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

November 2025

Diagnosis

After the bone marrow biopsy, but before all results are in, when you have some strength and an appetite, I make your favorites—turkeyburgers, coleslaw, baked beans. You stand in the doorway, eyes on me, just as you did when you were a child, waiting for whatever I’d create. Abracadabra, I’d say, presenting buttered French toast or a plate of still-warm chocolate chip cookies. You ate the cookies and cried for your addict parents who’d left you with me, who’d left a wound I couldn’t soothe.

I was the aunt who tried to replace them. But you were loyal and followed in your family’s tradition of depression and addiction. So many psych wards. So many rehabs, like your parents. Now, your white and red blood cell counts are low. I’ve tried to be your oxygen. I’m old now, foolish enough to think I can still be your breath.

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No Mud, No Lotus

A doctor rarely imagines becoming a victim of workplace violence leading to chronic pain. I was a young, idealistic geriatrician fresh out of my training when I began working in a memory care facility. It was a high-turnover unit, with residents dying or moving and new patients with dementia admitting almost daily.

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Holding Out Hope

In my twelve years as an American family doctor working in low-resource countries in the Middle East, I’ve seen and treated countless patients with little to no hope for improvement in their physical and emotional problems. Seeing patients in these circumstances is emotionally exhausting, but the importance of my role in supporting these patients continues to draw me back in.

Reflecting on the challenges they face, I often think of one in particular: a baby named Hiba.

Hiba’s mother, Layla, had received very little prenatal care during her pregnancy, as is common among poor, rural patients in low-income countries. She’d suffered from several prenatal complications, and Hiba was born via an emergency cesarean section.

Hiba’s condition was precarious.

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A Cruel Companion

Pain has been my constant—and cruel—companion for eighteen years. My suffering when bone was hitting bone in my left jaw led to the first of five maxillofacial surgeries. None worked, even when I had radiation to prevent more bone growth. I have had Botox, acupuncture, physical therapy, medication—but nothing alleviates the pain that radiates from my jaw to my ear, eye and head. The prosthetic device in my head prevents me from opening my mouth to any great extent; going for a dental cleaning is excruciating, while having dental X-rays is impossible.

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November More Voices: Chronic Pain

Dear readers,

If I had to start my medical career from scratch, I’d devote more time to studying chronic pain. Specifically, I’d want to arm myself with more and better tools for alleviating it.

Over the years, I had many patients with chronic pain, and my success at treating them was spotty. Pain relievers were helpful–sometimes. Physical therapy and acupuncture were helpful–sometimes. A pain-management referral was helpful–sometimes. A conversation about past emotional traumas was helpful–sometimes.

But there were patients whom nothing seemed to help.

November More Voices: Chronic Pain Read More »

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