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

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

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Stories

Incidental Finding

9 Comments / Stories /

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.

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Unmasked

40 Comments / Stories /

Carly Bergey

It’s called a missed miscarriage: You arrive, as I did, at the doctor for your first-ever pregnancy appointment, suffering from morning sickness and filled with joyful anticipation–only to learn that your body has not yet registered the death of your small embryo. Despite all of my doctor’s tinkering and double-checking, the ultrasound screen showed no movement. There was just the outline of a baby in me, quiet and still.

Hoping for a natural miscarriage, I told my coworkers what had happened, but asked that we not discuss it at work.

Day after day, I went to the Denver office where I worked as a speech pathologist, carrying my baby deep inside me, like a single stitch woven within fold after fold of tissue and blood.

I was asking my body to let the baby go. My body refused. So the waiting continued.

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Hearing Voices

10 Comments / Stories /

Robert Burns

“She’s been hearing voices,” says Adala’s nephew Diri. “She hears them every night.”

The three of us sit in an examination room of my private geriatrics practice. I’ve been in a community-based practice in Memphis, Tennessee, for nearly twenty years.

Adala is a tall, slender woman. Dressed in a gray-blue guntiino, a long piece of cloth tied over the shoulder and draped around the waist, she has her head covered with a shawl. Her gaze shifts from her nephew to me; her eyes search my face and then stare silently at the floor. Despite the differences in culture and language, she is like many of my patients brought by a family member. She’s not here by choice; she came in deference to Diri’s wishes.

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Brave New World

28 Comments / Stories /

Rosalind Kaplan

I think a lot about quitting medicine lately. A lot.

Then I have a morning like yesterday morning:

I see a patient I’ve known for more than twenty years, caring for him through an adrenal tumor, a major gastrointestinal surgery and now renal failure, for which he needs a kidney transplant. As we review his last set of labs (stable, thank goodness), he is sanguine, hopeful. He may have found a donor, and he might make it to transplant without dialysis. He has to live–he has a wife and a child.

Next, I mess up my schedule entirely by spending more than half an hour with a patient who only came in to talk–not about herself, really, but about her husband who has just been diagnosed with a probably fatal illness. I break all of my own rules and tell her what I’d do if this were my own husband–how to push him to get emotional support, where to go for a second opinion….When she leaves, we hug like sisters.

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Heart and Soul

20 Comments / Stories /

Fredy El Sakr

“Help!” I yelled out of our open apartment door.

I was seven years old, and my family had recently emigrated from Egypt to the US. We’d been feeling elated that week because, after months of interviews, my father had matched into a pediatric residency.

That morning he’d awakened feeling nauseated. My mother and sister went to buy some soothing food. I noticed that he’d vomited in the bathroom; now he was feeling worse.

He knew it was serious, because he put on his brown leather jacket and lay back in our blue recliner, waiting for my mom to return and take him to the emergency room. Now and then he’d look at me reassuringly with deep, dark, pain-stricken eyes, but he was clearly in agony. Then, as I watched, his eyes rolled back in his head.

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The Lady Behind the Curtain

7 Comments / Stories /

Scott Janssen

“Why don’t you talk loud enough for the whole damn hospital to hear you?”

I’ve just greeted my eighty-four-year-old grandmother, and now this irascible voice has erupted from behind the curtain that separates us from whoever is sharing Grandma’s room.

The nursing assistant who showed me in glares across the curtain at the other inhabitant.

“You shut up,” she tells the person firmly, “or I’ll smack you with a bedpan.”

Then she leaves us alone.

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An American Story

31 Comments / Stories /

“Mr. Douglas?” I call out into the waiting room. A short, grey-haired man in his sixties staggers towards me, bracing his back with his hands. Despite his pain, he gives me a warm smile, which I return.

As I help him onto the exam-room table, he winces, squeezing my hand.

“I’m a medical student,” I begin. “If you wouldn’t mind, I’d like to examine you before Dr. Smith sees you.”

He nods. “Go ahead, you can learn on me–just don’t break my leg!”

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Complainer

7 Comments / Stories /

Christina Phillips

The patient, age forty-nine, complained of abdominal pain. She was taking both slow- and fast-acting oxycodone to manage the pain, and she also took antidepressants and a sleeping aid. She’d come to the hospital several times in the past year, always with the same complaint. This time, not feeling well enough to drive, she’d come by taxi. The veins in her arms were small, threadlike and collapsed, like those of a ninety-year-old or a recreational drug user.

Her medical file was huge, with reports from her primary-care physician, from local hospitals and from the gastroenterology department of a highly regarded teaching hospital across the state.

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Doe Eyes

19 Comments / Stories /

Andrea Gordon

She burst into tears when I asked if she wanted to get pregnant.

Eman, a beautiful young woman from Jordan, sat in my family-practice office with her husband, Ali, and two adorable children about one and two years old. With her scarf and dark clothing covering all but her pale face and enormous sable-brown eyes, Eman looked closer to fourteen than twenty-four, and scarcely old enough to have any children.

“How can I help you?” I started.

“We wish to remove her IUD, so we can have another baby,” Ali answered.

I don’t think he expected me to address Eman directly.

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If Only

5 Comments / Stories /

Beatrice Leverett

When I first met Jason, I was a third-year medical student halfway through my psychiatry rotation, and he was a newly admitted patient halfway through a nasty comedown from crystal meth.

He sat slumped in his chair, scowling, his face hidden by a baseball cap and black hooded sweatshirt, growling responses to my interview questions.

“Why do I have to do this? I hate this crap. I’ve answered these bullshit questions a million times. I’ve been in the psych ward a million times, and it’s never done anything for me.”

Reading his records, I realized that “a million times” wasn’t such an exaggeration. At only twenty-five, he’d been admitted to most of the local psychiatric hospitals. For several years, he hadn’t been out of the hospital more than a few months at a time.

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Family Summons

9 Comments / Stories /

Startled out of sleep, I reflexively reach for my beeping pager. For a split second, I lie poised between wakefulness and terror in the pitch-dark resident call room, not sure where I am or what happened. I resolve to sleep with the lights on from now on.

I dial the call-back number.

“Pod A,” a caffeinated voice chirps. It’s Candice, one of the nurses.

“Hi. Amy here, returning a page,” I murmur.

“Oh, hi, Dr. Cowan,” she says. “I just wanted to let you know that the family is all here. They’re ready for the meeting.”

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Going Through the Grits

9 Comments / Stories /

Scott Newport

It was another day at a renovation project on the fourth floor of an office building. Glancing at my iPhone, I noticed that my buddy Dave had called a couple of times. Now, coming down a stepladder for what seemed like the hundredth time, I saw his name pop up again. This time I set down my hammer and found a quiet place.

“Hey Scott, ol’ buddy, I got a request,” Dave said. “Last week at hunting camp, a friend of mine was impressed with my restored knife. As we were sitting around the campfire, I told him that you’re kind of a blacksmith, and that you refurbish knives. I wonder if you could fix up his, too. He lent it to me, and I want to return it to him as a Christmas present.”

After work, I picked up the knife from Dave and headed home. There I walked into my workshop, a few yards from my house, set the knife on my bench, then went up to the house.

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