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

Checking Boxes

Regina Harrell

I am a primary-care doctor who makes house calls in and around Tuscaloosa, Alabama. Most of my visits are in neighborhoods, but today my rounds start at a house located down a dirt road a few miles outside of town.

Gingerly, I cross the front walk; Mrs. Edgars told me that she killed a rattlesnake in her flowerbed last year.

She is at the door, expecting my visit. Mr. Edgars sits on the couch, unable to recall that I am his doctor, or even that I am a doctor, but happy to see me nonetheless.

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A Different Kind of Miracle

Anita Fry

Once upon a time, I was a newspaper journalist: I chased down sources and sweated over deadlines. Then, in mid-career, I switched to doing marketing and communications for a regional healthcare system. This consisted of a large hospital and many outpatient clinics, including a community cancer center.

Because I handled communications work for the cancer center, I also had a seat on the Cancer Committee–an oversight group of oncologists, pathologists, nurses and other specialists, who met quarterly.

I found these gatherings a bit intimidating. My fellow members were welcoming, but they spoke almost entirely in acronyms and medical jargon–“OCNs,” “PET/CTs,” “staging,” “linear accelerators.”

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One Last Sale

Judith Reichtein

“Did you sell the business yet?”

I marvel at my patient Jack: despite his breathlessness, he’s somehow managed to greet his wife Sara with a complete sentence. Given his condition, it’s truly amazing. 

Most of his lung function has been devastated by his forty-year, pack-a-day smoking habit; the rest has been demolished by cancer. The easy, automatic breathing he once took for granted is just a memory. He can’t even lie down without feeling like he’s suffocating. Propped up on pillows in his hospital bed, he struggles for every breath–pulling it in, forcing it out–his brow creased in a perpetual frown of concentration. 

Sara and Jack have been married for thirty-five years, since before he took over his father’s small shoe concession and turned it into a thriving business. 

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Shattered

Kristina X. Duan

It was a Monday morning in Chengdu, the capital city of China’s Sichuan province. I was a premedical student who had traveled here from the U.S. to do a six-week summer term abroad at People’s Hospital, one of Chengdu’s largest cancer centers.

As the child of Chinese-born parents, I’d always felt a special fascination for my parents’ strange, captivating homeland. In college, I seized the first opportunity to pursue medical studies in China alongside native students. I’d found myself immersed in a healthcare system that was fragmented, corrupt and riddled with problems stemming from overpopulation and limited resources. 

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Saving My Appendix

Andrew T. Gray

The doctor was adamant. “This is America, not Sweden,” he told me. “We operate.” 

How did this happen to me? I wondered, looking at him across the ER exam room. How could I, a healthcare provider, not have insurance? 

I had woken up that morning with a mildly upset stomach. Nonetheless, I’d gone to my job (begun only six weeks earlier) as a physician assistant at a Beverly Hills HIV clinic. I’d seen patients until lunchtime, then attended a research meeting. The subject was a study of irritable bowel syndrome. 

“I need to be in this study,” I joked to a coworker. “My IBS is acting up.” 

I don’t have IBS, but I was indeed having crampy stomach pain. I continued to see patients until 3 pm, when the pain became steady: on a ten-point scale, I gave it a six. I left work early.

As I exited the building, my first thought was Freedom! I can get home early, relax, maybe take a nap…

Crawling into bed, however, I realized that my pain had coalesced in the right lower quadrant of my abdomen. Could it be appendicitis? 

Panic flooded me. After six weeks at my new job, I now qualified

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A Second Chance

Mitch Kaminski

My patient Maria sits before me, looking vaguely distressed.

She’s returned for a follow-up visit, six weeks after our first. The morning is half over, and I’m clipping along, staying on time, using the new electronic medical record system (EMR) without a glitch and with a sense of satisfaction. Three months back, when I joined this small-town practice as part of my new position as a health-system medical director, I found the EMR challenging, so I’m pleased that I’ve finally mastered it.

Maria’s face looks familiar–pretty, but with a worried look that matches her hastily applied makeup. 

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In Sickness and in Health

Larry Zaroff

Four months after having a knee replacement, I stumbled into the bathroom at three AM, not fully awake, hoping to urinate.

Losing my balance, I fell. The result was a compound fracture of my left leg–the one with the prosthetic knee. 

Gazing at my shiny white kneecap, I lost all logic, all control. I simply cried. 

At eighty, I was unprepared for this unexpected anatomy lesson: my twenty-nine years as a surgeon had simply not prepared me for viewing the inside of my own knee. 

It felt like my life was over. 

Fortunately my wife, Carolyn, a painter, four years younger than I, and without any orthopedic experience, took one look, said little, but acted.

She wrapped my naked bones in a clean towel and drove me to the emergency room. I had urgent surgery, with removal of the prosthesis, followed by a post-op period with no internal knee, organic or inorganic. Thus began my one-legged life, and what I now think of as Carolyn’s pre-widowhood.

After my discharge, because of the contaminated wound, I began four weeks of at-home intravenous antibiotics, then two weeks’ waiting to be certain there was no residual infection before I could be

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Bitter Medicine

Karen Libertoff Harrington

As a medical educator in a hospital setting, I often tell first-year medical students about disparities in health care and about the vastly different quality of care that hospitals deliver, depending on their resources. 

I tell my students how important it is to advocate for patients, to learn to navigate the healthcare system and to work respectfully with health professionals in order to get optimal care for your patients.

When my own son was hospitalized, I had an opportunity to put my teachings into practice, and found them wanting.

It was a Thursday evening in early spring, the first hint of green emerging on the lawn of my suburban Connecticut home. 

My son David called from Manhattan to say that he had a job interview the next day; he was going for a run before settling down to prepare. 

I sat on the deck, taking in the twilight and feeling hopeful about the future.

Five hours later, my husband Leo and I were hurrying to a Manhattan emergency room. The police had found David beaten and bleeding in Riverside Park. The park had seen more gang activity lately, and

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A TAB No More

Sandra Shea

I thought of Peter when I lost my TAB status. 

I lost it on vacation. These things happen. Suddenly, one Friday night in Florida, I was no longer a TAB. Shouldn’t have been too surprised, I guess. 

But I didn’t expect it would involve a chicken.

I should explain. 

I’m a medical educator: I have a PhD in experimental psychology/neuroscience, and I teach first-year medical students. In our curriculum, the students work through patient cases that are grouped by organ system. At the end of each case, we have a wrap-up in which we highlight the case’s diagnostic features and answer any student questions. Most of these discussions are faculty-led, but occasionally they’re run by a patient whose history mirrors the case we’re studying. Peter was one of these. 

Like the patient in one of the neurological cases, he had fractured his spine in a diving accident. In a matter of seconds, he’d been transformed from a typical teenager to a tetraplegic (someone paralyzed from the shoulders down), although he retained some motion in one arm.

Peter opened his sessions by telling the students that he would answer any questions

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Vanishing Act

Sudeep Dhoj Thapa

It was a summer night during my first year of medical school. Small bugs danced about the school buildings’ lights and filled the air with their penetrating hum. 

In the television room, located across a small grassy lawn from the dormitories, I sat watching old movies with my classmate and friend Rajesh. 

Rajesh was tall and chunky. He wore his thick, jet-black hair combed back, which made his broad face and smile appear even more so. I’d known him since our first days at medical school.

“Everyone in my hometown knows me,” Rajesh had told me. “I’m the first one in my area to go to medical school.” Clearly he enjoyed being the pride of his small town. Eyes alight, he’d talked about everything he wanted to do for his townspeople once he was a doctor. 

Living in a dormitory makes strangers into siblings, and we’d become great friends. During those first euphoric months of medical school, Rajesh, his roommate Bob and I had made a habit of getting together late at night with other classmates to watch old movies on TV.

Those nighttime gatherings had grown less frequent,

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Seeing Patients: The Sketchiest Details

Alan Blum


Editor’s Note: This week
Pulse is once again pleased to present sketches by Alan Blum, a family physician who’s been capturing his patients on paper, with grace and affection, for decades. These quick portraits are taken from a collection entitled Seeing Patients: The Sketchiest Details.

You say you think you got a medicine
to stop my seizures?
I don’t know why,
it’s the only exercise I get.

Well, it’s a long story with me.
Spent all my money on my wife
when she died.
Two years cancer.
Wasn’t able to do anything.
Wasn’t able to save her.
Spent all my money.
All the money I had saved
I spent on her.

You better just go ahead and do it now,’cause I am mentally prepared for y’all to kill me today.

Well, let me tell you a little story.
I had a little pain in my chest here.
I don’t know whether it was gas pain or not.
So the doctor took one of those electro things
with all the wires and he said,
“Well, it look good, but I need more tests.”

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Joe the Handyman

Angela Yang

“Forty-two-year old male, chronic pain syndrome,” the chart reads. 

I’m a third-year medical student doing an elective at a physical medicine and rehabilitation clinic, and this is my first time seeing Joe. 

Sitting expectantly in the exam-room chair, he’s a gaunt man with a long face and dark tattoos down his arms. Wire-rimmed glasses, stringy ponytail, faded jeans and leather jacket complete the look. 

“Nice to meet you,” I say. “I’m Angela, a medical student. I’m doing a couple of weeks here with Dr. Ross, the chief physician.”

“Thank you, doc. I’m Joe.” He smiles, dark eyes twinkling, and I glimpse yellow-stained teeth. 

Probably from smoking, I think. 

Joe starts talking, jiggling his leg nervously.

“My car was towed yesterday. And these past two weeks have been tough. I got kicked out of my apartment, had no money for the bus, so I had to walk here today, five miles, for my pain meds.” 

He’s here for refills, I think wryly. Can I believe his story? Someone who’s walked five miles in this hot weather should look worse–especially if he’s in pain. Or am I passing judgment because of his greasy

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