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

What’s Love Got To Do With It?

6 Comments / Stories /

H. Lee Kagan

My longtime patient Brenda let the top of her exam gown drop to her waist, stepped down off the exam table and turned to look at herself in the mirror. As I watched, she cupped her seventy-eight-year-old breasts in her palms and unceremoniously hoisted them up to where they’d probably resided when she was in her twenties.

“I’m thinking about having my boobs done,” she said. “My girlfriend had hers done, and she’s very happy with how they turned out. What do you think, doctor?”

As she spoke, her eyes remained on her reflection. Breasts held high, she made quarter turns to the right and left, then leaned back.

“I don’t like how they look now,” she said, appraising her reflection.

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Tough Love

9 Comments / Stories /

Maria Gervits

I miss Alba. I don’t know why, but I do. She was the most challenging patient I’ve ever had. I dreaded seeing her in the office–and yet, somehow, she won me over.

Alba was fifty-nine, with short, silver hair, a deep, gravelly voice from decades of smoking, and an attitude. She had lung disease, heart disease, depression, arthritis and HIV. She also had a complicated social situation. She’d used cocaine and heroin until her husband had died of HIV. She’d then moved in with her elderly mother and cared for her until her mother died of a stroke. Now Alba lived in a shelter right around the corner from where her father had been shot years before.

The biggest joy in Alba’s life was her granddaughter; but her estranged daughter wasn’t letting Alba see her.

Alba frequently missed appointments or, just as often, walked in without notice, demanding to be seen. She was always in crisis–and she generally took out her frustrations on me.

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Rendezvous

2 Comments / Stories /


Raymond Abbott            

Donald Wyatt. I have written of him before and did not plan to write about him again. Then, just today, something happened.

I was slated to meet him at the usual place. We’ve been having lunch together once a month for more than seven years. Not coincidentally, it’s been exactly that many years since I last worked as a social worker for a local mental-health agency. Donald was one of my clients. When I was about to retire, his mother asked me if I would have coffee or lunch with Donald once in awhile.

“Sure,” I said, never thinking it would go on for so long.

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Morning Rounds

12 Comments / Stories /

Veronica Faller

For my internal-medicine rotation as a third-year medical student, I was placed at Boston Medical Center, a large urban hospital that serves patients from all walks of life. My team included an attending, a pharmacist, a resident, two interns, two of my classmates and me.

Here is a snapshot of morning rounds with some of the patients I met, and of the emotions I experienced during my first weeks on the general-medicine ward. I refer to the patients by their illnesses not only for confidentiality but also to show how we sometimes identified them, despite our best intentions.

My First Patient: She comes in with altered mental status–confusion, sleepiness and memory loss–and she does not speak English. My resident tells me that she meets the criteria for systemic inflammatory response syndrome, but at this moment, I can’t remember what that means. My intern speculates about bacterial meningitis. My attending is concerned about viral encephalitis. They turn to me and ask me what I think. I can only contribute that she’s constipated.

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Taboo

7 Comments / Stories /

Ralph B. Freidin

Every fall, medical schools welcome nearly 20,000 college graduates. They arrive anticipating endless hours of lectures, too much coffee, and infinite facts to memorize. There is one thing they do not expect, however. I know. Forty-nine years ago, I was one of them.

The first day I walked onto the wards was in spring of 1967. I was in St. Louis, doing my second year of medical school. Previously my presence in the hospital had been restricted to the cafeteria. I was twenty-three, had only examined the eyes and ears of my classmates–never a patient–and was about to perform an unsupervised cardiac exam.

Anxiously, I waited with an instructor and three classmates outside the room of our assigned patient. We had just finished eight weeks of lectures on how to perform a physical exam, with two weeks devoted exclusively to the examination of the heart.

They’ve already told us this patient has a heart murmur, I reminded myself. How difficult can this examination be?

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2:00 am

21 Comments / Stories /

Katie Lin

It’s 2:00 am, and the fluorescent bulbs flicker gently overhead along the quiet hallways of the intensive-care unit.

Tonight I’m the ICU resident on call, and the weight of that title sits heavily on my shoulders. My team is in charge of keeping our critically ill patients safe from harm overnight. Although the supervising physician is only a phone call away, I’m the acting team lead for any codes called during the night on patients elsewhere in the hospital who may need our life-support services. Code Blue: cardiac arrest. Code 66: anything else requiring assistance.

The metronomic beeping of the life-support machines keeps time as I blink the weariness from my eyes and share a few muted smiles with the nurses who work tirelessly alongside me while the rest of the world sleeps.

Then the call comes over the intercom: Code 66, unit 74, Highwood Building.

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A Second Farewell

9 Comments / Stories /

Julie List

Two years ago, I’d just begun my new post as clinical supervisor at the caregiver-support center at a large medical institution. The center offers emotional and practical support to families of patients who are dealing with serious illnesses and hospitalizations.

In my short time there, I’d already encountered many memorable clients, but somehow I felt a special connection with one woman, Maria. A small, intense woman with piercing dark eyes, she often came to see us between her visits to her husband, Felipe, who lay gravely ill in the hospital’s cardiac intensive-care unit.

Always with Maria on her visits to Felipe were their three twentysomething daughters, Rosa, Alicia and Blanca. The family’s closeness touched me–especially when it became clear that Felipe’s health was going downhill.

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Never Leaving Wonderland

15 Comments / Stories /

Jacqueline Dooley

Three years ago I spent the entire month of September by my daughter’s side in her hospital room. From Ana’s window, we watched summer fade into fall as we waited, day after day, for her to be discharged, which finally happened in early October.

During her forty days in the hospital, Ana was diagnosed with an obscure, slow-growing cancer called inflammatory myofibroblastic tumor. The tumor, roughly the size of a cantaloupe, engulfed her liver. Her oncologists formulated a plan of action involving chemotherapy, steroids and a Herculean attempt to save her liver so that she wouldn’t need a transplant.

Ana was eleven years old and about to start sixth grade when she was hospitalized. She loved singing, drawing and being with her friends. Her long brown hair was her pride and joy, hanging nearly to her waist. That was the year she wanted to be Katniss from The Hunger Games for Halloween and braid her hair just like the character, but she lost her hair a week before the holiday, so she had to wear a wig.

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A Routine Transgender Visit

6 Comments / Stories /

Nat Fondell

“Hey, Rick. They warned you about me, I hope?”

My routine med-student opening line elicits a slight smile from my balding forty-two-year-old patient and the patient’s wife. As we shake hands, I continue the script.

“I’m Nat–the medical student. What brings you in today?”

“Well, I’d like to transfer my care to this clinic. We’ve brought my medical records.”

Together, they heave stacks of papers onto the desk. Rick’s hands slide back into the pockets of well-worn work jeans.

“Can you tell me a bit about yourself?” Classic open-ended question.

“Well, I’ve been seeing specialists for years about my headaches. That explains most of the paperwork. High blood pressure and high cholesterol. Plus my family has a bunch of cancers.”

“And what pronouns do you prefer?” Here’s where the script deviates from the medical-school boilerplate.

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A Day in the Life of a Psychiatrically Hospitalized Clinician (Part 2)

13 Comments / Stories /

Editor’s Note: This is the conclusion of Liat Katz’s remarkable story. Part 1 was published last week.

Lying here on this hard bed on the psych floor, staring at the white walls and ceiling, I think of my clients–and I don’t feel so alone. Their everyday experience is not so different from my short-lived experience here at the hospital. Often, they endure a whole day’s wait in the dirty Social Security and social-services offices, only to be treated patronizingly and have their needs go unmet.

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A Day in the Life of a Psychiatrically Hospitalized Clinician (Part 1)

29 Comments / Stories /

Editor’s Note: This week Pulse presents the first installment of Liat Katz’s brave and forthright story. The conclusion will appear next week.

I am a licensed clinical social worker. And, occasionally, a mental patient. Today, in this inpatient psychiatric unit, I am more a patient than a social worker.

It is Monday morning, and I am eating breakfast across from Owen, a muscular, flannel-clad, Paul Bunyan-looking patient. Little pieces of his scrambled eggs keep landing on his copper-colored beard. I sort of want to motion with my hand at where the eggs are on his face, but I’m too tired, and I don’t really care. About anything.

A Day in the Life of a Psychiatrically Hospitalized Clinician (Part 1) Read More »

Giving Blood–and Other Acts of Courage

6 Comments / Stories /

Liz Witherell

I donated blood today. I’m one of those people who doesn’t shudder at the thought of needles piercing my skin, or get queasy as I watch the blood drain from my vein into the collection bag. It’s no big deal. I eat the cookies and drink the juice afterwards, and I kind of enjoy talking with the elderly volunteers.

I think I’m lucky. I know so many people who are sickened by the sight of blood, afraid of needles and terrified at the thought of pain.

Several years ago, a nurse-practitioner friend convinced me to volunteer a few hours a week at a free dental clinic. I took health histories and blood pressures. By the time people came to us, their teeth were generally beyond saving. Their mouths were infected, their gums were inflamed, and they often had other conditions, such as diabetes and heart disease. But still they’d put off coming to the clinic as long as possible, because they were afraid it would hurt.

Giving Blood–and Other Acts of Courage Read More »

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