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

Birth of a Hospice Nurse

Sara Conkle

The woman lying on the transport cot in the examination room was terrified. I could see it plainly in her eyes, but there was no time to stop and comfort her.

I was a young, recently graduated nurse in a busy urban emergency room, struggling to keep up with its daily array of shootings, stabbings and crises. ER nurses hustled. We dealt with life and death, and we did it quickly. That may be why I paid so little attention to the pain and fear in the woman”s eyes.

I asked her to get onto the examination table and duly recorded the facts: her last menstrual period had taken place several months before; her bleeding and cramping had started earlier this evening.

Tossing her a gown, I told her to put it on and get back onto the cot so that she could rest until the doctor could come and examine her. Then I left, forgetting about her the moment the door closed behind me.

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No Crying

Riddhi Shah

“There’s no crying in baseball!”

Over the years, my fellow surgery residents and I heard these words shouted countless times by Dr. Norris, a cantankerous elderly surgeon with whom we had the dubious pleasure of working.

Dr. Norris was a former Navy ship surgeon. He didn’t operate much anymore, but he fondly remembered the “good old days” when trainees spent days on end in the hospital. The phrase emerged whenever he felt a need to remind us that medicine was a grueling pursuit with no room for weakness, perceived or actual.

I don’t know if his remark was a thinly veiled sexist jab or merely an allusion to the movie A League of Their Own, but it stopped mattering once I realized that medicine was much more than an endurance game. Nonetheless, five years later, as I pursue my work as a wound specialist in nursing homes, I sometimes still hear Dr. Norris’s voice in my mind.

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I Need a New Stethoscope

Jenni Levy

I need a new stethoscope. I have to wrap my fingers around the fissures in the tubing to make this one work.

For me, these days, listening to the patient’s chest is more a ritual than a means of diagnosis. After twenty years as a primary-care internist, I now work full-time in hospice and palliative care. I spend more time listening to stories than to hearts and lungs. Even so, there’s something about leaning over and finding the right spot on the chest that makes me feel like a real doctor and helps my patients know that they’re being cared for.

Every morning I put this stethoscope around my neck and walk down the hall of our inpatient hospice unit, and every morning, I forget until I touch the first patient. I wonder about the silence in my ears, and then I remember and close my fingers over the stiff, unresponsive black tubing.

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Say It Ain’t So

Dominic Donato

I am in my twenties.

I am a student in dental school. My seven classmates and I have gathered, notebooks and pens in hand, for the first day of our ten-day rotation at the Veteran’s Hospital oncology department.

Dr. Steele, a published expert in oral cancer, instructs us to follow him to the outpatient clinic. Some of those he’ll examine are initial consultations; others are follow-up exams. All are U.S. veterans. Many are homeless alcoholics, whose lifestyle, we’re told, predisposes them to oral cancers.

“I want each of you to take a look at this lesion on the right lateral border ventral side of the tongue,” says Dr. Steele in resonant tones. We bob our heads to find the right line of vision. The lesion is nothing more than a small red spot. Dr. Steele applies dye to the spot, examines the patient’s head and neck lymph nodes, then dismisses him.

“Well, what do you think?” he asks.

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Pimped

Anne Whetzel

It’s two months into my second year of medical school, and I’m at the clinic, preparing to shadow Dr. Neiland, a primary-care physician.

I didn’t want to come here this morning.

Yesterday, one of my preceptors decided that it was my turn to be “pimped.” Pimping, in medical education, is when the preceptor asks you questions until you get one wrong. Then he asks more questions, highlighting your ignorance. Theoretically, this ensures that once he tells you the correct answer, you’ll never forget it. This works for some students, but not for me. I get defensive, and the right answer, whatever it is, goes in one ear and out the other.

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He Ain’t Heavy

Edward Beal

In my decades as a psychiatrist, I’ve seen many different kinds of patients; only in the past five years, though, have I worked with soldiers.

I see them through TeleHealth, an organization that offers patients long-distance care via a sophisticated form of Skyping.

I originally took this job for financial reasons (during the economic downturn of 2008), but I quickly discovered its unique rewards.

Early on, for instance, as I stood waiting for an elevator, a quadriplegic soldier maneuvered his electric wheelchair alongside me.

When the doors opened, he looked up and said, “After you, sir.” That’s not a memory that fades.

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Finding a Bed in Bedlam

Jo Marie Reilly

There’s a full moon tonight.

“That’s when crazy things happen,” my superstitious mom always says.

I’m a family physician doing weekend call at my urban community hospital. My pager rings incessantly. As I answer yet another call from the emergency room downstairs, I think, Maybe Mom has a point.

“Got a suicidal patient with nowhere to go,” the ER physician yells into the phone, against the background commotion. “This guy John has been here for three days. He’s casted on both feet and can’t walk. The insurance company’s authorization nurse says she can’t admit him because it’s not medically indicated–but if a doctor gives her an indication, she’ll authorize it. Can you do it?”

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Wednesday’s Child

Cortney Davis

It was a Wednesday in late spring, 1972. I was a nursing student in my final months of training, eagerly awaiting graduation.

When I arrived on the maternity ward that morning, my nursing instructor told me that I’d be caring for a baby, only hours old, with special needs.

I thought she’d send me to the neonatal ICU. Instead, to my surprise, she motioned toward the linen closet, its doors closed tight.

“The baby was born without a complete brain,” she said. “A condition called anencephaly. He can’t see or hear. And,” she added, “they don’t expect he’ll live out the day. So try not to get attached.”

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Last Writes

Hilton Koppe

Jeez mate, you are really dead. “Really fucking dead,” as you would say. I don’t need to be a doctor to know that. The cop who rang me was right. You must have been sitting in your lounge chair, dead, for at least twelve hours, maybe more. Looks like you were enjoying a quiet drink when you checked out.

I’ve got to tell you mate, it’s pretty weird sitting here at your dining table, with you there, slumped over all mottled and cold, while I’m trying to fill out your death certificate. With your advance-care directive staring at me from on top of all your papers on the table. Was it left there as a gift for me? I did feel a little better when I read that you wanted to be allowed to die a natural death. That you didn’t want any more medical interventions (God knows, you’d had enough of those already). That you wanted to die in your home.

Was it the chemo that knocked you off in the end? That’s what I want to believe. Because if it wasn’t that, then it might have been the high potassium level in your

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How Will I Know You’re Not Dead?

Raymond Abbott

I never thought it would go on for so long–seeing Donald Wyatt, I mean. I certainly didn’t plan it this way.

More than six years ago, I retired at age sixty-six from my social-work job at a mental-health agency. Donald had been my client there for about eight years.

As I was cleaning out my office, his mother called. She explained how Donald’s father had left when Donald was not much more than an infant, which had made him sensitive to abandonment, especially by male figures. Could I, she wondered, meet Donald once in awhile for coffee or lunch?

“Yes,” I said, “I can do that.”

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Surprise Ending

Ellen Kolton

“He’s just expired,” said the nurse as I approached Ray’s room in the large inner-city hospital where I work as a patient advocate. “And his wife has just arrived. Why don’t you go in?”

I found Natalie bent over Ray’s body. His hollow cheek was drenched with her tears.

“I’m so sor–“

“I told him yesterday to talk to Jesus,” Natalie interrupted, speaking quickly. “I told him if the two of them decided it was time for him to go, then it was okay with me. I guess they had their talk,” she said, glancing at Ray as though expecting an answer.

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My Father’s Girl

I’m walking very slowly with my dad down the produce aisle at the local supermarket, past the colorful waxed apples, Mexican mangoes and Rainier cherries, and imagining my life’s blood trickling onto the floor from an invisible wound.

As I pass by the misting system spraying the bins of green, red, yellow and orange peppers, past the lady reaching for carrots, past the stock guy balancing the heirloom tomatoes into a precarious stack, I want to scream. The sense of loss is overpowering.

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