Stories Archives - Page 38 of 58

Day of Reckoning

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

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

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

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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Birth of a Hospice Nurse

18 Comments / Stories / Sara Conkle

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

9 Comments / Stories / Riddhi Shah

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

24 Comments / Stories / Jenni Levy

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

8 Comments / Stories / Dominic Donato

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

25 Comments / Stories / Anne Whetzel

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

9 Comments / Stories / Edward Beal

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

4 Comments / Stories / Jo Marie Reilly

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

19 Comments / Stories / Cortney Davis

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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