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

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

Death Watch

Even dying, Dad fills the hospital bed. He’s a big man. His slumped body bears two bed sores, one on each leg. A matching set.
Once, he ruled me. A slap of one hand hand here. A smack of his other hand there. “I’ll give you something to cry about.”
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“Better to Ask a Question Than to Remain Ignorant”

Any class of first-year medical students contains a mix of genders, races, socioeconomic ranges, ages and cultures. We try to convince students their tutor groups are safe places to ask questions and the only bad question is one that isn’t asked. Sometimes that openness leads to challenges. 
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Careful Fingers

It was a Friday night in February. I was finishing up a poster for a conference on cancer genomics I had to attend the following Monday. As I worked, I thought about the possibility of making mistakes on the data analysis.

Gingerly, I went back to the raw data and repeated the process. Highlight this portion of the data. Make sure the data is valid. Copy and paste it into the statistical software. Click this button before pressing “Enter.” My eyes darted across the screen, watching every move my fingers made.

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A Shared Language


I was waiting on a friend who had injured her arm. They entered later and huddled in the seats nearby, murmuring in hushed Korean and peering at the English signs.
Feverish and weak, the mother clutched her stomach while her husband stroked her arm. You could tell the son was anxious by the way he kept tugging at his father’s wrist to check his watch, the way he paced in little circles and rubbed his mother’s hand.
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The Color of Tears

“Hey Doctor Curly!”

“Hey Hungry Hippo!”

“You still haven’t gotten a haircut? Have you had one since your Bar Mitzvah?! What nice Jewish girl’s gonna go on a date with you with your hair that long?!”

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Witness

 
I am the product of a couple hundred years of Western European immigration to the northeastern United States. My parents were left-leaning but square churchgoers who were inspired by the Civil Rights movement and the Reverend Martin Luther King, Jr., in particular. My father began a career as a Methodist minister. However, being a rather cerebral introvert, he soon realized the ministry suited him poorly. When he left the profession suddenly, we landed in Poughkeepsie, New York, where he was able to secure work through IBM.

In a few years, we were financially back on our feet. But, much to the horror of friends and family, my mother insisted that we remain in the Poughkeepsie schools. About 70 percent of the children in the district were African-American. She rightly saw the rampant de facto segregation and, due to a combination of her political idealism and plain stubbornness, kept us where we were. The fact that this was viewed as a radical act in my parents’ social circle speaks volumes about race in America.

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Black, Blue, Green and White

My life and experiences have been defined by contrasts. I am a physician and a military officer. Yet, in my presence and out of ear shot, I have been called such names as Nigger, Oreo, Tutsoon and Spear Chucker.

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A White Girl Grows in Philadelphia

 
I grew up with my older sister and our mother in a fourth-floor walk-up in Center City, Philadelphia. Most of our immediate neighbors were gay and white, but Center City, like all of the city’s neighborhoods, abutted a diverse range of cultures, including an Irish Catholic neighborhood and a black neighborhood. South of the black neighborhood was a bastion of Italian-Americans–the home of Rocky and open-air markets. Fanning out from Center City were enclaves of African-Americans in West and North Philadelphia; Jewish, Polish, Puerto Rican, Chinese and Ukrainian neighborhoods; and several historic and hippie areas.
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Race in the Advance Directives Conversation

 
Much of my work as a Palliative Care physician involves conversations with patients and their families for whom the medical outlook is bleak: to help them receive the treatment they want, not more and not less. Such discussions are best held in tandem with the primary medical team and with the nurse. Many times, both attending doctors and housestaff have said, “But it’s so much harder to get a DNR (Do Not Resuscitate Order) with African-American families.”
My experience differs.  
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Bare Hands and an Open Heart

 
I am constantly obsessing over fingers and toes in the ICU. They can tell us so much about whether our high-tech machines and drugs are helping to keep our patients’ bodies perfused with oxygenated blood. Some patients’ fingers and toes are warm and pink. Some are cold and black, even falling off. A lot are dirty…really dirty. Like with actual dirt clogged under overgrown nails. I won’t lie and pretend that these nails don’t gross me out a little bit. Or deny that I typically wear gloves when I am touching these patients’ hands or feet.

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No Retakes

I was midway through my internal medicine internship when elderly Mrs. Armstrong was transferred to our service for treatment of a pulmonary embolus (aka PE–a blood clot in the lungs) after a knee fracture repair. I remember thinking, disparagingly, “Surgeons should be able to treat a PE!”

The following morning, our team rounded on our patients and hurriedly wrote orders and notes because Susan, my senior resident, and I would be in clinic all afternoon. As we worked, another resident, Greg, stopped by and invited us to a party that evening. “I hope I can come,” I said. “If I finish early enough.”

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Paprika

The insistent chirp on the phone was a reminder from Fran. “Don’t forget to stop at the compounding pharmacy.” For $58 cash these specialists turned a pill into a cream. GERD made Fran intolerant of most oral medicines.

Tired from the long drive, I thought back on my years of marriage. Back pain was the first problem, I think. Then GERD, then migraines, dizziness, TMJ, panic attacks, fibromyalgia. They were all tough, serious problems. But all together?

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