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February 2010

The Case of the Screaming Man

Paula Lyons

As everyone knows, the human body has orifices. Occasionally, these become occluded, or occupied, by things that aren’t supposed to be there. Every doctor knows this, as does almost everyone else. Who hasn’t heard, as a child, the cautionary phrase “Don’t stick beans up your nose”?

Human nature being what it is, almost every clinician must deal with foreign objects–flora, fauna–that have been put into places where they don’t belong. Sometimes, though, “beans” can materialize without a patient’s permission.

Here is one such case–a personal favorite of mine–that I’ve mentally entitled “The Screaming Man.”

I was back in the furthermost part of the clinic, arguing with an insurance company representative about the need for a patient’s CT scan, when one of our receptionists ran up.

“Dr. Lyons! There’s a man screaming in the waiting room!”

“Is he bleeding?”

“No, he’s banging his head with his hands and screaming! I think he might be crazy!”

I ran to the front. There in our packed waiting room was in fact a seemingly crazy man, screaming, dancing around and batting at his left ear with both hands. The other patients were cringing » Continue Reading.

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Death at a Distance

Your message hung on the phone line

like his striped shirt blowing
in the last wind of his life:
softly and with dignity.
His facial bones,
and body contours
he allowed to be chiseled
to an insubstantial sharpness
by the flow of chemicals and
the relentless labor of his disease:
both polished his body to dust.
Your life that has breathed that dust
for years will, someday,
carry it to the stars,
where it belongs.

About the poet:

Edwin Gardiner, a urologist, was in private practice for thirty years in San Diego; he did his surgical training at UCSF and NYU-Bellevue Medical Center. “I’ve written since my undergraduate days at Amherst College but have had only essays and professional monographs published before. From the early 1980s on, I occasionally wrote poetry, but since retiring I’ve found poetics an essential part of sampling the temperature of my daily life.”

About the poem:

The man in this poem and I were friends for many years. This poem was a whisper of condolence to his wife upon receiving a phone call with the news of his

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Keeping Secrets

Reeta Mani

Rohit walked into our HIV-testing center in South Mumbai one busy morning. I was struck by how stylish he looked in his jeans and casual linen shirt, very different than the usual patients who visit our sprawling public hospital campus. He paced back and forth in a corner, looking at his watch and whispering into a cell phone.

I guessed that he’d chosen this crowded setting because of the anonymity it afforded; here he stood little risk of running into an acquaintance who might start to wonder.

During Rohit’s pre-test counseling, he confided his fear of being HIV-positive. He told us about having unprotected sex with female commercial sex workers during overseas business trips–and about a routine insurance health checkup that had hinted at something wrong.

He was here to learn the truth.

The next day, when he came for his results, Rohit was astonishingly calm.

“Your blood sample has tested positive for HIV,” I said and, per our routine, handed him the lab report so he could see for himself.

Rohit held the piece of paper and sat, gazing deeply into nowhere. Just when I thought he might have

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Sandy Brown

Coming out of my exam room on a Monday morning, I saw two overweight police officers standing in my waiting room. From past experience, I knew that they were there to tell me that one of my patients had died and to collect information for the coroner’s report. Even as I geared up to hear the impending bad news, the doctor in me couldn’t help wondering how they’d passed their department physicals.

“Do I need to call a lawyer?” I joked, trying to guess which of my patients it could be.

“Michael Freund died on Saturday,” said Dalia, my office manager.

It was a shot to my gut. Mike was seventy-three years old, but one of my healthiest patients for his age. He neither smoked nor drank, took no medicines except for the occasional Viagra and played tennis with a passion. He was fit and trim, and I couldn’t imagine what had done him in.

I hadn’t seen Mike in the months since he’d come in for his annual exam, which had raised no red flags. Then I remembered that he had called me the previous Thursday with some vague complaint that I

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