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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 2013

A TAB No More

Sandra Shea

I thought of Peter when I lost my TAB status. 

I lost it on vacation. These things happen. Suddenly, one Friday night in Florida, I was no longer a TAB. Shouldn’t have been too surprised, I guess. 

But I didn’t expect it would involve a chicken.

I should explain. 

I’m a medical educator: I have a PhD in experimental psychology/neuroscience, and I teach first-year medical students. In our curriculum, the students work through patient cases that are grouped by organ system. At the end of each case, we have a wrap-up in which we highlight the case’s diagnostic features and answer any student questions. Most of these discussions are faculty-led, but occasionally they’re run by a patient whose history mirrors the case we’re studying. Peter was one of these. 

Like the patient in one of the neurological cases, he had fractured his spine in a diving accident. In a matter of seconds, he’d been transformed from a typical teenager to a tetraplegic (someone paralyzed from the shoulders down), although he retained some motion in one arm.

Peter opened his sessions by telling the students that he would answer any questions » Continue Reading.

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Vanishing Act

Sudeep Dhoj Thapa

It was a summer night during my first year of medical school. Small bugs danced about the school buildings’ lights and filled the air with their penetrating hum. 

In the television room, located across a small grassy lawn from the dormitories, I sat watching old movies with my classmate and friend Rajesh. 

Rajesh was tall and chunky. He wore his thick, jet-black hair combed back, which made his broad face and smile appear even more so. I’d known him since our first days at medical school.

“Everyone in my hometown knows me,” Rajesh had told me. “I’m the first one in my area to go to medical school.” Clearly he enjoyed being the pride of his small town. Eyes alight, he’d talked about everything he wanted to do for his townspeople once he was a doctor. 

Living in a dormitory makes strangers into siblings, and we’d become great friends. During those first euphoric months of medical school, Rajesh, his roommate Bob and I had made a habit of getting together late at night with other classmates to watch old movies on TV.

Those nighttime gatherings had grown less frequent,

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Jack Coulehan

Forty years passed. His body replaced
its cells, with the exception of his heart’s
persistent pump and the mushroom-like paste
of his brain. Only scattered synaptic charts
of his internship remain, etched in myelin,
a few of them deeply. Nonetheless, a dried
umbilical cord connects that powerful womb
to the aging man, across a gulf as wide
as imagination. He doubts there’s a thread
to follow, a blockaded door to open,
or a fusty corridor down which to tread
to a solution: those he hurt, the woman
he killed with morphine, more than a few
he saved. His ally, hope, will have to do.

About the poet:

Jack Coulehan is a poet, physician and medical educator whose work appears frequently in medical journals and literary magazines. His most recent collection of poems is Bursting with Danger and Music, published last year. He received the Nicholas Davies Award of the American College of Physicians in 2012 for “outstanding lifetime contributions to the humanities in medicine.”

About the poem:

“As I approached the end of my medical practice, I thought a lot about its beginning, especially my internship, which was a traumatic experience. Am I the same

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Seeing Patients: The Sketchiest Details

Alan Blum

Editor’s Note: This week
Pulse is once again pleased to present sketches by Alan Blum, a family physician who’s been capturing his patients on paper, with grace and affection, for decades. These quick portraits are taken from a collection entitled Seeing Patients: The Sketchiest Details.

You say you think you got a medicine
to stop my seizures?
I don’t know why,
it’s the only exercise I get.

Well, it’s a long story with me.
Spent all my money on my wife
when she died.
Two years cancer.
Wasn’t able to do anything.
Wasn’t able to save her.
Spent all my money.
All the money I had saved
I spent on her.

You better just go ahead and do it now,’cause I am mentally prepared for y’all to kill me today.

Well, let me tell you a little story.
I had a little pain in my chest here.
I don’t know whether it was gas pain or not.
So the doctor took one of those electro things
with all the wires and he said,
“Well, it look good, but I need more tests.”

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