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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July 2010

James and Bob

Paul Rousseau

I think his name was James, but I can’t remember for sure. What I do remember is the day’s heat, the metal cart and a rust-colored dog. 

Like many homeless people, James carried his belongings in a grocery cart–a sort of mobile home for the homeless, but without the protection of a roof, the support of four walls or the security of a front door.

I’d just walked out of the local Safeway store into its parking lot. He ambled over from a park across the street. His eyes were narrow, his face tanned and his clothes dirty brown from weeks of sleeping in the streets.

Being a dog lover, I found my eyes drawn to the dog–a mixed breed with matted hair, worn eyes and gray hairs on his snout. He looked underweight; I guessed he weighed no more than thirty or forty pounds. He stood obediently by James’ side, tethered by a rope leash. 

“What’s his name?” I asked.

“He’s Bob–best dog there is. In fact, best friend a man could have,” said James in a deep smoker’s voice. He smiled and rubbed Bob’s back. 

Then he asked, “Can you give me some money so I » Continue Reading.

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The Cruelest Month

Ray Bingham

One day in April, I took the assignment none of the other nurses wanted: Baby Michael. A hopeless case. 

Born almost four months premature, weighing barely a pound, he was now all of six days old. His entire body wasn’t much longer than my open hand. As he lay motionless on a warming bed with the ventilator breathing for him, the night nurse gave me report: serious intestinal infection, bowel surgery, septic shock, multiple antibiotics, infusions to support his failing heart, transfusions to replace the serous drainage seeping from the surgical incision on his darkened, swollen belly. 

“Take good care of him,” she finished. “He’s been through so much already.” 

As experienced nurses, we both knew that a premature infant rarely survives so many medical complications.

Tiny and sick as he was, his parents Frank and Tonya loved him. Midmorning, they came to visit. They were a young African-American couple–he, tall and wiry; she, shorter, with thick, wavy dark hair. They both looked so weary. 

With the attending physician, Dr. Moore, I joined them at Michael’s bedside. Trying to be compassionate but honest, we described the progress of Michael’s infection and his grave prognosis.

Still, when Tonya held

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Third Party

Mary E. Moore

Tipping forward to escape
the wheelchair’s confines, the ancient one
pleads with her feet, “Go home.”

It’s her companion who volunteers 
the Chief Complaint: “Ever since her stroke,
Mother’s back seems to hurt.

Her doctors say there’s nothing can be done, 
but I thought that perhaps a specialist ….”
She strokes the old woman’s shoulders. 

“Does it hurt here, or there, or if I touch this?” 
My fingers probe among birdish bones.
Ignoring me, the patient whimpers, “Home.”

When the daughter’s eyes register pain, I say,
“I’ll inject this spot near her sacroiliac joint.
It may provide relief, in any case do no harm.”

I fill in the charge sheet attached to the chart.
Low back pain. Trigger point injection. 
Return PRN.
 But how should this be billed?

With the old woman’s medical insurance?
With the daughter’s?
Or should I pay for this one?

_______________

Editor’s Note: PRN is an abbreviation of the Latin phrase pro re nata, which in English means “as needed.”

About the poet:

Mary E. Moore earned a PhD as an experimental psychologist, but after working in a hospital, she decided to study for an MD. She became a rheumatologist, ultimately heading the division of rheumatology at Albert Einstein

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Trauma in the ER

Michael Gutierrez

It was 5 pm on a cold November day. I was a third-year medical student heading into my first night on surgery call.

Changing into my scrubs, I wondered what it would be like. I knew that we had to carry a “trauma pager” and, when paged, get to the ER as fast as possible. There my job would be to listen as the ER physician called out his exam findings and enter them on a history-and-physical form.

I felt a mix of things. I was excited about the learning possibilities, but I also knew that whoever gets wheeled through the ER doors is someone’s daughter, son, mother or father. I decided not to think too hard–I’d just take what came my way and organize my thoughts later.

The night started off slowly. I checked on a patient our team had operated on earlier and added a couple of people to the next day’s surgery list. If the evening stayed this mellow, I might have time to study in the call room and get some sleep before rounds the next morning. 

Around midnight, my pager went off: “29 y/o female; head on motor vehicle collision; laceration of head;

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The Winner

Majid Khan

I pull up on the side of the road on this rainy British summer’s day. The rain doesn’t make it easy to get my doctor’s bag out of the trunk, which I do in a hurry so I can make my way to the house where I’ve been asked to visit a 37-year-old man named Kenneth.

This really isn’t ideal. Now my bag is wet, my papers are wet, my trousers are wet and my mood is wet. I didn’t want to do this visit anyway, but I’m still in my last year of training before becoming a full-fledged GP, and I’ve been given the task by one of the senior GPs in the practice.

“Cough/temperature” says the note the receptionist has scribbled. But while reviewing this patient’s records at the surgery I’d also spotted the words “demyelination” and “bed-bound”–words that had triggered my resistance to coming at all.

I knew this visit would upset me. Kenneth has an autoimmune disease like multiple sclerosis that is slowly destroying the sheaths covering his nerves. Kenneth is only nine years older than me.

The brown wooden door opens, and a plump, smiling lady wearing an apron welcomes me in, tells

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