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

A Grandson’s Tale

12 Comments / Stories /

Jonathan Gotfried

From my wife’s grandparents’ Manhattan apartment, I could hear the noises of traffic and pedestrians in Central Park, seven floors below. The sounds made a refreshing change from the beeping monitors, overhead pages and ringing phones that are the usual backdrop to my work as a physician in a large Philadelphia medical center. Here the only background conversations I heard were those of loved ones in the kitchen, not those of patients’ family members, overheard through flimsy curtains ringing an adjacent bed.

The hospice nurse quietly moved about the apartment. My wife sat close by her grandfather, Werner (whom we called Saba, Hebrew for grandfather), speaking softly with him as he lay there in bed. Our two-year-old son sat nearby, dutifully flipping through a Dr. Seuss book, occasionally drawing my attention to a funny-looking fish or tree.

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You Have a Split Personality

6 Comments / Stories /

Raymond Abbott

I am a social worker working with severely mentally ill adults. One of my clients is Lawrence Walters, a small, thin man in his late fifties, very schizophrenic even while on medication. He talks about spirits holding him down, making him do things he doesn’t wish to do. He is impossible when off meds, tolerable when on, and difficult just about all the time. But at last I’ve got an edge on Lawrence–and it’s not because of any particular social-work skill.

Lawrence often asks me to take him places–usually shopping, but sometimes to medical appointments, such as an eye exam. (Lawrence is missing one eye, which some say he himself poked out when especially ill. I can’t confirm this story, however, and I’ve not asked him.)

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Lost in the Hospital

7 Comments / Stories /

It’s easy to get lost in the hospital. I’m only an intern, and already I know it like the hallways of my old high school, every doorway and doorknob. But overnight, as I float between the floors and the units, answering pages, I quickly lose track of where I am, what time it is, what day it is.

I am vaguely aware that I’m on the fifth floor, the top floor of the hospital, when the nurse approaches me.

“Doctor, the patient in Bed 32.”

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Ritual Healing

16 Comments / Stories /

Joseph Fennelly

In recent years the medical profession has witnessed a surge in burnout and depression among physicians and other health professionals. Efforts have been made to address this–for example, by offering Schwartz Center Rounds, in which caregivers openly and honestly discuss the social and emotional issues they face. Health professionals can also reduce stress through counseling, meditation or massage, or through practical steps such as cutting back on their working hours.

In the most traumatic cases–those marked by the death of the patient–physicians have yet another powerful source of comfort and emotional support. This support, offered by the patient’s family, comes within a context that allows the caregiver to accept it without forfeiting professionalism.

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Ten-Minute Miracle

11 Comments / Stories /

Melissa Zhu Murphy

On Mother’s Day 2007, as I was finishing my freshman year at Vanderbilt University, I joined my parents for a warm, happy reunion in an Italian restaurant, celebrating both the day and the completion of my first year of premedical studies.

My father was blissfully breathing in the steam wafting up from his ravioli in lobster cream sauce as my mother prepared to dig into an enormous plate of basil penne pasta with spicy meatballs.

I took a bite of crusty Italian bread and lifted a forkful of manicotti to my mouth, getting ready to describe how hard I’d had to study for my biology and chemistry finals. Then I realized that something was wrong.

Very wrong.

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Going Solo

28 Comments / Stories /

Amanda Anderson

I softly scrub blood from the teeth of a man who died moments ago. From the chair where I sat quietly writing nursing notes while he quietly ended, my patient’s sallow skin and sunken cheeks looked so peaceful. But the weeks of stagnant residue on his teeth bothered me.

To brush the teeth of someone who was in the process of dying would have contradicted my orders to provide comfort care, and my own good sense. So I waited until he took his last breaths before I closed my computer screen and gathered my tools–washcloth, water, toothbrush.

I brush now, so briefly, for the pride of this man I didn’t know, and I brush for the family that I wish was here to care about him. He does have family–it is they who authorized removing his life support, in keeping with the wishes expressed in his living will. Their brief go-ahead over the phone satisfied their legal obligations, but their absence during his actual passing has left me feeling oddly confused.

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Night Call

10 Comments / Stories /

Heidi Johnson-Wright

When I was nine years old, I was diagnosed with juvenile rheumatoid arthritis, an autoimmune disorder that triggers an inflammatory response of the joints, causing swelling, stiffness and severe pain. The disease sped through my body like wildfire.

By the time I was fifteen, my hip joints were utterly ruined. Just getting out of bed was a slow, carefully choreographed sequence of movements, with frequent pauses to allow the pain to subside. When I walked, my hips emitted sickening crunching sounds, bone grinding on bone.

I kept denying how bad my hips were, because I knew that the only solution was joint-replacement surgery. The thought of having my joints sawed through and torn away, and then having metal replacements hammered down into the bone shafts, petrified me. So did the prospect of a long, painful recuperation. But one day I tearfully confessed to my mother that I couldn’t take it anymore.

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Special Delivery

3 Comments / Stories /

Deborah Pierce

I first met Marie five years ago. A petite, soft-spoken woman in her thirties, she was the patient of one of the residents whom I supervise at our community hospital. Marie worked in housekeeping for a large corporation; she and her husband, a bus driver, had a six-year-old son. Now she was twenty-six weeks (six months) pregnant with their second child.

Marie’s blood pressure was markedly elevated (168/120), she had fairly high amounts of protein in her urine, and her baby measured small on the ultrasound. These pointed to severe preeclampsia–a serious complication that can quickly worsen, leading to kidney damage, seizures or even death for mother and child, and that can only be cured by delivering the baby.

The resident and I reached a swift, unanimous decision: Marie’s pregnancy was far too high-risk for our hospital. She needed to be transferred to the University Hospital across town–“the U,” as it’s known. And the baby would need to be delivered soon.

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Day of Reckoning

11 Comments / Stories /

Suzanne Minor

Yesterday my friend Sophie asked me to accompany her to a Miami hospital intensive-care unit to see her older brother, Guillermo. He’d been admitted the previous night with seizures and cardiac arrhythmia.

Joined by my husband, we made our way to the ICU. When she saw Guillermo lying immobile, swollen and unresponsive, with a breathing tube in his mouth and other tubes snaking into his chest from IV poles, Sophie broke down sobbing.

Seeing her reaction, I felt a little ashamed at my own calm, although I knew it was hard-earned. During my years as a family doctor working in Miami-Dade County’s community clinics, I’d witnessed countless scenes like this one. Where Sophie saw a beloved brother utterly vulnerable and present only physically, I saw a fluid-overloaded patient hooked up to a ventilator, with the appropriate drugs being administered and a dialysis machine cooling and filtering his blood to treat his seizures.

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House Beautiful

11 Comments / Stories /

Liat Katz

Virginia is sweet. And I don’t mean that in a patronizing, “Isn’t she cute and sweet in her neediness and cluelessness” kind of way. You can tell that she has always been a warm and inviting person, and that she likes people. And today, I need sweet.

As an Adult Protective Services (APS) social worker, I’ve had quite a week among the belligerent abusers, the angry hoarders and the adult children unwilling to help their aging parents who are living in squalor. So I am thrilled that my new client, Virginia, is sweet.

Virginia came in as a financial-exploitation case. Apparently some men had bilked her out of $25,000, promising that in exchange they would cut down some trees in her yard. When she told her church friends how thankful she was and showed them the empty yard, her friends called us, because no one remembered seeing any trees there in the first place.

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Homecoming

22 Comments / Stories /

Ronna L. Edelstein

For years, and especially as he entered his nineties, my father kept begging me not to “dump” him into a nursing home. He had seen too many of his cronies abandoned in this way by family members; his visits with these friends left him feeling depressed and hopeless for days. I assured Dad that I’d never put him in a facility.

It was an easy promise to make. I didn’t want him in a One Flew Over the Cuckoo’s Nest setting with a Nurse Ratched supervising his care. I didn’t want him waking up at night disoriented and lonely. Because he was inching closer to death, the greatest unknown, I didn’t want a facility, with all of its unknowns, to replace his familiar apartment, which I’d been sharing with him for more than a decade.

But in spring of last year, six weeks after Dad turned ninety-eight, I broke my promise.

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Last Stand

23 Comments / Stories /

E. Wesley Ely

The first time I saw Jessa, she lay crumpled in the ICU bed, paralyzed, expressionless and unable to speak. A military veteran, she had fought in Desert Storm, but she now was facing a deadlier and more inexorable foe: amyotrophic lateral sclerosis (ALS), aka Lou Gehrig’s disease.

This disease causes progressive loss of muscle control, and Jessa was unable to speak, eat or breathe on her own. Her only means of communicating was through small facial movements–opening and closing her eyes or mouth, raising her eyebrows.

A dozen people made up her ICU team: three interns, three residents, a pharmacist, a nurse, a respiratory therapist, a social worker, a hospital chaplain and myself–the lead physician, or intensivist.

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