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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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June 2010

Sleep Hygiene

Daniel Becker

Outline the night and all its objects
in black magic marker.

The world through closed eyes
needs texture 
the way tires need tread, 
brains need wrinkles, and hypnosis
needs the power of suggestion–
traction, surface area, and control
might also apply to a cat
buried alive underneath the sheets; 
if so, don’t forget the one on top.

Stay up for several nights before
the night you plan to sleep.

Oil the ceiling fan.

True or false: the bladder
is on a separate circuit?

Don’t eat in bed, especially chips.

Snoring + sleep apnea + restless legs
+ hemorrhoids + lumbago =

the human condition. The winter itch
as well would be unfair.

Use pillows to solve or suppress all of the above,
a pillow shaped like the horizon
or the supine profile of your partner, or even better 
a partner who won’t mind being used as a pillow–
together you become the mountains and their clouds, 
between the two of you a hidden canyon,
lost in your slopes there are deep limestone caves, 
hot springs, the occasional tremor 
of tectonic plates and knees.

About the poet:

Daniel Becker practices and teaches general internal medicine (an endangered specialty) at » Continue Reading.

Sleep Hygiene Read More »


Ken Gordon

I have never told this story to anyone.

It all started one night about ten years ago, three months into my internship. I was on call, having just admitted a man with a possible meningitis.

He now lay curled up in fetal position on the bed in front of me, looking thin and ill. Preparing to administer a lumbar puncture (a diagnostic test that involves removing fluid from the spinal canal), I gently pushed his head further down towards his legs.

He told me that he knew he was dying. AIDS had been ravaging his body for years. He wondered aloud whether this was a punishment for his previous lifestyle–especially the drugs. Everyone he’d cared for had either died or left him. 

As I listened, I placed the spinal needle into the curvature of his back. I thought about dignity–something he hadn’t experienced much of in the last few years. He seemed so close to death; I wondered briefly whether making a diagnosis of meningitis would be of any real help to him–whether we had anything to offer him in the last stages of this terrible disease. Then I thrust the needle into his spinal column.

I used

Stuck Read More »

Ms. Taylor

Remya Tharackal Ravindran

Ms. Taylor was one of three newly hospitalized patients I saw that morning. She was a previously healthy woman in her forties, single and childless, who worked in the fashion industry. As I scanned her admission notes, three things stood out: shortness of breath, elevated calcium level and kidney failure. I read on, thinking of possible causes, then something caught my eye. Her breast exam had revealed multiple breast masses, and her chest x-ray showed fluid-filled lungs.

Everything fell into place: cancer, first in the breast and then spreading to the lungs. I was spared a diagnostic challenge, but I now had to face something more difficult–talking with Ms. Taylor about her diagnosis. Did she even know what it was? It didn’t seem so.

For me, breaking bad news is an elusive art. As I walked to Ms. Taylor’s room, I tried to recollect some of the strategies I’d been taught, like finding out what the patient thinks is going on and asking how much he or she wants to know. Still, I didn’t know how Ms. Taylor would react. I felt nervous. 

Ms. Taylor was sitting upright in bed, wearing an oxygen tube. She was a

Ms. Taylor Read More »


Elizabeth Kao

Today, her head is spinning, just like yesterday, 
And the day before that. She is dizzy, experiencing 
pain we can’t know unless our heads have hurt like
she hurts now. All she wants is to lie down, and
when we tell her she just woke up, she says she
can’t sleep, because we don’t understand that
she’s not concerned with the sleeping. She’s the
same with food, telling us everything tastes bad,
merely eating to keep from being hungry.

She felt nothing to be worth doing after the fence fell, 
just another part of a neglected house, but not 
so neglected as to scream injustice to the world.
No one would mind that she did nothing, nor 
would she–or more accurately, she didn’t care.
So she turned inward, after seventy-three years of 
War, raising a daughter and two sons, watching the 
grandchildren for them, then left alone because 
she seemed strong, for their convenience.

Tomorrow she will get up, eat breakfast, and sit 
in her chair. By the afternoon, she will lie down in
her bed again, staring into space, wishing the pain
but not-pain will go away. And we blame a
chemical imbalance and wonder whether we

Grandmother Read More »

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