Pam Adelstein, Author at Pulse

Unraveling

Leave a Comment / Awaiting a Diagnosis / Pam Adelstein

A certain patient and I had always enjoyed an easy rapport at his annual exams and occasional acute care appointments.

Then one morning he presented with an itchy skin rash. The skin findings were minimal; he had tried over-the-counter creams to no avail. I prescribed a more potent topical medication, and he left satisfied. Two weeks later he called again, this time asking for an urgent visit. The rash had spread and the itch was keeping him up at night. He sent photos via the portal, but their blurriness made them difficult to decipher.

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Menopausal Moments

2 Comments / Loss / Pam Adelstein

The personal question patients used to ask me was “Are you pregnant?” Recently, a patient inquired, after sharing that his wife had started menopausal hormonal therapy, “Do you also take this?”

I have indeed started what I call my Menopause Trifecta: an estrogen patch, a progesterone pill, and a testosterone gel. Estrogen made me miserable during puberty; helped me become a mother of two children; and drove cyclical cravings, cramps, and crying. But my ovaries no longer produce estrogen. My “childbearing potential” is gone. Unused menstrual supplies gather dust in a cabinet.

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Spiraling

4 Comments / Hospitalized / Pam Adelstein

As a primary care physician, I like my patients’ charts to be updated, without redundant or irrelevant information. So, before initial appointments with patients I “inherited” when I joined my current practice, I take some time to “clean up their chart.”

When patients have complex medical histories and medication lists, cleanup is challenging. But worth it. This process helps me build a two-dimensional picture of the patient, their disease trajectory, relationship with specialists, and longitudinal overall health. When I meet the patient, I can then focus on listening and observing and understanding them three-dimensionally.

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Boys or girls?

7 Comments / Diversity / Pam Adelstein

Like many parents, I love to talk about my children. A conversation with someone to whom I’m newly introduced often begins with “Do you have children?” (Yes.) “How many?” (Two.) Then the natural and understandable follow-up question is usually “Boys or girls?”

Usually, I revel in the possibilities inherent in meeting someone new. However, at such moments, I pause and protest silently. Ugh! This is a question one should never ask someone you’re just meeting.

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Decades

2 Comments / Grit / Pam Adelstein

I’ve been aboard a “choo-choo train” for decades. I traveled to college, to medical school, to family medicine residency, to become an attending physician, then a medical administrator. Each new locale exposed me to a novel culture, with new languages, rules, and personalities—forcing me to learn different ways of thinking and relating to my environment.

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Listen Carefully to the Youth

2 Comments / Trans / Pam Adelstein

With tears in my eyes, I burst out of the classroom, seeking refuge from my teacher’s and classmates’ endless verbal battering of me. We were mired in a debate about whether the canon of religious music should be omitted from public school choral groups’ repertoires to “appease” students who felt uncomfortable with such music. The discussion was framed with a particular implication—that because of a squeaky and unreasonable minority, the majority of students were deprived of critical singing opportunities.

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Telehealth from the Driveway

2 Comments / A Ray of Hope / Pam Adelstein

My computer chimed a familiar DING, and my patient’s face flashed up on the screen. They were seated in their car, parked in the driveway of their grandchildren’s home, before they went inside for a visit. My patient eagerly declared, “Today is the day!” A broad smile graced their face. “I’m ready,” they said.

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The Sounds of Grief and Mourning

10 Comments / Listening / Pam Adelstein

Since mid-January, I have focused on listening. One morning the phone’s ring pierced my slumber. I listened intently to my mother’s words and tone as she explained that my father was hospitalized. New urgency and concern cut through her usual anxiety, altering the quality of her voice.

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Déjà vu all over again

1 Comment / Omicron / Pam Adelstein

The news is full of reports about the havoc omicron is wreaking on our health-care system. But last week I was on vacation, and as I sipped my daily latte and strolled on the beach, COVID-19 seemed like a distant memory. As soon as I checked my work email after getting back, however, my vacation bliss shattered—boom!

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A Moment on Your Lips . . .

1 Comment / Eating / Pam Adelstein

Nine-year-old me, while devouring Judy Blume’s book Starring Sally J. Freedman as Herself, came upon what seemed like a brilliant adage: “A moment on your lips, forever on your hips.” I thought, “Perhaps this ditty was the missing piece in the how-to-be-thin puzzle.”

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Pam Adelstein