was twenty-five, slender but muscular, and very excited about the prospect of this job. He was polite and engaging. He surely was capable of lifting cans into the “load-packer” and running beside, or hanging onto the side of, the trash truck as it went on its rounds cleaning » Continue Reading.

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One More Child Left Behind

Brian T. Maurer

Making the diagnosis might be straightforward, but sometimes getting adequate medical care poses a more formidable challenge.

It was the end of an exhausting afternoon in our busy pediatric practice in Enfield, Connecticut. I had just finished seeing what I thought was the last patient of the day, only to find yet another chart resting in the wall rack, a silent signal that one more patient waited behind an adjacent closed door.

His name was Aaron. Six years old, he sat on the exam table cradling his left arm in his lap. The most striking thing about the arm was the large bluish bulge on the side of his elbow. His mother stood by his side; his grandmother sat in the corner chair.

“What happened?” I asked.

“Another kid pushed him off a table at school. He won’t move his arm.”

I took a step closer. “Let’s have a look.”

Gently, I palpated the borders of the blue bulge. Aaron winced in pain. I felt his wrist to check the circulation to his hand. “Squeeze my fingers,” I said. He tried and winced again.

“It’s likely broken,” I explained. “At

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Reading Entrails

Sugar poisons

ruin your blood,
runs your legs
while you sleep,
revs your irregular
heart beat.

Maple sap, tree ripened
orange, dark chocolate,
honey dripping
from the comb
are not viable substitutes;
only abstinence
and the eleven day
skin crawl withdrawal.

Or an asymmetrical death:
one part at a time,
organ by organ,
memory fog,
the surgeons gnawing
like rats
at the leper’s limbs.

About the poet:

Kenneth P. Gurney lives in Albuquerque, NM, where he hosts a poetry salon at his home twice a month. His poetry mostly appears on the Web. His has two self-published poetry books, Writers’ Block and Greeting Card. Other pleasures he enjoys: baseball, bicycling, hiking the desert and foothills trails, Scrabble and good conversation. Gurney’s Web site is

About the poem:

“A few people I know are/were in denial about their adult-onset diabetes. So I wrote and performed this piece a couple of times in public in the hope of jarring them into taking care of themselves. One of these people did go through

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Andrea Gordon

It was a good night, but it’s been a brutal morning.

As a family doctor who does obstetrics, I generally enjoy my time with laboring patients. When I arrived on the maternity floor last night to start my call, things looked pleasantly uneventful. Several patients were in labor. Only one wasn’t progressing well: Ana, age twenty-two. 

I was told that Ana had come to the floor two days earlier, leaking puddles of clear fluid but not contracting. She still wasn’t contracting, even after two days on pitocin, the drug that causes or strengthens uterine contractions.

To add to this difficulty, there was Ana’s shift nurse, Barbara.

Barbara and I had a history. Another night, caring for a very annoying patient, I’d thought that Barbara had acted unprofessionally, and she’d accused me of shirking my responsibilities. We hadn’t parted on the best of terms.

As the night wore on, Ana’s uterus finally began to contract, but she didn’t tolerate the discomfort well. She was also fearful of taking any pain medication–a perfect catch-22.

Avoiding a replay of our last collaboration, Barbara and I managed to soothe Ana and her husband, and they changed

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Steep Sledding

Jonathan Han

“Don’t worry,” my doctor said.

I barely heard what he was saying; lying there in the hospital bed, I was caught up in contemplating the diagnostic procedure I was scheduled to have the next morning.

“With these anesthetics,” he continued, “you won’t feel or remember a thing after it’s over.”

“Okay,” I answered weakly, signing the consent form with unaccustomed legibility. But could I really forget the emotional trauma of these past twelve hours?

I’m a physician, and blessedly accustomed to standing on the other side of the health-and-illness divide. But after four days of crampy abdominal pain, my self-diagnosed “gastroenteritis” had horribly morphed into a “rule out carcinoma” directive. Now I faced another twelve hours of waiting–reviewing the possibilities, expecting the worst–until my procedure could be performed. Could I stop silently reviewing my CAT scan findings (that suspicious abdominal mass) and numb my feelings of anguish and anticipatory grief?

“Do you want a sleeping pill for tonight?” asked my doctor.

“I don’t know,” I stammered.

“It may help you sleep,” he pressed.

“Okay,” I said, grasping at the chance to escape this nightmare. Inwardly, though, I craved

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