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

Continuing Education

H. Lee Kagan

The nasogastric tube was killing me. It had been in place for twelve hours now, threading its way up my nose and down my throat, past my esophagus, into my stomach. Try as I might, I couldn’t swallow away the nasty lump stuck to the back of my throat. And every time I tried, it hurt.

Decades before, as a physician-in-training in upstate New York, I’d put in more nasogastric (NG) tubes than I could remember. At the time, I hadn’t regarded NGs as a big deal. But now I was having my first personal experience with this vile little snake, and it sucked–in every sense of the word.

Two days before, I had come down with a viral gastroenteritis, or stomach flu as it’s often called. Twenty-four hours into my illness, the miserable feeling that some dead critter lay rotting inside me still hadn’t eased.

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Q & A

Kyle Bernard

The interview had lasted fifteen minutes so far, and we’d made minimal progress. I was a medical student doing a rotation at a physical medicine and rehabilitation clinic back in my home state, Wisconsin. It was the end of the day; to save time, the senior resident, Paul, had joined me in the exam room so that we could hear Leora’s medical history together.

A year earlier, Leora, in her mid-fifties, had suffered a stroke. After a few weeks in the acute-rehabilitation hospital, she’d been discharged, and she and her husband, Ellis, had been lost to follow-up. Now they were back, hoping to resume Leora’s care.

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The Arm

David G. Thoele

I was on the cusp of my first year in medical school, and time was running out. Classes started in two weeks. I needed a place to live–ideally someplace cheap, not too far from school.

There was an opening at Phi Chi medical fraternity, a large brick house of faded elegance located less than a block from my classes at the University of Minnesota. At $75 a month for a tiny room in the co-ed fraternity, it fit my budget. When I learned about the “beer machine,” an old Coke machine that dispensed beer at 15 cents a bottle (a bargain in 1979), it felt like my kind of place. I signed the lease.

But throughout the entire discussion with my prospective frat brothers and sisters about the charms and quirks of Phi Chi, no one mentioned The Arm.

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No Place Like Home(less)

Josephine Ensign

Recently I had dinner with a friend of mine who, decades ago, had sat on my doctoral dissertation committee. At one point we touched on my dissertation, which covered the health issues of Baltimore’s homeless teens.

“You always had an uncanny connection with homeless kids,” my friend said. “You really understood them.”

I gazed out the window, seeing the homeless people with their shopping carts in the park across the street.

Then I said, “That’s probably because I was homeless myself.”

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Collateral Damage

Brenda Scearcy

Dr. Robert’s office felt right to me, with a musical birdsong soundtrack, soft lighting and fresh green tea, and I had my best friend in tow: piece of cake. In this serene atmosphere, I was sure that I’d find out what to do next to finish treating my endometrial cancer.

It’s probably gone now, since my hysterectomy two weeks back, I thought. But let’s play it safe; he’s the gynecological-cancer guru.

Like a general gearing up for combat, Dr. Robert said, “We can beat this. We’ll do a second surgery to remove lymph nodes and omentum–robotically, of course, so your recovery time will be quick. Down the road we’ll definitely do radiation and chemo, and your odds of recurrence will go way down.”

That tone. So assured…

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The Pros and Cons of Living with a Terminal Illness

Ellen Diamond

Before I retired in 2000, I worked in a state agency as a peer counselor, or more formally, an employee assistance program (EAP) coordinator. The “coordinator” part was there because my job description wasn’t actually to do counseling; it was to assess the problem and refer the client for help.

But of course both of those processes involved counseling. We just couldn’t call it that.

In 1986, shortly after I’d begun the job, I was separately visited by two employees with HIV/AIDS. Treatments such as the antiviral drugs used so successfully today were nearly a decade away, and a diagnosis of HIV meant almost certain death. These clients were understandably upset and frightened, but they each made it clear to me that they were still feeling pretty good, though with ups and downs.

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Saving Grampa

Alia Moore

You were supposed to die of cardiac arrest as you circled toward home plate. Or of a brain aneurysm in the summer during one of your countless hikes through the mountains.

You weren’t supposed to die here. Not in a hospital bed, inhabiting this fragile new body, with an oxygen tube in your nose and tumors in your lungs.

Two days before you left us, I traveled home to visit you. I’d last seen you six months before, shortly after your eighty-eighth birthday. You were a lifelong athlete and adventurer, but you seemed just a little less spry than I remembered.

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Cover-up

Carol Scott-Conner

“The plastic surgeons tell me that women who like to swim do much better with reconstruction than with prostheses,” says a young breast surgeon at our weekly Breast Cancer Tumor Board, the working conference where we discuss every new breast cancer patient before starting treatment.

There’s a slight note of surprise in her voice; to her, it’s simply another consideration when advising women before mastectomy.

For decades, the only option after a mastectomy was a prosthesis, or breast form–something shaped and weighted to fill the empty cup of the brassiere and lie, more or less comfortably, against the chest wall. I sometimes tell my patients that using a prosthesis is a bit like going back to the days when we were little girls, stuffing our bras with tissues or old socks to fill them out.

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Getting a Grip

Raymond Abbott

“Ray, can you bring me some Poligrip?” says the message on my voice mail. “My teeth are falling out.”

I know Barbara means just her uppers, because she has no bottom teeth.

“I don’t get my check until Tuesday,” she adds. It’s now Friday afternoon.

I smile, thinking, Where does she think I might get Poligrip? Does she think I have a supply in my desk drawer?

The support staff, who have a lot of items, won’t have Poligrip. If I asked them for it, however, they too would smile.

Smile is the word you want to remember in this account, because Barbara makes me smile–and I especially value those who can do so these days.

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Sharing Secrets

Maria Gervits

“I feel bad…” Amy whispered, then paused.

I’m a family-medicine resident, and I was doing my gynecology rotation, which involved spending a few days at a Planned Parenthood facility. This was my first day. I’d been assigned a patient to shadow: a young woman named Amy, who was here to have a first-trimester abortion.

I’m a fan of Planned Parenthood’s work providing high-quality, affordable contraceptive and gynecological care. In college, when I lost my health insurance, I’d gone to Planned Parenthood for birth control. Now, as a doctor in training, I was curious to see how the clinic worked from the inside.

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Bonding Time

Nelly Schottel

As an intern in the neonatal intensive-care unit (NICU), I am one of several doctors who rarely see or touch the tiny patients we treat. We sit in a back room off a distant hallway, far removed from the babies, reviewing lab results and blood gases on the computer. Much of the time I feel like the Wizard of Oz, controlling a marvelous machine from behind a curtain.

The only uninterrupted time I have with my patients comes at 5:30 am, during pre-rounds, when I hurriedly examine my ten small, complex charges. This is the most rushed part of the day, but these are also the rare moments that I actually spend with a patient.

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(Not So) Golden Years

Madge Kaplan

When I read news articles about caring for elderly parents at a distance, I sometimes shake my head. There’s a tendency to put the best spin on the experience: as long as you contact the right people, get the right information and treat the ups and downs as just part of life’s challenges, you’ll be fine. You can do this!

I find myself wondering when the author last talked to a caregiver at her wits’ end–emotions and finances drained, logistics spiraling out of control.

I was a long-distance caregiver for twelve years. I believe it’s best to resist a formulaic approach in favor of one informed by the details–and always, always, humbled by the truth.

(Not So) Golden Years Read More »

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