While leafing through a medical journal some years ago, it struck me that the scientific studies that filled its pages bore only a slight resemblance to my experience of the practice of medicine. For one thing, the patients in the studies seemed to enjoy swallowing pills. They remembered to take them and didn’t seem to mind their accompanying side effects. (Many of my patients, by comparison, already had a dozen bottles cluttering their kitchen counters; a new pill that made them tired or queasy was the last thing they wanted.) 

For another, the studies assumed that the pills were readily available—and affordable. In real life, pills can be expensive; insurance companies may not pay for them without time-consuming phone calls; and even the best coverage can lapse. 

These journals had glossy images of smiling patients who were now leading active lives thanks to antidepressants or anti-inflammatory agents. My experience with these same pills was a little different: many didn’t work nearly as well as advertised. Despite my best efforts with some highly touted medications, most of my depressed patients were still depressed, and many arthritic patients were still looking for pain relief. 

The health center where I worked at the time wasn’t making things easier for patients, who complained about doctors (myself included!) who made them wait and telephones that rang and rang unanswered.

What would it be like, I wondered, if there were a magazine that told about health care the way it really is? What if patients and health professionals alike got to tell their stories?

Around the same time, I had a stairwell conversation with a hospital director of nursing. It stopped me short. “For the first time in my long career,” she said, “I’m ashamed to be in this business.” 

To me, this sounded like a cry for help; it sounded like a system in crisis. And yet, for the most part, popular magazines and medical journals seemed oblivious. 

It occurred to me that if we found a way to share our stories—the difficult moments along with the glorious ones—perhaps we could jump-start a national conversation about health care. Maybe this exchange could lead us toward a better health system.

Around the country, my colleagues and friends—in and out of medicine—thought this was a good idea. Many wanted to participate. And now, several years later, we have come together to launch Pulse—voices from the heart of medicine. 

I have great dreams for Pulse. I’d like readers to come to think of Pulse as their own, a place where they can speak from personal experience and from the heart. A place where generous listening leads to understanding and the inspiration to advocate for change.

Paul Gross MD
Editor-in-Chief