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

Out of the Blue

Marianna Crane ~

As I sit in the exam room waiting for my first patient of the afternoon, the phone rings. It rings four more times before I realize that Amanda Ringwald, our eighty-year-old receptionist, hasn’t come back from taking a rare lunch break.

I pick up the phone and say, “VA Hospital. Marianna Crane.” Oops, I’m not back at the VA anymore. “Senior Clinic,” I quickly add.

“Hello, my friend.”

The familiar voice makes my throat tighten and my eyes water. How in God’s name did he track me down at work?

“Mr. Foley. How are you?”

Out of the Blue Read More »

My First Code

Jessica Greenberg ~

“Code Blue, Interventional Radiology suite,” blare the overhead speakers.

I am a new third-year medical student, doing my first rotation in internal medicine at Yale New Haven Hospital. This morning, I’ve been rounding on patients with my medical team.

The alarm sends us lumbering down the halls, struggling to keep our clogs from falling off our feet, clutching our white jackets to our chests to keep the pockets full of stethoscopes and pens and patient lists from bouncing.

Arriving in the IR suite, I stop about twenty feet from the middle-aged woman lying in the patient bed. More than a dozen physicians and nurses crowd around her, obscuring my view.

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Simple Acts

Dianne Avey ~

One night on my nursing shift in the cardiac intensive-care unit, I received a new patient from the operating room: an eighty-eight-year-old woman who had suffered a major heart attack and had just undergone emergency coronary-artery bypass surgery.

Her bed was wheeled into the room along with the usual accoutrements: six different IV drips, a ventilator, an aortic balloon pump and various other lines and monitoring devices. Her name, I saw on the chart, was Mrs. Green.

The young surgeon took me aside.

“I don’t care what it takes, just keep her alive for twenty-four hours,” he told me, clearly more worried about his surgical-outcome stats than he was about Mrs. Green’s welfare. The hospital and insurers kept data on these procedures; it didn’t look well for a surgeon to have too many patients die during or right after surgery.

“No problem,” I replied confidently and went right to work, adjusting drips to maintain her blood pressure, cardiac output and heart rhythm.

Despite my efforts, Mrs. Green’s health status remained very unstable. Her heart was extremely weak, and she showed signs of brain damage.

Simple Acts Read More »

Learning Respect

David Edelbaum ~

When I finished my medical training, almost sixty years ago, I was like many new graduates: I thought I knew it all.

I opened a private office in Los Angeles and paid courtesy calls on the local physicians to let them know my qualifications and my availability for consultation, as both an internist and a nephrologist. (The treatment of kidney disease was then in its infancy, and I was the area’s first such specialist.)

With a wife, two children under age four, a home mortgage and an office to support, I needed to make a living. I took call at the local emergency rooms, worked nights at the VA Hospital and told my answering service to mention my availability to other physicians who might need assistance.

One of the very first doctors I visited was Dr. Lud, a large, friendly, highly competent and respected family physician. His patients adored him, and if he asked you to consult on one of his cases, that was the Good Housekeeping Seal of Approval: It assured your standing within the medical community–and, of course, a steady income.

Learning Respect Read More »

Who Would Want to Do This?

Kristin Beard ~

“Get the patient on the monitor.”

“How long has he been down? Someone get on the chest!”

“Keep ventilating. He’s in v-fib. Defibrillate at 200.”

“Charging, everybody clear?…Shock delivered.”

“Resume compressions. Push one of epinephrine…Hold compressions. What rhythm is he in?”

“He’s asystole, resume compressions.”

We repeat the process a hundred times over. The medic said they started coding the patient an hour ago. The family is in the consult room with the chaplain.

Who Would Want to Do This? Read More »

It Takes a Tokyo Village

Ruth Harimoto

 I have lived in Japan for more than half of my life. I first came here as a nine-year-old child, the daughter of a missionary. Later, after several years of study and work in the US, I returned as an adult with my Japanese husband. You’d think that after more than thirty years here, I could almost call myself Japanese! But no. In this homogeneous country, I’m still a foreigner.

The role of a foreigner in Japan is, for the most part, a comfortable one. Japanese people are polite. They don’t expect foreigners to know Japanese, so when I do speak it (with my learned-as-a-child accent), I’m applauded and praised. This role can also be lonely, though.

As I go about daily life, my five-foot-seven height and Caucasian features automatically set me apart; there’s no possibility of melting into the crowd. Small children stare at my blue eyes and light hair. Sometimes, on a crowded train, the open seat next to me will remain open. Gaijin, the Japanese term for anyone non-Japanese, means “outside person.” I must accept that I am, and always will be, a gaijin.

It Takes a Tokyo Village Read More »

Matching Rings

Joy Liu

The room is stuffy, but the woman is shivering.

Her husband stands by her bedside. An interpreter that they’ve hired to stay with her day and night stands at the foot of the bed. And then there’s me, the doctor (I’m an intern), waiting to deliver one of many sad speeches I must give today.

Smiling wanly, she struggles into a sitting position and shakes my hand.

Even with a diagnosis of metastatic stomach cancer, she has movie-star looks. She’s only twenty-six–the same age as me. I can imagine her stepping out of a red-carpet premiere in Shanghai. Instead, having hired personal interpreters and taken a flight halfway across the world, here she is in this hospital bed, waiting expectantly for me to tell her what we can offer her.

Matching Rings Read More »

Saving Private Ryan

Gregory Rutecki

The late Eighties was the worst of times in medical education–the era when doctors in training worked a virtually unlimited number of hours each week. This unceasing and inhumane workload led residents, understandably, to view patients purely as collections of physical ailments.

Back then, I was an attending physician at a community teaching hospital. One day, as usual, I was preparing to make morning rounds and, simultaneously, to do my best to teach my team of internal-medicine residents.

Fourteen patients awaited us, every one of them quite sick. As my team and I proceeded from one bedside to the next, struggling to cram the patient interviews into ever-dwindling snippets of time, I felt a familiar sense of growing pressure; it was a struggle to focus fully on each patient.

Despite this, our last patient’s chart notes grabbed my complete attention.

Saving Private Ryan Read More »

Just Middlin’

Alexandra Godfrey

My dad was once a physician for the coal mines in Yorkshire, England, where I grew up. It’s been decades since I accompanied him on his rounds, and fifteen years since I moved to the States and began to practice as a physician assistant in the Appalachian Mountains of North Carolina. But I still vividly recall my childhood days and the Yorkshire dialect we spoke.

Somehow, the seventy-three-year-old woman sitting in my exam room takes me back to that time.

She’s coughing violently–hacking thick yellow mucous into her tissue, spraying the floor with spittle–just as my father’s patients did.

Just Middlin’ Read More »

A Doctor Confesses: I Screwed Up

Marc D. Wager

When I was in medical school, more than thirty years ago, I felt I received pretty good training on how to communicate clearly and effectively with patients and families. I even remember the name of the fictitious character we had to practice telling about his wife’s demise: “Mr. Gottrocks, I’m afraid that your wife has taken a turn for the worse; I think you should come to the ICU right now.” As a pediatrician, more recently, I’ve been trained to discuss vaccines in a nonjudgmental way with parents who, contrary to my wishes, decide not to vaccinate their children.

Despite all of this training, though, and despite many articles on the merits of doctors admitting their wrongdoing, nobody ever taught me how to say, “I’m sorry, I think I screwed up.”

A Doctor Confesses: I Screwed Up Read More »

A May-December Friendship

Hanan Rimawi

Ms. Connie was known, to her delight, as the Jackie Kennedy of Our Sanctuary nursing home. A tall, eighty-something woman who tucked splashy flowers into her voluminous curls, she’d strike up a conversation with anyone she encountered.

These chats were never a half-hearted “How are you?” tossed off before zipping away in her wheelchair. She’d ask an aide if her ailing daughter was feeling better, or check whether the receptionist’s son had heard from his dream college–“I’m keeping my fingers crossed for him!”

Ms. Connie shared a suite with Ms. Alice, a woman who was in her nineties. Ms. Alice was more reserved, but equally good-natured. Morning and evening, you’d find her sitting in her room, absorbed in a book. Despite their contrasting personalities, the two were close friends.

We met when I was fourteen, two years after I’d started volunteering at Our Sanctuary.

A May-December Friendship Read More »

Incidental Finding

Deborah Pierce

“You need to give me the name of a different specialist,” Ashley asserted.

For several years, Ashley, age twenty-nine, has been my patient at the residency practice where I work as a family doctor. Our relationship is not entirely comfortable; after visits, she frequently seems dissatisfied, yet she refuses to see anyone else.

Ashley’s body is a source of distress to her, often developing various pains and discomforts that fade away without explanation. In search of relief, she asks for many tests, but often, when I recommend a treatment, she refuses it or has difficulty tolerating its effects. When we talk, she’s usually very guarded about any aspects of her life besides those directly related to her symptoms.

I often feel ambivalent about ordering tests for Ashley, because all tests carry risks. Mostly, the risks are small. But one big and worrisome risk is the possibility of an incidental finding–something unusual that requires further testing and that would have posed no problem had it gone undiscovered.

Incidental Finding Read More »

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