Pamela Adelstein, Author at Pulse

Medication Automation

2 Comments / At the Pharmacy / Pamela Adelstein

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!

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Original Scars

Leave a Comment / Scars / Pamela Adelstein

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.

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The Portal

2 Comments / The Biopsy / Pamela Adelstein

“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?

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The Greatest Health Care System in the World

1 Comment / Cold / Pamela Adelstein

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.

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Long Grief

Leave a Comment / COVID Redux / Pamela Adelstein

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.

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Is It Safe Here?

1 Comment / Traumatized / Pamela Adelstein

I have always been aware that I am Jewish. In the antisemitic neighborhood where I was raised, my unique religious identity was central to all interactions. I was perpetually othered. Supposedly I was smart because I was Jewish. My (ugly) appearance was Jewish. My (weird) last name was Jewish. I was different. Undesirable.

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Inner Duality

2 Comments / Tough Calls / Pamela Adelstein

If you have ever been in therapy, you likely discovered that while you share personal details about your life, the therapist reveals little information about theirs. From my understanding, when and what to disclose is part of a therapist’s training. In contrast, in medicine, relatively little about self-disclosure is taught. Instead, it is up to the individual to figure it out on their own.

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Skin Rash

4 Comments / Bedside Manner / Pamela Adelstein

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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The Heat is On

Leave a Comment / Heat / Pamela Adelstein

During a busy clinic, my eighteen-year-old texted concerns of sudden torrential rains causing flash flooding in our yard, with potential basement flooding. Centuries ago, our backyard was swampland. Now it is developed land and a flood plain.

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Priorities

1 Comment / Pills / Pamela Adelstein

Two dreaded words for medical providers and patients: Prior Authorization (PA). For the fortunate few who have not needed to engage in this process, here’s a definition from the American Medical Association website: Prior authorization is a health plan cost-control process by which health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.

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Finding New Purpose

Leave a Comment / Alone / Pamela Adelstein

Having a purpose in life is as critical to one’s well-being as food and shelter. I’ve learned, over my 25 years of doctoring, that a sense of purpose both helps us develop our identity—our sense of self—and connects us to something greater than ourselves.

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Hard Questions

1 Comment / Coming Undone / Pamela Adelstein

My routine clinic day was interrupted by a startling message. During a moment of extreme stress, a long-term patient of mine left a threatening voicemail on my colleague’s phone. The target of her anger was me. It was difficult to discern her garbled speech in the recording of her screaming, but I heard loud and clear that she intended to find me at my clinic and physically hurt me – or worse.

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

Pamela Adelstein