fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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Stories

The First Cut

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Ralph B. Freidin

“Just cut through,” said Dr. Trotter, my anatomy professor.

I had read the instructions in her 1947 dissecting manual. My copy, purchased used, was preserved by stale formaldehyde and smudged with the tissues of past cadavers who’d guided earlier first-year medical students from anatomical landmark to anatomical landmark within the human body. 

The time: forty-six years ago. The day: my first day of medical school. 

The dissecting room was on the second floor of a building that had been new in 1927. The windows, opened to capacity, vainly invited in any breeze from the still St. Louis fall afternoon. The cinnamon aroma of dry sycamore leaves floated from the sidewalk to the windowsill before being repelled by the pungent embalming chemicals permeating the room.

Amid the sycamores’ sweetness and the acrid formaldehyde, eighty-eight medical students stood beside forty-four black slate dissecting blocks on which lay black rubber body bags, suffused with formaldehyde. They held the preserved cadavers–our Charons, preparing to guide us on our three-month journey across and through the landmarks of the body, from the land of the living to the land of the dead. From there, each of us would be on our own to » Continue Reading.

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Florence

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Ben White

When I first met Florence in the ER, she’d already been dying for some time.

I was a third-year medical student doing my internal-medicine clerkship. Florence was a soft-spoken, tired woman in her sixties. To her, I was yet another face asking all the same questions, but she didn’t mind telling her story again–although she did stop in the middle to tell me, “You have beautiful eyes.” I paused to smile, then continued taking my history.

Florence was very overweight, diabetic, a mother to children who were somewhere far away, and a wife to a quiet, slender man with bags under his eyes. She and her husband both seemed less worried than I’d expected.

Only a month prior, Florence’s nagging cough had revealed itself to be a cancer that had taken up half of her chest and part of her brain. She’d never smoked a cigarette in her life.

She’d been briefly admitted to the hospital and then released. After she’d been home for two weeks, her husband had been awakened early one morning by their bed’s shaking: Florence was having a

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Lost and Found

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Julie Evans

When Mom died of alcohol poisoning on her sixtieth birthday, I was seventeen and then I didn’t have a mom anymore. 

My heart was crushed, but there was no time to grieve, because my dad was dying. A man in his late fifties, he’d battled emphysema, a brain aneurysm, colon cancer and then bone-marrow cancer. 

Over the following months, and after starting my first year at the University of Minnesota, in Minneapolis, I’d pace the halls of St. Mary’s Hospital as Dad met with the doctors or had his lungs suctioned out. With no health insurance, and no hope of improvement, he was eventually moved to a nursing home. He died a few weeks later, when I’d briefly stepped out of the room.

In 1973, there were no systems in place for a young girl like me–nowhere I could go to talk to somebody who could help me. Instead of feeling lonely or abandoned, I felt numb. I majored in journalism, but also worked as a nursing assistant with cancer patients at the University’s Masonic Hospital. It felt very sustaining; my parents

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Note to My Patient

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You might be surprised to know that I’m lying here in bed still thinking of you two weeks after you’ve died.

During the month that I watched you die, I often wondered what it felt like to be you, with your deep, husky voice, rounded belly and stubborn anger. You’d once owned your own mechanic shop; now you were sitting here in a hospital bed, staring up at the medical team as we whirled in and out of your room. Staring up at me as I drew blood from your central line each morning.

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Nineteen Steps

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Tuesday morning, eight o’clock, and I have seven things to do. Check vitals, change a dressing, get a patient out of bed, send another to the operating room. Review lab results, give medications, start a blood transfusion.

I have six patients, and they have an average of five morning medications each. I make three trips to the med room for supplies, two trips to the pantry for fresh water.

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Missing Piece

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Ray Bingham

I entered the hospital by a back door. It was evening. As I walked down the quiet corridors, their cinder-block walls, green paint, tiled floors and soft fluorescent lighting granted me a superficial sense of familiarity: I’d walked these halls countless times over the last five years.

Now, however, I also felt a bit apprehensive. I was not supposed to be here. 

Two weeks before, I’d been laid off. It had been the second round of staffing cuts in six months–due, the administrators said, to declining revenues. They made this claim despite the continued high numbers of patients in my unit, the newborn intensive-care unit, or NICU. 

As a veteran nurse, I’d spoken up. The cuts, I’d said, were leading to understaffing, to increased stress among the nurses and to declining care for our fragile patients. Soon after, they’d canned me. 

Not risking the elevators, I climbed the stairs to the third-floor landing outside the NICU. I had a flimsy pretext for visiting: I wanted some of my former colleagues’ phone numbers to use as job references. Mostly, though, I just missed

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Code Blue

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Stephen W. Leslie

I was startled awake at 3:40 am by a loudspeaker blaring “Code Blue…Code Blue.” 

As the hospital’s newly hired chaplain intern, I’d been sleeping in the overnight room. Stumbling out of bed and groggily changing out of my pajamas, I made sure to put on my hospital badge. 

I made my way to the hospital’s “Z” building, where the ICU was located, and took the elevator to the fourth floor. The elevator opened onto a row of doorways, each decorated with a red warning sign: “Stop! Do Not Enter. Authorized Staff Only.”

I picked one and went through. 

I’d guessed right: At the far end of a hallway, a group of gowned nurses swarmed around a woman lying in a hospital bed, her hospital robe trailing off to one side as they worked on her.

I approached the group, feeling a bit intimidated and uncertain of my role. 

“Sixteen minutes ago, her heart stopped,” someone told me. Moving closer to the patient, I saw that she was a short, slightly plump woman about sixty-five years old. With a shock of disbelief, I realized that she was one of the patients I’d talked to earlier that evening. I

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Nothing to Hide

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About thirty years ago, after I’d completed my internal medicine residency and a rheumatology fellowship, my wife and I moved with our three-year-old son to my wife’s hometown. 

There I joined a multispecialty group practice as the second rheumatologist. Over time, the plan was for me to build a rheumatology practice, but while that was happening I took on all kinds of patients, both primary-care and intensive-care. I felt very comfortable doing general internal medicine, and I also liked the intensity of ICU work.

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Hurricane Sandy: Two Tales of One City: Part 2

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Not Your Usual Halloween 

 
Alice Teich

Hey Manisha,

Last night–Halloween–I went and volunteered at a shelter in a school basement/gymnasium in the Nineties on the Upper West Side. 

There were more than 100 folks staying there, mostly evacuated from the Lower East Side. The shelter, run by the City, had some volunteers at the front desk, a few security people, a medical team that consisted of myself, one other doctor and a nurse (volunteers through the NYC Medical Reserve Corps–if you’re a provider, you can sign up online; it only takes fifteen minutes), and more than twenty awesome volunteers of all ages. 

It was a mess. 

Quite a few folks staying there were evacuated from flooded shelters–i.e., they were homeless even before the storm. 

Some of the older folks with chronic diseases, who’d normally have home attendants, are there without anybody (and without any ID, much less their medication lists or their medications). 

Only one guy had a home attendant. She got evacuated with him–very unhappily, as she is stuck away from her family and is not sure if she’s getting paid for this time. She thought

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Hurricane Sandy: Two Tales of One City

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Editor’s Note: Hurricane Sandy hit New York, Pulse‘s home, on Monday, October 29. Eleven days later, many parts of our area are still limping toward recovery. Today we bring you two stories, rather than the usual one, about the hurricane’s impact. The first is by a medical student who was suddenly thrust closer to his newly adopted city. The second is an e-mail written to a colleague by a family physician who volunteered time in a City shelter.

New York Welcomes You 

 
Paul Lapis

Just three short months ago, I took my first steps into the medical world when I put on my white coat and began my first day as a student at the NYU School of Medicine.

A lifelong Californian, I’d always dreamed of coming to New York. I was delighted to know that I’d be spending my next four years in the city.

Despite my short time here, I can honestly say I love New York. This city has always stood as a symbol of everything I’ve come to value. I especially love the rich cultural and ethnic diversity of the people who live here–and,

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No Red Lights

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Loreen Herwaldt

As far back as I can remember, I’ve deliberately spent my life on the high road. I was the seventh-grader who was told by adults that she was very serious. I was the college student who majored in chemistry because it was the strongest premed major. I became a doctor.

Before becoming a doctor, I imagined that I would be the epitome of compassion. I envisioned pausing for a moment before I saw each patient to pray for that person and to ask for wisdom. During my last two years of medical school, I enjoyed hanging out with my patients, just listening to their stories. I was the one who made a special trip to buy a book that I thought might encourage a patient. I was the one who sat by a women wrapped in the pain of metastatic malignant melanoma as she moaned, “They shoot sick dogs, don’t they? Why can’t they do that for sick people too?”

During the first month of my internship at St. Louis’s Barnes Hospital, when I was on call every other night in

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