2022

When I received a message from one of our clinic nurses that Mr. R had passed away, at age 82, I called his house, spoke to his wife and son, and expressed my condolences. I learned that he’d gone quickly, from fast-moving pneumonia. The day was drizzly, the clouds dark, and I was reminded of a Baudelaire poem I’d read in high school: “Quand le ciel bas et lourd pèse comme un couvercle sur l’esprit…” (“When the low, heavy sky weighs like a lid on the spirit…”).

He shunned the sunshine. He also refused to come into the mobile medical van where we saw patients. He’d been sitting on the curb, across the street from the van, in the shade, every day for a week. The van’s male physician and nurse had been unable to entice him to step into the van for an exam, to talk with them, or to accept anything from them. Maybe a woman would have more luck? So I went over to him.

It is no secret that medicine and art are intimately linked. Consider the utility of music therapy, the innate beauty of medical illustration, and the use of the performing arts to promote healing. As a jazz saxophonist, I have always seen playing and listening to music as a form of relaxation. But what I never realized was how connected playing a musical instrument can be to performing a medical procedure like endoscopy. That may seem an unlikely pairing to some, but they are not so different after all.

How to thank the on-call physician? Not on MyChart. My brain previously so flustered I couldn’t put a name to the voice; only by checking “Medications,” where he’d written a thorough note, could I make the link, but impossible to message directly.

Lori is here today with a chief complaint of dizziness and headache. At least that’s what my medical assistant tells me. But after practicing family medicine for almost twenty years, I’ve learned that there’s usually more to the story.

I recognize the expectation to match the story and physical exam to a reasonable diagnosis, especially one that the patient can trust. All in 20 minutes. No pressure at all!

Very early on a Sunday morning, my friend Marla called asking for help. She was in excruciating pain—bone metastases, as it later became clear, from her breast cancer. She’d been instructed to head to the emergency room and needed a ride.