fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

November 2017

A Time of Tribulation and Thanks

 
Ma always made the most delicious Thanksgivings: turkey with stuffing; mounds of mashed potatoes dotted with bright green peas; a Jell-O mold containing pineapple and cranberry sauce; cole slaw and candied yams. Her holiday dinners were culinary feasts—meals that stretched the elastic waistband of my pants but still left room for me to nibble on leftovers later in the evening. Thanksgiving with my parents, maternal grandmother, and two children was the perfect holiday—until the year it wasn’t.

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Native Ways

Jan Jahner ~

They came up from the center of the earth, The People
where sky speaks to corn,
speaks to cottonwoods, to runoff in the wash.
Living beneath black-slashed canyon walls
home to sheep and weavers.
He is one of them, my patient
one of the ancients; leathery face carved and quiet
she is his daughter, fingers on the covers,
ready should he wake.

He is dying and we can’t say it.
Soft sounds unknown to me, their language of wind, cottonwood and wool
in the center of this circle is knowing and not saying
the medicines continue
but we turn, bathe, suction and weave the fibers close.

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Last Call

It’s been a few months since he died. A simple, white stone now stands watch for him at Camp Butler National Cemetery.

I have put off canceling his cell-phone service as long as possible. His children, friends and family from all over the world still call to hear him say “Leave me a message,” then weep and pour their hearts out into his voice mail.

But money is tight. The phone has to go. It really wasn’t much good, when none of his doctors would call him on it when he so desperately needed them.

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Counting to Thirty

I am with people when they are most vulnerable: in the hospital, stripped of their clothes, with nothing on but a thin gown that has been worn by many bodies before. My role is a constant balance between “human” and “robot.”

T-minus three minutes. The room is ready; the positions are assumed; the monitors are set. We stare at the clock as the seconds slowly pass, standing in silence to conjure up the stillness before the storm.

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No Right Words

It wasn’t supposed to happen that way.

I knew Amy wasn’t doing well; when I had seen her on Friday, she just laid in bed, breathing heavily. She didn’t even turn to look at me, much less talk. I had sat with her for a while, sang Amazing Grace almost inaudibly, and left the small bag of bananas and salt prunes she had requested on the small table beside her bed.

I had left strict instructions with the nurses that night—Please, call me if anything happens. Call me if she passes. I want to know. I didn’t know if they’d be able to reach any family for Amy, as family contact had been spotty at best the entire time she’d been in the hospital. I wanted there to be someone who could bear witness to her last moments. 

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She Likes Chocolate

Nadine Semer ~

“She doesn’t like vanilla,” Mr. Wyatt says, staring at the nutritional drinks sitting on his wife’s bedside hospital table.


I’m here as the palliative-medicine consultant. As my resident Susan and I stand still, taken aback, Susan’s expression says it all: She’s dying, and her husband is worried about which flavors she likes?

Mrs. Wyatt, fifty-six, came to our urban hospital’s emergency room with abdominal pain. She was admitted and given intravenous fluids and broad-spectrum antibiotics. Her workup revealed widespread, untreatable cancer. Her medical team has consulted us because they’re frustrated at her family’s unwillingness to acknowledge that she’s failing.

“Explained her poor prognosis; she needs to be DNR,” read the consult request. “But still, the family wants everything done.”

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Blum Data Art

Data Art 2

Alan Blum

About the contributor:

Alan Blum is a professor and Gerald Leon Wallace MD Endowed Chair in family medicine at the University of Alabama School of Medicine in Tuscaloosa. A self-taught artist, he has published three books of his sketches and stories of patients, and his artworks have appeared in more than a dozen medical journals and textbooks. Many of his sketches have appeared in Pulse. He is a frequent guest speaker at medical schools in courses in the humanities.

About the artwork:

“For the past five years, on the first Thursday evening of each month, I have hosted an Art of Medicine Rounds for medical students, residents and faculty, at which I often distribute a story or poem from Pulse or else one of JAMA’s ‘Art and Medicine’ or ‘A Piece of My Mind’ essays.

“Above and beyond being a devoted reader of JAMA, I am especially drawn to the

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Data Art

 

Alan Blum

About the contributor: 

Alan Blum is a professor and Gerald Leon Wallace MD Endowed Chair in family medicine at the University of Alabama School of Medicine in Tuscaloosa. A self-taught artist, he has published three books of his sketches and stories of patients, and his artworks have appeared in more than a dozen medical journals and textbooks. Many of his sketches have appeared in Pulse. He is a frequent guest speaker at medical schools in courses in the humanities.

About the artwork:

“For the past five years, on the first Thursday evening of each month, I have hosted an Art of Medicine Rounds for medical students, residents and faculty, at which I often distribute a story or poem from Pulse or else one of JAMA’s ‘Art and Medicine’ or ‘A Piece of My Mind’ essays.

“Above and beyond being a devoted reader of JAMA,

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Mystery Solved

I’m sitting at my desk when the phone rings. A blue jay is feeding her baby in the coral tree outside my window. She is determined and direct, pecking her catch in gentle spurts into the little bird’s gaping beak. The fledgling squawks hoarsely for more. I pick up the phone.

It’s my son’s oncologist. My heart no longer jumps into my throat when I hear his voice; we speak frequently now, comanaging my son’s leukemia–a case that is proving anything but ordinary. I have no idea why he is calling today.

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Dad

My 72-year-old dad is in neurologic intensive care in a strange hospital in a strange city far from his home and from mine. In the midst of my fully-booked morning of seeing patients, I am trying to reach my diminutive stepmother on the cell phone that she does not know how to program to hear her layperson’s interpretation of what the strange doctors are telling her.

Unable to get through to my step-mother, I step into the next exam room to see Mr. P, a 72-year-old man with stable coronary disease and gastroesophageal reflux disease (GERD). He has difficulty hearing and is here with his protective wife for a routine checkup.

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Sorry to Wake You Up

My twins were born just twelve hours after I came home from work, but six weeks earlier than expected, so I extended my maternity leave for as long as possible. My partners were accommodating and generous while I was away, but they were plenty glad to have me in the call rotation when I came back. So, after my four months’ leave, I was on the schedule within a week or two of returning to work.

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