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Nothing to Hide

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

 

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

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

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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Five Years Later

Steve Lewis

Evenings in the Sloan-Kettering ICU were starkly lit–nowhere to hide from the glare, bloodshot eyes trained on blinking lights, buzzing machines, masked men and women passing soundlessly through sliding glass doors, and little but hours and hours of bright, eerie luminosity ahead.

By contrast, the days then were dark. No comfort to be found in the sunrise or in that old salve about everything looking better in the morning. My wife and kids and I sat on the edge of uncomfortable couches in dimly lit waiting rooms where the waiting was always either too long or never long enough; we stood shoulder to shoulder in airless elevators with strangers sharing the same muted despair; we sat huddled in the cafeteria and did not eat.

When I was alone I paced the circular halls of that cancer-riddled sixteen-story building, cloaked in green gowns and latex gloves. My beard was always wet with acidic breath behind the paper mask. I slathered my hands in Purell every time I made a move, because it seemed as if germs were the only thing left in my life I could control. Because practically everything I’d once assumed to be true was now a

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Emergency Landing

Shumon Dhar

In the summer of my first year of college, I did an internship as a nursing attendant in a rehab hospital’s stroke unit.

As a premed student, I had little idea of what it meant to be a physician. But that didn’t stop me from feeling slightly superior to others who weren’t on the same path. Although I didn’t know how to take someone’s blood pressure, I often treated friends to detailed descriptions of the biochemistry of complex metabolic diseases.

My summer job took me totally out of this academic comfort zone. 

I found myself washing, dressing and caring for the most debilitated people imaginable–unable to walk and suffering from cognitive impairment and, often, incontinence. Throughout the day, the halls echoed with their moans of pain.

Every morning, it was my job to wash, dress and transport several of them to the dining room before breakfast. The work didn’t come naturally to me. Long-haired, underweight and completely unused to manual labor, I was quickly labeled a burden by the nurses.

To counteract this humiliating reality, I tried every minute to project an

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Father and Sons

Kathleen Crowley

It was early November–the sky a sharp, deep blue that only comes at that time of year–and my primary-care clinic in the heart of the city was booked full with bronchitis and early flu. The TV in the corner was tuned to CNN. Children bounced around in boredom, chatting away in an assortment of languages–Haitian and Portuguese creole, Spanish, English. 

My last patient of the morning was Jack, a man I’d been seeing for the past few years. He was a middle-aged guy–almost the same age as I was, in fact. I found him sitting quietly in the examining room, reading glasses on and newspaper in hand, wearing a jacket with his employer’s logo on the front. 

Unlike most of the people in the waiting room, Jack was feeling well. He was only here to follow up on the usual suspects–diabetes, hypertension, cholesterol, weight struggles. When I checked his blood pressure, though, it was way out of control.

“That’s strange,” I said, looking through his records. “Your pressure is usually pretty good. Have you missed your medications at all in the last few days?”

“No. I take them every day. Might just be”–he took his glasses off and

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Telling Nick

Marianne Lonsdale

“What’s going to happen to Catie when she grows up?”

I was driving with my son, Nick, to the store when he asked this about his fifteen-year-old cousin, Catie. Nick, age eight, had just spent his spring break at Catie’s home. Blind, she was now losing her ability to talk, but she always recognized Nick’s voice. She adored having him by her side; whenever Nick walked into the room, her face lit up, and she raised her arms for hugs. She was the closest Nick was going to get to having a sibling.

“Will she get a job?” he piped up from the backseat. “Or will someone still have to take care of her?”

Small for his age, Nick was just about big enough to stop using a booster seat, but still young enough to be afraid that monsters in the closet were real. 

I’d been wrestling with when to tell him more about Catie. Now, here came this question from out of the blue. 

“Her mom and dad will always take care of her,” I said. My first instinct was to

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Beyond Reason

Kathy Speas

Visiting the dementia unit of a nursing home is never easy.

First off, you have to find your patient amid the assemblage of people–mostly women–seated in wheelchairs, recliners, wingbacks, sofas and assorted walkers, or wandering around. 

Then, you must make yourself known to the person you’ve found. Here’s where the harder questions arise: How can I introduce myself and convey my role–a hospice chaplain–to someone who has outlasted language? Is my state of mind so calm and engaged that my very being will exude peace and generate trust? Am I totally present, or is my mind bouncing back and forth between tomorrow and yesterday? And just what does it mean, as a hospice chaplain, to provide spiritual support to someone at the end of life?

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Five Years to a Cure

Ellen Diamond

Recently, while reading a post in an online chat group for people with chronic lymphocytic leukemia (CLL), I spotted an intriguing comment. At an important conference, a world-renowned hematologist had referred to a “five-year timeline” for a cure.

This took me back fourteen years, to when I’d just been diagnosed with CLL. There was a Gilda’s Club near my workplace; I’d always passed it quickly on my way home. Now I found myself stepping through the doorway to hear a top specialist talk about my disease.

I recall his closing words: “Give me five years, and I’ll give you a cure.” 

As desperately as I wanted to believe this pronouncement, I felt reluctant to pin my hopes on it. Fourteen years later, my skepticism remains. 

I’ve heard many CLL experts make similar predictions, but despite great advances in research and treatment, no one with CLL has ever been cured. I’ve never doubted the doctors’ sincerity and good intent, but at times I’ve felt quite angry at their willingness to raise their audiences’ hopes in this way.

Given the facts, how can they

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Remembering John

Hilton Koppe

I remember you the day we met. It was five years ago. I was terrified. You seemed relaxed and at peace. I’d been invited to join the Lennox Head Club, in the town where I live and work; this over-thirty-five match was the first game of soccer I’d played in twenty-five years. I was the oldest on the team. You were the youngest. For you it was just the start of another season, your loping, languid style belying your skill and your speed.

I remember you sitting next to me in my car on the long drive home from a game at Nimbin. You telling me about your long journey with Crohn’s disease, about the colectomy you’d had in your twenties and about your two broken bones last year. I couldn’t stop myself from being a doctor and suggesting that you get your bone density checked.ch

I remember you sitting in my consulting room. We had many years of shared conversations–me offering ideas, and you running your race in your own way, not always by the book, but always with great intelligence

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House Call

Kendra Peterson

I approached my father in the yard of his most recent home, a small, run-down duplex shack. His hair was whiter than I remembered, his old blue sweater shaggy. He was clipping the hedge in his careless but enthusiastic way; when finished, it wouldn’t look good, but it would look clipped. 

One of his eyes was red and tearing up. A splinter had flown into it as he trimmed the boughs above his head. He hugged me nervously, and we went inside. 

He pushed a stack of newspapers off the sofa, and we sat down and awkwardly tried to talk. The cramped living room was dirty, and dominated by boxes and piles of books. 

“Just moving in,” he apologized. He rubbed his eye, and I told him not to. 

My father was sixty-two years old. For much of his life, he’d been an accomplished university professor of American history, and a charming and eccentric character. But in the past few years, he’d taken many wrong turns: He’d increasingly used illicit drugs, including cocaine and methamphetamine, and had been arrested for drug possession.

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