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

Stories

Cushioning the Fall

Meghan G. Liroff ~

Angela Harris has been here in the hospital for six hours, awaiting the results of her CAT scan. I won’t take responsibility for all of that wait time: complicated CAT scans and labs do take a significant amount of time to perform. But she didn’t need to wait the last hour.

She was waiting on me–her emergency physician–because I needed to confirm her cancer diagnosis with radiology, arrange some oncology follow-up…and find the most appropriate phraseology for “You have stage IV cancer, but you don’t meet admission criteria.”

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Scarred

Joe Burns ~

“Did you have heart surgery?”

The shy seventeen-year-old girl’s question caught me completely off guard.

Her name was Sarah. Everything about her seemed perfectly organized–her long black braid falling ruler-straight between her shoulders, her folder with all of its documents sorted by date, her matching shoes and shirt, her entire wardrobe without a single wrinkle.

Her health was a bit less perfect. She’d been born with an atrial septal defect (ASD)–a hole in the wall separating the heart’s right and left chambers. Tomorrow she was to have an operation to repair the hole, so she’d come in today, accompanied by her parents and brother, to sign the presurgical consent forms.

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The Magic Touch

Betsy Willis ~

Many months have passed since the spring day when I was hit with the news from my yearly mammogram, but those typewritten words are forever etched in my memory: “The density appears greater in left breast.”

My doctor comforted me with statistics showing that mammograms aren’t 100 percent accurate–but she also lost no time in sending me to a surgeon, Dr. Prewitt. Upon meeting him, I immediately felt sure that I would be in good hands. He explained the procedure he’d use and answered my questions with clarity and a very welcome gentleness.

He too expressed doubt about the diagnosis, but said, “I’ll schedule you for a parking-lot appointment with the traveling MRI-guided breast-biopsy machine.” (I pictured a brain on wheels.)

“The biopsy is minimally invasive,” he explained, “and it can locate the suspicious area precisely and remove cells that we can use to make a clear diagnosis. Based on what we find, we’ll make a treatment plan.”

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A Tingling Sensation

Mitch Kaminski ~

It had been a hectic day in the urgent-care clinic of my large family practice, and I was starting to worry about the time: My last two patients had put me thirty minutes behind.

I felt relieved when I saw the note for the next patient: “Seventy-four-year-old female with UTI.”

A urinary-tract infection! This should be quick and uncomplicated….

I walked into the room to find a well-dressed older woman seated on the exam table. I had just enough time to wonder fleetingly, Why do some patients decide to wait on the exam table while others stay seated in the chair nearby? Then I turned my full attention to the woman before me.

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Compassion: A Two-Way Street?

Carey Candrian ~

I am an assistant professor of health communication. Since 2008, as a volunteer, educator and researcher, I have been active in hospice care. As many people know, hospice teams (nurses, social workers, doctors, chaplains, volunteers) help dying patients and their families live as fully as possible during their remaining days together.

In November 2016, right before the presidential election, I started a project aimed at identifying the best practices in communicating about hospice to prospective hospice patients. The intent was to help them make an informed choice about whether or not to enroll.

For six months, I observed hospice nurses, patients and caregivers during prehospice consultations, and interviewed most of them.

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You Never Know Who’s Listening

David Edelbaum ~

I always warn my medical students to be careful what they say in front of patients, or patients’ families or friends. “You never know who’s listening!” I add. They may think that I’m exaggerating–but I have my reasons.

Early in my career as an internist/nephrologist, if I had a free moment I’d head for the emergency room. I might get a referral, and the coffee and conversation were usually entertaining.

As I chatted with the ER doctor one morning, a cardiac-arrest victim came in, and the doctor and staff began administering CPR. In the midst of this, another cardiac-arrest patient arrived. The doctor asked me to evaluate this man and, if necessary, to direct his CPR.

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A Series of Unfortunate Events

Holland M. Kaplan ~

I’m sitting in the ICU team room, staring at the computer, trying to look like I’m writing a note. But my head is pounding.

As an internal-medicine resident doing my first month of residency, I’ve found the ICU of the bustling county hospital a jarring place to start my training. Although I’d anticipated the clinical challenge of caring for very ill ICU patients, I was unprepared for the emotional burden of having to deliver devastating, life-altering news to them and to their family members.

Faint yells emerge from Room 7. They have an almost rhythmic quality: “Ahhh!”…(three seconds)…”Ahhh!”…(three seconds)…”Ahhh!”

It’s Ms. Burton. I’ve just gotten back from checking on her, but I plod back again.

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Walk-In

Ingrid Forsberg ~

It’s 10:00 am on a Monday in June. I’m the nurse practitioner on duty in a convenience care clinic housed in a corner drugstore in urban Chicago.

Sunlight is pouring through the huge storefront windows when my first patient of the day walks in. He’s in his late twenties, muscular, crew-cut. He looks like someone who’s used to being in charge.

Right now, though, he looks anxious. He’s pale, with dark circles under his eyes. His eyes scan the store, looking for something.

I know immediately that he’s looking for me.

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Riding Out the Storm

Dan Yashinsky ~

In Cape Breton, Nova Scotia, if a blizzard keeps you in your neighbor’s house, they say you’ve been “storm-stayed.” I first learned this term from a storyteller in the Maritimes, and it’s come to hold special meaning for me and those I work with.

I am the storyteller-in-residence at a research and teaching hospital for the elderly, in Toronto. My work here, known as “storycare,” reflects the institution’s philosophy that literature and storytelling are essential to health care.

Every week, I work with clinicians and therapists to bring storycare to patients in the palliative-care, rehab and long-term-care units. Twice weekly, I head to the fourth floor to co-lead storytelling circles for the geriatric psychiatry patients.

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A Stranger Comes to Town

Syed M. Ahmed ~

Twenty-five years ago, having completed my family-medicine residency, I left Houston to start a two-year stint practicing in a remote village of fewer than 2,000 souls in the Appalachian Mountains of Ohio.

The day I arrived at my new workplace (a two-person practice in the only clinic for fifty miles), my new colleague Dr. Jones told me that she was leaving the next day on a two-week vacation.

Hearing this, I felt anxious, to say the least. I’d expected her to take time off, but so soon? Also, not only were this Appalachian town and its folks completely unknown to me, and vice-versa, but I was the first Asian physician to come to those parts.

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Fear No Evil

Scott Janssen ~

“You need to get here now!” The nurse whispers anxiously. It’s after midnight. One of our hospice patients has just died at home, and her husband is threatening to shoot himself when the funeral home shows up.

“Has the funeral home been called?” I ask.

“No.”

“Does he have a gun or weapon?”

“We’re out in the country. There are deer heads on the wall.”

I try not to stereotype, but deer heads are a giveaway. There are probably lots of guns.

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Epilogue

Sara Bybee ~

It’s 2:02 pm when my pager beeps. I pull it out and read: “Juan may have just passed. Going in now.”

As a social worker in the region’s only cancer specialty hospital, I provide emotional support for patients and their families–including talking about their wishes for end-of-life care.

Juan is a sixty-five-year-old Ecuadorian man with stage 4 pancreatic cancer. I’ve known him for about a year. Polite and easy to talk to, he often listens to Spanish sermons as he walks through the halls, IV pole at his side.

Over the months, we’ve grown close. He’s told me about his life in Ecuador, his first job (delivering pizza) and how proud he is of his children. I’ve met his wife, Yolanda, and their daughters, Diana and Maria.

Recently, as Juan’s cancer progressed, he told me that if he stopped breathing, he didn’t want to be intubated or resuscitated.

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