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

Paging Cardiology

Geoffrey Rubin

At 5:07 pm on July 27 of last year, my pager’s beep pierced the bustle of the hospital hallway: “CARDIAC ARREST, 6GS room 356 bed 2. Need cards STAT.”

It was only seven minutes into my first overnight call as a cardiology (“cards”) fellow, and I felt like I’d received a code-dose shot of epinephrine. In a most un-doctorly manner, I sprinted up the four flights of stairs to the ward.

Panting, I burst into the patient’s room, to be greeted by a cacophony of bells, bleeps and whistles, latex gloves snapping and catheter kits crackling.

A mob of nurses, residents, care coordinators and technicians turned to face me. Twenty pairs of eyes focused on my own.

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Giving Thanks

Victor Fornari

One autumn morning, a woman called the division of child and adolescent psychiatry at the Cohen Children’s Medical Center on Long Island, asking to speak with me.

In more than ten years as the department’s director, I’ve received countless phone calls, but this one instantly got my attention.

“She says that she was your patient in 1984,” said my assistant, Eileen. “Her name is Anne–“

“Jones,” I said instantly.

“You don’t remember her, do you?” Eileen exclaimed.

“I certainly do,” I said. “The hospital opened this unit on Valentine’s Day, 1984, and she was the first child admitted. How could I ever forget?”

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At Day’s End

Marc Tumerman

This is a story of two deaths. That these patients’ stories intersected on the same morning, in the same building, in two adjacent rooms, has left me thinking about them now that the day is almost done.

I was surprised to see Mrs. Stevens’ name on my schedule today. She came to the office last week, and I felt sure that she’d be too weak for another visit. But I was glad she’d made it, as I’ve become quite fond of her.

She’s seventy, and dying of metastatic lung cancer. She’s a lifelong smoker, but at this point I’m not worried about cause and effect, accountability and responsibility. None of that changes what I must do now as her physician.

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Deathbed Epiphany

As a family-practice resident, I’ve found that a premium is placed not only on my clinical acumen but also on how well I respond to my patients’ mental and emotional experience of illness.

Yet the work of learning to be a doctor is just that–work. And in overwhelming amounts. Time management becomes ever more vital: As I take the time needed to gently break bad news and to console a patient, I must also stay conscious of the next patient’s appointment, the next phone call to make, the next exam to study for, the next lecture to attend, the next research project to complete and the next practice guideline to learn.

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Paying It Forward

Caroline Wellbery

In the middle of a five-way thoroughfare intersection, with the early-morning sun’s glare on my windshield, I hit the curb of the median and blew out my left front tire. Amid stopped traffic, I ran to collect my escaped hubcap, whose silver eye stared helplessly from among the automotive debris of previous accidents.

A policeman blocked the lanes until I could pilot my car into the gas station on the other side of the street. The attendant perched behind the bulletproof window told me that his mechanics wouldn’t be in until 9:00 am. I called the clinic to say I’d be late to work, but no one picked up the phone.

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The Secret

Gabriel Foster

“If my father dies, you’re going down with him.”

The words pierced the air, and suddenly there was silence.

I hadn’t noticed Frank’s son at first. He’d been pacing in the back of the family group gathered in our ICU waiting room. Now, up close, I could appreciate how large and intimidating he was. And I’d just had the thankless job of telling him, along with the rest of his family, a shocking, completely unexpected truth: Frank wasn’t dying, he was already dead.

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Crash Course

Marilyn Barton

“Nursing students needed to work in the University Hospital, good pay, orientation.”

As a rising nursing-school senior in the 1970s, I naïvely applied for the job above without getting the full details. No one mentioned that I’d be working in a psychiatric unit housing twenty-five aggressive, catatonic or schizophrenic patients, many of whom had been locked away for years.

The entrance sign, which should have read “Locked Psych/Med/Surg Unit,” said simply “5 East.”

On my first evening shift, I overheard two nurses discussing how to monitor a new patient, transferred from the federal psych facility across town.

“Can we get the student to do it?” said one.

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Third Degree

Susan S. Turner

When I find a lump in my left breast I am stunned. I probably shouldn’t be surprised, but I’m immobilized. It takes me several days before I tell my partner, who has to push me into action. I get the referral from my doctor and schedule a mammogram. The radiology practice fits me into their schedule that same week, but I still have several days to sit with the unknown.

Finally the day of the appointment comes. I wait in the reception area for an hour before the X-ray technician calls my name. As we walk to the exam room, me in my usual long leg braces and aluminum forearm crutches, she is chatty and asks, “How did you get here today?”

“I took the Thruway to Exit 133,” I respond. “The office was easy to find.”

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Overkill

Daniel Lee

Primum non nocere. First, do no harm.

I learned that in the first year of medical school. “Nonmaleficence” is the fancy name given to this sentiment, and it’s one of the four pillars of modern bioethics. In real life, it’s an impossible standard: We harm patients all the time. But the spirit behind the principle is what matters. Do the least possible harm to patients as they go through the medical system. Do only what is necessary. Act only when the benefits clearly outweigh the costs.

As a third-year medical student on rotation in the intensive-care unit (ICU), I admitted David, an elderly man transferred from another hospital because a severe lung infection was making it hard for him to breathe.

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Tales Out of School

David Power

I am a professor of family medicine at the University of Minnesota Medical School. During their third and fourth years, students must complete a four-week clerkship in family medicine. The clerkship includes a “significant-event reflection” project, in which students discuss patient encounters that they’ve found especially meaningful.

Over nearly a decade as a facilitator for these groups, I have heard many powerful and emotional stories. I’ve often felt deeply moved–and admiring of the students for their honesty, courage and humanity. Here are three of many whose stories I carry with me.

“Sure, I’ll go first!” said Rob. A fourth-year student, he was about to enter a radiology residency. Rob had a bright, open face and quick smile, and knowing that family medicine wasn’t his chosen specialty made me appreciate his enthusiasm all the more.

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Never Say Die

Christine Todd

In November of my intern year, I had trouble finding the sun. It was dark when I woke up for work, and it was dark when work was done and I headed back home. I’d picked up the service on the cancer ward from an intern named Bob, and Bob had left me six handwritten pages on the subject of Jim Franklin.

And this was the deal: Jim Franklin, thirty-seven years old, had been living on the cancer ward for the last three months. He had a two-foot-high stack of records, and the pity and admiration of nearly every nurse, tech and doctor in the hospital. He’d been diagnosed with Hodgkin’s lymphoma four years earlier, treated with chemotherapy and thought to be cured. A year ago his cancer had recurred, and he’d been failing therapy in what could only be called a spectacular manner ever since.

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Selfie

Melanie Di Stante

In 2000, my husband Brian was diagnosed with Stage IIIB Hodgkin lymphoma, which has since become a prominent part of our lives. My children and I belong to Gilda’s Club, a cancer support community, and recently we were asked to help record a promotional video to be featured at a fundraising gala for the local chapter and on the club’s website.

I’m not a “spotlight” kind of girl, and I don’t feel drawn to video cameras or speeches, but I’ve been going to two Gilda’s Club programs–a caregiver-support group, and a writing group–for nearly five years. Everyone is nurturing, supportive and so nice. My son Marco and daughter Gabriella also attend a group, where they do projects to help build resilience for kids impacted by cancer. It’s priceless, and it’s free.

If this is something I can do to give back, I thought, I’ll do it. My kids were on board as well.

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