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 2016

Witness

 
I am the product of a couple hundred years of Western European immigration to the northeastern United States. My parents were left-leaning but square churchgoers who were inspired by the Civil Rights movement and the Reverend Martin Luther King, Jr., in particular. My father began a career as a Methodist minister. However, being a rather cerebral introvert, he soon realized the ministry suited him poorly. When he left the profession suddenly, we landed in Poughkeepsie, New York, where he was able to secure work through IBM.

In a few years, we were financially back on our feet. But, much to the horror of friends and family, my mother insisted that we remain in the Poughkeepsie schools. About 70 percent of the children in the district were African-American. She rightly saw the rampant de facto segregation and, due to a combination of her political idealism and plain stubbornness, kept us where we were. The fact that this was viewed as a radical act in my parents’ social circle speaks volumes about race in America.

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Prison Break

Jack Coulehan

I eavesdrop on the cells in your brain,
which are trying to bust out of a prison
surrounded by broken connections.

They make an almost inaudible hum
beneath mechanical whooshes and pings
surrounding your hospital bed. I listen

while sitting with your hand in mine,
not comforted by the confusion
of intensive care–I know your brain

is scheming, despite these machines
and my heartache, to escape. Its intention
is clear–get out while there is still time.

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A White Girl Grows in Philadelphia

 
I grew up with my older sister and our mother in a fourth-floor walk-up in Center City, Philadelphia. Most of our immediate neighbors were gay and white, but Center City, like all of the city’s neighborhoods, abutted a diverse range of cultures, including an Irish Catholic neighborhood and a black neighborhood. South of the black neighborhood was a bastion of Italian-Americans–the home of Rocky and open-air markets. Fanning out from Center City were enclaves of African-Americans in West and North Philadelphia; Jewish, Polish, Puerto Rican, Chinese and Ukrainian neighborhoods; and several historic and hippie areas.

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Race in the Advance Directives Conversation

 
Much of my work as a Palliative Care physician involves conversations with patients and their families for whom the medical outlook is bleak: to help them receive the treatment they want, not more and not less. Such discussions are best held in tandem with the primary medical team and with the nurse. Many times, both attending doctors and housestaff have said, “But it’s so much harder to get a DNR (Do Not Resuscitate Order) with African-American families.”
My experience differs.  

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Bare Hands and an Open Heart

 
I am constantly obsessing over fingers and toes in the ICU. They can tell us so much about whether our high-tech machines and drugs are helping to keep our patients’ bodies perfused with oxygenated blood. Some patients’ fingers and toes are warm and pink. Some are cold and black, even falling off. A lot are dirty…really dirty. Like with actual dirt clogged under overgrown nails. I won’t lie and pretend that these nails don’t gross me out a little bit. Or deny that I typically wear gloves when I am touching these patients’ hands or feet.

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No Retakes

I was midway through my internal medicine internship when elderly Mrs. Armstrong was transferred to our service for treatment of a pulmonary embolus (aka PE–a blood clot in the lungs) after a knee fracture repair. I remember thinking, disparagingly, “Surgeons should be able to treat a PE!”

The following morning, our team rounded on our patients and hurriedly wrote orders and notes because Susan, my senior resident, and I would be in clinic all afternoon. As we worked, another resident, Greg, stopped by and invited us to a party that evening. “I hope I can come,” I said. “If I finish early enough.”

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A Conversation About Race, Fear and Connection

Paul Gross

In the wake of recent events, many speak about the need for conversations about race. In our country, the implications of race are a moral issue, a humanitarian issue, a justice issue and, yes, a medical issue. (One need only examine how racial categorization affects rates of death.) But what would this conversation about race look like?

Today, Pulse’s editor provides one offering. In August, we’ll invite all Pulse readers to join in with their stories, when Race will be the theme of More Voices.

I grew up in Stuyvesant Town, a middle-class housing development just north of Fourteenth Street on the east side of Manhattan. Built after World War II, Stuyvesant Town was a leafy and desirable place to live. There was a long waiting list to get in, and priority was given to World War II veterans, like my father.

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beginning of healing hschneiderman

The Beginning of Healing

Henry Schneiderman

About the artist: 

Henry Schneiderman is a palliative-care physician at St. Francis Hospital in Hartford, CT, and a professor of both medicine and nursing. He has been drawing since age five and studied for a time at the Art Student’s League in New York. His beloved wife Ro died this winter, after thirty-eight years of a good marriage. “Counseling and a spousal-bereavement support group have been helpful; so have the spoken words of friends and family, and the written words of others. This sketch is an expression of quiet, howling grief.”

About the artwork:

“On our garden deck one cold spring day I was looking at the sprouting of seeds I had planted a couple of weeks before. They were seeds I had bought with my wife, Ro, in the autumn, when she was fatally ill. As with so many other material remnants of our time–love letters, food in the freezer, clothes she bought for

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Paprika

The insistent chirp on the phone was a reminder from Fran. “Don’t forget to stop at the compounding pharmacy.” For $58 cash these specialists turned a pill into a cream. GERD made Fran intolerant of most oral medicines.

Tired from the long drive, I thought back on my years of marriage. Back pain was the first problem, I think. Then GERD, then migraines, dizziness, TMJ, panic attacks, fibromyalgia. They were all tough, serious problems. But all together?

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Killer Shrimp Ceviche

Kristin Hirni

It’s October, and I’m a second-year medical student. My best friend Carly and I have just finished a backpacking trip through South America. We fly out tomorrow from Lima, Peru, and we have just one thing left to do: eat shrimp ceviche, the classic South American dish of raw seafood marinated in lime or lemon juice, oil and spices.

We wander along the busy streets until we find the restaurant our hostel’s desk clerk recommended. It’s a small, dingy joint that doesn’t look up to the current health code, but I don’t give that another thought once a giant bowl of amazing shrimp ceviche is placed in front of me.

It’s incredibly delicious, and we quickly demolish it.

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