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

A Fine Man

I’ve been afraid twice as a result of my multiple sclerosis. The first time, I was twenty. As I sat down on the edge of the bathtub one day, the backs of my legs felt oddly cold–even numb. I ran to the library and looked up MS, and my heart began to race. Yes, odd sensations of hot and cold were among MS’s symptoms. Suddenly, I could see my future life as my grandmother’s–as that of someone who sat in a chair all day, used a walker and watched TV, not as that of the geologist I was studying to be.
My actual diagnosis came twenty-two years later, after I’d had three children and was embarking on a second career. By the time I received the news, I’d experienced enough incidents like the bathtub moment that I expected it. I wasn’t afraid then.
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Hold Me

Wendy’s hoarse howling startled me. She was usually among the best-behaved, highest functioning residents in our group home for adults with mental challenges. But today I turned to see my colleague, Sandra, struggling to bring Wendy back to her room, while fending off her kicks and bites the whole way. I fought my own fear of getting hurt and ran to help.

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What If

I undo the front of the cloth gown and step closer to the menacing machine. The female technician gently lifts one of my breasts—usually she begins with the left—onto a cold, flat surface. I shiver as my warm skin reacts to the chilly metal. Then, the top of the machine slowly descends, pushing into the top of my breast, flattening it, and squeezing it until tears form in my eyes. 

“Hold your breath,” the technician states.

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Working Without a Net in Kenya

The thirteen-year-old boy sits in a battered ENT exam chair. Henry, my Kenyan colleague, hands me a blurry CT scan. “His neck mass has grown for two years,” Henry says. “We think it is a glomus vagale tumor. Do you agree?”

I hold the scan up to a window. The vascular mass fills the side of the boy’s neck, displacing his carotid artery. “That’s probably right,” I respond. “At home, we would get more studies. We would prepare for bleeding. This kind of surgery can be very dangerous, even fatal.”

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The Care Piece

He was in his younger middle years, generally well. Before he had a wife and kids, he had been a competitive cyclist, an Olympic hopeful. He stayed active, ate thoughtfully, took no medications. But in the mornings, first his hands and within months other joints would swell and ache terribly, refusing to move. His primary doc sent him to a rheumatologist because, based on his symptoms, it appeared that an inflammatory process was to blame. The rheumatologist ran tests and then more tests; all were negative, but she agreed–this was rheumatoid arthritis.

He was started on a medication that made him feel better. Not fully better, but generally able to get up and move in the mornings without significant pain, which he certainly preferred, and his life went on.

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Late-Night Calls

Many things frighten me–from creepy-crawlers to turbulence on airplanes, from intravenous needles to walking across bridges over menacing rivers. However, late-night phone calls, especially from my family, send shivers up and down my spine. That is why I froze with fear when I received a call from my parents at 11 p.m. on February 28, 1986.
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Life or Death

It was election night. November 8, 2016. As a southern, affluent, white male from a conservative household I leveled with her: “This election isn’t life or death.”

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Universal Act of Emotion

 
Throughout most of my life, I regarded crying as a sign of weakness. Just as men often don’t like to cry, I saw crying as a symbol of sensitivity and fragility. Whenever I found myself needing a good cry, I would lock myself in my room and let it all out–let out the pain, let out the suffering, let out the anger. I would cry so much that it felt as if a gallon of water was pouring out of me, as if weight was physically being lifted off of my shoulders. I thought that the only reason I should cry was out of anger or pain.
 
But I have since learned that sometimes I need to cry just to cry–and that that’s okay.
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After “All We Could”

 
She is now six years old, attending first grade and riding a bike.

But six years ago, she was in the NICU, with six chest tubes, a ventilator on its maximum settings, and pulse oximetry readings–which should have been close to a hundred–that were dropping into the sixties. X-rays showed everything in its proper place, but this preemie was failing fast.

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Unalienable Right

 
The Declaration of Independence endows all of us with “certain unalienable Rights…among these are Life, Liberty and the pursuit of Happiness.” An ill person who lacks medical support does not have the wherewithal to pursue happiness. An ill person who is denied health care due to prohibitive costs does not possess liberty. Most fundamentally, a government that deprives its citizens of affordable health care profoundly undermines the life of those citizens. 
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25 Minutes

Pager rings. Just 5 minutes to get to the ED. Calling down as I rush to the trauma elevators, they tell me over the phone “Shots fired at a hotel in downtown Los Angeles.” I know that place…

At least 3 people arriving. The ED is bustling, preparing for their arrival. Blade and Prolene stitch in my scrub pocket, I am ready. We are ready.

For a moment the ED almost seems silent.

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The Turkeys

Lou arrived alone when she’d come for her blood pressure and itchy skin. Sharp, funny, she told me of her daughters, grown up and far away, and her life in the neighborhood as it changed around her. She had lived there for decades, long after her husband left, long after raising two on her own, long after the cottages around her were torn down for industrial sites. Neighbors were scarce and stray dogs plenty.

When her daughter arrived with her, I knew something had changed. Having driven sixty miles to bring her, Lou’s daughter was here to report on the increasing forgetfulness, the neglect of her garden. She was worried her mother was developing dementia and wanted her to move closer, where she could keep a better eye on her. Lou was having none of anyone else keeping an eye on her, though. We talked about memory and independence and safety and planning—at least as much as one can squeeze into a protracted twenty-minute visit. We all agreed to watch.

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