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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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September 2023

The Judgment of Solomon

As a cancer doctor, I’m no stranger to asking patients with a life-threatening malignancy about their wishes. My question generally goes something like this: “Going forward, do you want to pursue intensive treatment, or forgo it in favor of enjoying the time that remains to you, with relief for your symptoms as needed?”

Asking this question is an intrinsic part of my job. But when I found myself having to ask it of a family member, I felt shaken. This was different.

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Editor’s Note: This piece was awarded second place in the Pulse writing contest, “On Being Different.”

When I started as an intern at a regional Australian hospital in the late Nineties, there was a patient—let’s call her Laura—who was notorious among the emergency-department staff.

Laura had sliced up much of her available skin over the years and had moved on to swallowing cutlery and razor blades. She’d had numerous operations to remove the silverware in her stomach, and countless sutures to stitch up the lacerations atop the old scars on her limbs and trunk. Over and over she would be discharged, only to turn up again with yet another macabre self-mutilation.

Each time, the surgical and emergency teams rolled their eyes and gritted their teeth.

Borderlines Read More »

A Good Psychiatrist

“Do you want to be a good psychiatrist?”

When Dr. G posed this question to me, I was a senior medical student on the last day of a month-long elective on the inpatient pediatric psychiatry unit. I knew by then from Dr. G’s teaching, and from his demeanor, that his questions were often not questions. They were, instead, buckets, drawing from the dark wells of patient stories to make the unknown known, the unseen seen.

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Skin Rash

Being a child of medical parents brings special challenges. For example, such children grow up with a unique idea of appropriate dinner conversation. When I exclaim, “Guess what I saw at work today!” my children interrupt to inquire if my story has blood or something “gross” in it. And they regularly yell, “HIPAA!”—a reference to the federal patient privacy regulations—even though I always deidentify patients.

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Bedside Manner

Boundaries, respect, culture and personality are all parts of bedside manner. Boundaries and respect are, ideally, reciprocal between physician and patient. I want to project warmth, humanity and concern but I don’t want to burden my patients with my fears, frustration and anger.

During a delivery of a young woman of her first child, she said to me “You look really scared. Are you okay?” I had just found a concerning fetal heart tracing, and my bedside manner was not helpful to her. I quickly tried to rearrange my face.

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Music and Medicine

It’s the end of a long day on Internal Medicine Ward H (“Hey” in Hebrew) at Soroka Medical Center, in the desert city of Be’er Sheva, Israel.

I’m a third-year medical student at the Medical School for International Health at Ben-Gurion University of the Negev, and this is the floor I’ve been assigned to for my six-week internal-medicine clerkship—my very first clinical rotation.

My fellow students and I wrap up our responsibilities for the day and head to the student room to gather our things. Stowing my stethoscope and notebook in my bag, I exchange it for my guitar, sitting in a dusty corner.

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My American Dream

I came to the US ten years ago, barely sixteen years old, with no family or friends here. I saw myself as a lone traveler—an immigrant woman on a journey to the American Dream. I now realize that, along the way, I was also reaching out to others who could help me adapt, acculturate and navigate this new terrain.

I was born and raised in Nigeria, one of a family of eight.

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Heat at the Border

The last patient on the last day of my critical care rotation arrived at the ED by airbus. She was 21 years old, barely responsive, and accompanied by border patrol. The ED called us about 30 minutes later, once they’d stabilized her. We arrived in her room, and the ED resident recounted what had occurred. She’d required intubation and several rounds of CPR to achieve resuscitation. The situation had calmed for a moment, but then she started to convulse. They administered medications and her shaking stopped.

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