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

Chocolate Cake

Sanyu Janardan

I was a first-year medical student, starting my first afternoon at an outpatient clinic as part of an introductory course in clinical medicine. My white coat was freshly washed; I had a rainbow of pens in one coat pocket, and my shiny name tag dangled from the other. I only hoped that I was as prepared as I looked.

I entered Mrs. Carr’s room. A fifty-five-year-old woman, she sat gingerly at the edge of her chair, looking ready to get up at any moment, as if the appointment were already over. She gave me a cursory glance, then went back to folding and refolding the bus-ticket stub in her hands.

I asked a well-rehearsed question: “What brings you to our clinic?”

“Chocolate cake,” she answered.

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Go Ask Alice

Ellen Rand

In 2010, I became a hospice volunteer.

My mother had died of a brain tumor five years earlier at age eighty-seven. I saw being a hospice volunteer as a way to express my gratitude for my mother’s compassionate hospice care and to help other caregivers to weather a loved one’s passing. And, as a former reporter and writer, I thought I could help people to write their life stories, if they were interested.

In short, I wanted to act on E.M. Forster’s words, which for me sum up the goal of hospice: “Only connect.”

I soon realized, though, that by the time most people come to hospice, they’re too ill and/or too demented to carry on a conventional conversation, much less to express complex thoughts about the arc and meaning of their lives.

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Thirty Below

Kristie Johnson

One cold February morning during my third year of medical school, I walked through the entrance of the rural hospital where I was doing a nine-month rotation, and made my way to the nurses’ station. Feeling the warmth return to my face, I set down my coat and bag and hung my stethoscope around my neck.

The charge nurse, Barb, waved me to her computer.

“Kristie, you have a patient.”

She shuffled through papers, grabbed a blank chart and placed the patient’s admission note on top. When she saw the name, her face fell.

“Ah, it’s Peggy.”

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Sick of Getting Sick

I awoke one Saturday morning to a terribly familiar feeling–a tight, barky cough, fast breathing, severe shortness of breath and burning in my chest. Another severe asthma attack. I knew I was in trouble.

Twenty-three years ago, when I was an internal-medicine resident, I went to be evaluated for recurrent pneumonia. I wound up being diagnosed with cough-variant asthma. Most asthmatic patients wheeze; when my asthma is bad, I cough.

I now realize that I’ve probably had asthma all my life. When I was a child, though, cough-variant asthma wasn’t recognized as a disease, at least not in the small upstate New York town where I was raised. So, instead, I was the “sickly child”–the one who got a cold with a cough that lingered for a month, who missed thirty days of school each year, who was teased for being smaller than the other kids and who, in high-school, coughed furiously after every cross-country running practice.

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Assaulted by “Health Care”

Sandra Shea

I’m no stranger to dealing with the medical world and its billing systems. I’m a triple cancer survivor, had knee surgery in 2012 and now have ulcerative colitis. All told, I’ve had eleven surgeries and fourteen colonoscopies. Paperwork is practically my middle name.

But the last twenty-four hours have been ridiculous.

In that time, I’ve had three different encounters with healthcare billing–each absurd in its own way, and each more challenging than the last. Things got to where I almost had to laugh. And if almost $10,000 of my money hadn’t been at stake, I would have.

Yesterday morning and early afternoon were punctuated by the following events:

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Popping the Question

Mitch Kaminski

Mr. Dwyer isn’t my patient, but today I’m covering for my partner in our family-practice office, so he’s been slipped into my schedule.

Reading his chart, I have an ominous feeling that this visit won’t be simple.

A tall, lanky man with an air of quiet dignity, Mr. Dwyer is eighty-eight. His legs are swollen, and merely talking makes him short of breath.

He suffers from both congestive heart failure and renal failure. It’s a medical catch-22: when one condition is treated and gets better, the other condition gets worse. His past year has been an endless cycle of medication adjustments carried out by dueling specialists and punctuated by emergency-room visits and hospitalizations.

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I’m Happy

Raymond Abbott

On my voice mail is a message from Donald Wyatt. He doesn’t often call, but every Monday morning he comes to see me at the Louisville, Kentucky, mental-health clinic where I’m a social worker.

His message is brief: “I’m not feeling well, and I am planning a trip to either St. Louis or Elizabethtown.”

I smile, wondering at the odd pairing. Elizabethtown is a small city of 50,000 people. And, well, St. Louis is St. Louis, a metropolis.

This behavior is not unusual for Donald. He’s disappeared before, always out of state and by bus. He doesn’t have the money to travel any other way, although once he took his parents’ van and drove to Ohio. (He has no driver’s license.) Never before, however, has he called beforehand.

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Casting Out Demons

Jef Gamblee

As I stand beside the bed in Mr. Jerome’s living room, his pit bull puppy sniffs the body bag lying on a stretcher nearby. His cat curls up on the bedside shelf.

“That dog gonna be a problem?” asks Jude, one of the crematory guys.

“She might get underfoot,” says the neighbor, whose name I can’t remember. “But she’s a lover, not a fighter.”

Jude and Chuck are here to pick up Mr. Jerome, who died of prostate cancer today. His body lies on the bed–the wasted husk of a once lively, athletic man who had taught history in a New Jersey middle school.

I’m a hospice chaplain; Mr. Jerome was my client. I’d known him for about six months.

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Friday Before Christmas

Deborah Pierce

On the Friday before Christmas, I received an unusual gift.

Like any job, being a primary-care physician has both challenges and rewards. The challenges are many, and the rewards are often fleeting–a smile or a “thank you” from a patient or coworker, for instance. And I’ve found that being a teacher of medical students and residents brings an additional layer of rewards and challenges.

One Friday before Christmas, these arrived in an especially potent mix.

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Chemo or Lourdes? Welcome to Cancerland

Michael Carbine

Dr. Peterson, the radiation oncologist, gets right to the point.

“The medical center’s tumor board has concluded that your cancer is inoperable, incurable and untreatable,” he says flatly. “Any chemotherapy or radiation treatments would be palliative in nature.”

He begins explaining the reasons behind the board’s verdict, but everything he’s saying washes out. My mind stopped working as soon as I heard the words “incurable” and “palliative.” I am sliding into shock.

Dr. Peterson pauses.

Chemo or Lourdes? Welcome to Cancerland Read More »

The Case of the Lima Bean

Matthew Webb

“Matthew, go see this lady about her breast mass,” says my attending physician at the clinic where, as a third-year medical student, I’m doing a family-medicine rotation.

Okay, I think. I’ve done my ob/gyn rotation; breast masses are no big deal.

I don my short white coat, freshly baked from sitting in the back of my car as I drove to work on this oppressively hot morning. As I sling the stethoscope around my neck, I feel my inner voice (my constant companion amid the stresses of medical school) gearing up, ready to offer insights, questions, distractions….

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Two Timelines

Timeline One

Day 1: For over thirty-five years my strong, spirited spouse, Carlo, served around the world in the Air Force. Now retired from the military, he still serves at the air base as a civilian security police officer.

His neck hurts. A lot. He blames the pain on the unbalanced weight of the bulletproof vest that Uncle Sam added last year to the uniform he proudly wears every day.

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