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

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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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Pamela Adelstein

The Heartbreaking Question

2 Comments / Bravery /

The unspoken question looms. I might ask first, dropping a bomb that disrupts the medical visit. Or the patient asks at the appointment’s conclusion, when I query, “Anything else today?” Patient concerns brought up when their visit has ostensibly ended are dubbed “doorknob questions.” Previously, these were predictably about Viagra or vaginas. Since the November 2024 election results, my patients voice their terror that access to gender-affirming medical care will cease to exist.

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Birth Story

Leave a Comment / Birth /

When my now-grown children were babies sleeping, my husband and I quipped as drunken smiles spread across their faces, “Womb.” When their sleepy smiles faded and they whimpered and pouted we commented, “Birth canal.”

As a family physician who has “delivered” hundreds of babies (medical speak for attending a birth), I consider myself well appraised of the uterus and vagina of a person in labor. I have wiped away blood, amniotic fluid, meconium, vomitus, stool and urine. I have touched tissues and instrumented bodily orifices.

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Rapid Mobilization

4 Comments / Recovering /

Since November 6, 2024, nothing has been routine for health care providers like me who proudly provide gender-affirming health care to trans and gender-diverse people. Now, every medical visit is marked with a pregnant pause after I enter the exam room, say hello, and ask how the patient is today . . . after which each patient expresses their profound fears and anxieties about whether they will be able to continue to get the care they need to be healthy and safe. My clinical sessions are packed with patients, and discussions such as these need time and attention, so now I run more behind than ever.

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Sex Ed

Leave a Comment / Getting Motivated /

Behind the closed door of the exam room, patients always hesitate in a predictable manner before asking uncomfortable questions. As the visit winds down, they finally summon their courage and inquire. We providers recognize this scenario, having witnessed it countless times before. Perhaps the patients sense us relaxing into the familiar and feel briefly encouraged to proceed.

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Aging in America

1 Comment / Palliative and Hospice Care /

A dentist friend once mused that people should be born with a third set of teeth that would erupt late in life, since our permanent teeth evolved at a time when humans’ life expectancy was shorter and thus they wear in midlife. Imagine the Tooth Fairy visiting us in our sixties!

Since that conversation, I’ve pondered how long our bodies are meant to last. As a family physician, I wonder whether medical advances have set up some body parts to fail prematurely. I’m deeply saddened that societal structures have evolved minimally to keep pace with the way we now age.

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Watching for Survival

5 Comments / A Turn for the Better /

While I was driving to work on a sunny Friday morning many years ago, the opening music for the StoryCorps broadcast streamed from the radio. I raised the volume and listened. A daughter asked her father how he’d made it out of a psychiatric hospital where he received shock treatments. He had been committed for insanity at age 22. He replied simply that he watched television to see how “normal” people acted and mimicked what he saw. Eventually, the staff released him.

The interview ended. I lowered the volume on the radio and reflected on this man’s smarts and the deplorable state of inpatient mental health in the 1960s. And then I started bawling.

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Stalemate

2 Comments / Regrets/No Regrets /

Once I looked forward to his visits, but years later I dreaded them. My change of heart began after he was laid off from his janitorial position. He worked diligently, applying desperately for jobs, but the economy was slow, and no one was hiring. The stress of not being able to make ends meet was crushing. His blood pressure rose, and he grew angry and depressed.

Stalemate Read More »

Medication Automation

2 Comments / At the Pharmacy /

I should have said no years ago when the person at the register kindly asked, “Would you like to sign up for auto-refill?” Smiling, I replied, “Sure!” and volunteered my information to be uploaded into their computer.

Back then, this seemed revolutionary. No more remembering to call every month before I was out of pills, no searching my medicine cabinet for the most recent prescription bottle to get the seven-digit number I needed to punch into the phone for a refill. Now I’d never run out of medication!

Medication Automation Read More »

Original Scars

Leave a Comment / Scars /

My chest tightens, then relaxes, as the tears roll down her face. She gradually bares her soul, revealing the events that led her to my exam room. She may have been born to a mother whose own experience with trauma stunted her ability to be a supportive parent. She may have suffered abuse at the hands of people who were supposed to be trustworthy. Or she may have experienced the loss early on of the primary person in her life who understood her.

Original Scars Read More »

The Portal

2 Comments / The Biopsy /

“Hello?” I answered the yellow phone with its coiled cord dangling from the kitchen wall. To my surprise, my doctor was calling ME, a seventh grader, with results of my blood tests. (Mono.) I still recall my shock that a doctor – practically a celebrity! – would call my home. Shouldn’t his staff be calling?

The Portal Read More »

The Greatest Health Care System in the World

1 Comment / Cold /

One might reasonably assume that diabetes testing supplies could be simply obtained. Continuous glucose monitoring (CGM) eliminates fingersticks and enables more precise knowledge of sugar levels. Recently insurance denied coverage of CGM supplies for a patient I see. My patient’s blood sugars were higher than last year. My patient was upset about their elevated blood sugars AND their lack of glucose monitoring supplies. I pressed the pharmacy to learn the reason for the denial. Insurance would not cover CGM because the patient’s diabetes control had worsened, which indicated that the CGM did not help lower their blood sugars.

The Greatest Health Care System in the World Read More »

Long Grief

Leave a Comment / COVID Redux /

There used to be much to do. Reciting the Mourners’ Kaddish daily. Making phone calls, waiting on hold, filling out forms, managing the estate. Sorting and donating Dad’s personal goods. Answering panicked phone calls and texts from my mother. Explaining my status as a mourner—taking a year off from dancing at celebrations, declining blindingly joyous events that chafed against my mourning soul. Responding to friends checking in. Processing feelings. And marking all the “firsts”—first Thanksgiving, first Father’s Day, first birthday—without Dad.

Long Grief Read More »

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