August 2019
The Anguish of Ambiguity
Adam, my twenty-five-year old son, died of a heroin overdose two years ago. Several days after his death, and before the funeral, I sat up late one night talking with his ex-girlfriend. She revealed that he had been sexually abused for several years by a close, male family member starting when he was eleven. The perpetrator threatened to harm our family if Adam ever told anyone. Adam told a few people but the secret was kept from me.
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Every Doctor’s Nightmare
Bobak Akhavan ~
I was an intern, doing a rotation in the coronary-care unit (CCU) of a large urban hospital. It was very challenging: The patients had complex medical issues, and my fellow residents and I were given lots of responsibility for their care. Still, I felt I was finally getting the hang of residency.
One of the first patients I saw was Mrs. Smith, a middle-aged woman who had come to the emergency room with chest pain. We admitted her to determine whether she was suffering from coronary-artery disease that might lead to a heart attack.
Mrs. Smith was a kind, soft-spoken woman. Her daughter, Crystal, in her twenties, had inherited her mother’s brown eyes and hair. She lived with her mother, was very involved in her care and made sure that we knew her full medical history.
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Tree of Life
“This piece reminds me of the life that I see every day and brings up memories of the many people I was honored to know throughout my career. Every day brought new challenges, joys and sorrows, and as a chaplain I was fortunate to walk their walk.”
A Poignant End to Chemotherapy
When Joan was in last week and told me she had just completed chemotherapy for breast cancer, I assumed congratulations were in order. When I smiled and offered them, she suddenly became forlorn and began to cry. And these were not tears of joy.
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Better Is Still an Option
Ella was a surprise sent to me by a geriatrician for osteopathic manipulation (OMT). With knees and back stiffened by osteoarthritis, Ella had found that chiropractic care and her walker kept her mobile enough to get out to family events and church activities. Now she could no longer afford chiropractic care, but visits with me–her family physician–would be covered.
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I’ve Never Been a Mother Before
At thirty-six, I had my first child. Up until then, my focus was on my career to become an ob/gyn physician.
During my pregnancy, I chose a doctor and hospital that were not affliated with my hospital. I wanted to be a patient, not a doctor who happened to be pregnant. I ended up having a scheduled C-section; my child was breech, and no amount of encouragement would change that.
As soon as my OB walked into the operating room, he loudly announced, “She is an OB too!” And, in an instant, the cat was out of the bag. No longer could I be anonymous.
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A Life Lived in Spite of Everything
I was called to the NICU to see a baby who had just born with hydrocephalus. The CT scan showed he had Dandy-Walker syndrome. His teenage parents were told he would be severely handicapped, so they refused permission for a shunt and wanted him to die. The NICU staff was horrified and asked me (the neurologist), “They can’t really do that, can they?” I said no they can’t, and immediately called the hospital lawyer. She brought a judge into the NICU who agreed, obtained legal custody and assigned guardianship to a local advocacy agency. The new guardian authorized the shunt which worked well. The boy was discharged into foster care and eventually adopted.
But then it got really interesting. Yes, he had Dandy-Walker syndrome and hydrocephalus, but he was developing normally!
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Chief Complaint: Not Always What You Assume
If I did not ask, I would have assumed regaining muscle control was the “chief complaint” of the young man I was caring for during my brain injury elective. He was an active college student up until a few months ago when a tragic accident left him wheelchair-bound and dependent on nursing staff for even the smallest of tasks.
The first time we met, he introduced himself to me through a laminated copy of the alphabet. Spelling out his name took some time, due to the severe spasticity that still engulfed his musculoskeletal system, but it was his only means of communication due to the loss of control of his vocal cords.
“I am here to join your care team,” I had told him. “I want to help you work on facing your biggest problem right now. Can you tell me what that is?”
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Unexpected
Christine Loftis ~
“You’re twenty-seven-and-a-half weeks pregnant.”
As I lay on the exam table, time froze.
How can this be? I wondered dazedly. I’m a second-year medical student. I’ve just completed a course in female reproduction and endocrinology. How could I have missed the signs?
I attribute my obliviousness to the surgery I’d gone through only months before: the removal of a twenty-seven-pound, mucus-filled ovarian cyst. My lack of menstrual periods was nothing new; they’d been irregular for years. My recent abdominal bloating must, I’d thought, be the cyst recurring. I hadn’t worried about it because, frankly, I’d always put my health and personal life second to my future career as a physician.
The Warrior
When I first met my future sister-in-law—I was fifteen, she was seventeen—I assumed that her life was perfect. She was pretty, perky and popular—everything I was not. She was dating my brother, a medical school student, while I had never been on a date. I just knew her life would be a fairy tale with a happily-ever-after ending.