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An Orphan’s Tale

Leave a Comment / Stories / Peter Ferrarone

Peter Ferrarone

At the outset, I confess that I have no experience in the medical field. I’m not a doctor or a nurse; I’m a recent college graduate, a writer and someone who’s interested in the world. And, all last summer, I was a volunteer in Uganda.

I’d met a Ugandan priest who was visiting the States on a lecture tour. He described his work overseeing an orphanage located in Western Uganda, a day’s bus ride from Rwanda and Kenya. When he invited me to go and help out there, I accepted.

Upon arriving, I discovered that the orphanage was a small, broken-down concrete house perched on a hill above a muddy soccer field. The building had four bedrooms and no running water. The yard featured a wandering mountain goat and a smelly outhouse with a faulty latch.

Fifteen orphans lived there–eight girls and seven boys, ages eight to twenty-one. In summer, when the schools let out, as many as ten more children came to stay.

Life at the orphanage ran along unusual lines: There were no adults on hand, so the oldest orphans » Continue Reading.

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Cadaver Happy Face

Leave a Comment / Stories / Rachel Willis

Rachel Willis

Sitting with my mother in a white-walled exam room, awaiting the surgeon’s arrival, I felt happy.

Earlier this spring, I’d landed hard on one leg during a volleyball game and collapsed, hearing my knee make a terrible cracking sound, like all ten knuckles firing off. When I resumed playing, after several weeks of rehab, it happened again.

Now we were awaiting the MRI results.

You’d think I’d be nervous. I was seventeen, college-bound on a full-ride volleyball scholarship. Would this injury jeopardize that? But I felt glad–and touched with a kind of glamour. During hundreds of boring or grueling practices, I’d longed to sprain an ankle or break a leg. Now I had an iron-clad excuse to duck the huge workout packet my college coach had sent.

My doctor bounded in. A tall African-American man in his fifties, with white hair and beard, he radiated energy.

I liked him–his energy, the contrast of his bright white hair and brilliant smile with his dark skin.

Swiftly, he pulled an MRI image from its envelope, clipped it to a board and pointed.

“That,” he

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July Intern–Taking Off My New White Coat

1 Comment / Stories / Heustein Sy

Heustein Sy

I became a doctor of internal medicine in my home country, the Philippines, in 2005. The following year, I immigrated to the United States. In order to practice medicine here, I must complete one more journey–a three-year medical residency in the U.S.

My first week at the hospital has been a hectic blur–one task right after another. I’ve been existing on minimal amounts of sleep, food and social contact and maximum amounts of coffee.

Inside my head, though, this week has also been all about me. How lucky I was to have been picked for this coveted residency in this highly regarded hospital! How can I regain my rusty diagnostic skills? How do I look in my new white lab coat?

Rushing here and there, checking on lab results, taking comprehensive histories from patients, doing my best not to miss a single differential in the most ordinary cases and trying to impress my seniors, I’ve felt a bit like Superman: I’m saving lives!

At times, I’ve slipped into a state of mind where every patient becomes just a room number and every diagnosis just a billing code with its corresponding treatment algorithms. When I’m in that zone, time passes quickly.

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What About Bob?

Leave a Comment / Stories / Joseph Fennelly

Joseph Fennelly

The time: early one morning, thirty years ago.

The place: my local hospital.

At this point, I have been an internist for twenty years. I’ve just entered the cardiac care unit, where my patient Bob, a ninety-five-year-old man with advanced senility, has been brought because he’s having chest pain.

As I step through the door, Bob codes. The young residents and staff swing into action, rushing the crash cart over to his bed.

Quickly, I jump between them and Bob.

“Don’t resuscitate him!” I shout.

Looking stunned, they eye me as I stand there with folded arms, making myself into a human shield.

Bob lies motionless, not breathing, his monitor registering occasional spontaneous heartbeats.

Suddenly it hits me: I need to see the situation through these young residents’ eyes. After all, isn’t this a patient in the cardiac care unit? Aren’t his monitors signaling a heartbeat? And isn’t their duty to protect life?

To help them understand why I’ve staged this aggressive assault on their training in high-tech medicine, I must help them to understand Bob. They need to know this gentle,

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Cold Comfort

Leave a Comment / Stories / Mary T. Shannon

Mary T. Shannon

Leaning against the hospital bed’s cold metal rails, I gazed down at my husband lying flat on his back. Under the harsh fluorescent ceiling lights, his olive skin looked almost as pale as mine.

We’d been in the outpatient unit since 6:00 am for what was supposedly a simple procedure–a right-heart catheterization to assess the blood pressure in John’s pulmonary arteries. Now it was 3:00 in the afternoon.

Before we’d arrived that morning, John had seen the procedure as a chance to take a day off from the clinic where he practices internal medicine.

“I think I’ll go out this afternoon and hit a bucket of balls,” he’d said as we drove to the hospital. “My procedure shouldn’t take that long.”

“Are you sure you’ll be up to golfing afterward?” I’d asked.

“Right-heart catheterization is a simple outpatient procedure,” he’d answered, as if talking to one of his patients. “The pulmonary artery pressure will probably be somewhat elevated, just like the echo showed, and then the pulmonologist will decide if I need another medication, that’s all.”

After thirty years of marriage,

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Gentle Men

Mother And Son

Leave a Comment / Stories / Adnan Hussain

Adnan Hussain

I judge. Even though I’m not supposed to, even though I try my best to stop myself, I still judge. Fundamentally, I guess, I’m a creature of habit, caught up in an endless current of seemingly instinctive behaviors. As a first-year medical resident, I sometimes feel acutely aware of this in my dealings with patients.

I stand at the bedside of Sharon Weathers, an unassuming woman in her mid-thirties for whom I’ve been caring over the past few days. She was admitted with excruciating abdominal pain that has proven resistant to our attempts at pain management. Each morning, I visit her to ask, “How did you sleep? On a scale of one to ten, how would you rate your pain?” And each morning, I feel a pang of suspicion–near-certainty, actually–that her pain is mostly a calculated attempt to get us to give her ever-higher doses of morphine.

This morning, Sharon looks as if she just woke up, her tangled blonde hair falling haphazardly across her face. As she struggles to sit up, I’m struck by how incongruous the cheerful polka-dot hospital gown looks on her tough-looking physique.

Sharon looks strong; she has the aura of a battle-hardened gladiator.

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Stepping Into Power, Shedding Your White Coat: Donald Berwick’s Graduation Address

2 Comments / Stories / Donald Berwick

Donald Berwick

Editor’s Note: Donald Berwick, recent Administrator of the Centers for Medicare and Medicaid Services in the Obama Administration, and a founder of the Institute for Healthcare Improvement, gave this speech at his daughter’s graduation from Yale Medical School on May 24, 2010.

Dean Alpern, Faculty, Families, Friends and Honored Graduates…

I don’t have words enough to express my gratitude for the chance to speak with you on your special day. It would be a pleasure and honor at any graduation ceremony. But, I have to tell you, to be up here in this role in the presence of my own daughter on the day that she becomes a doctor is a joy I wouldn’t dare have dreamed up. I hope that each of you will someday have the chance to feel as much gratitude and pride and love as I feel right now, joining you, and, especially, joining Jessica. Thank you very much. I am so proud of you, Jessica.

Now, I have to tell you the truth about Jessica. Jessica was supposed to be a boy. At least that’s what the ultrasonographer said when we took a look at “him” in utero. “Never been wrong,” said the ultrasound

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Epiphany

Out of This World

Leave a Comment / Stories / Katelyn Mohrbacher

Katelyn Mohrbacher

When I met Jasper, I was a third-year medical student doing a nine-month rural clerkship, and he was an eighty-year-old man in a coma.

Family members surrounded Jasper–a tall, broad-shouldered man–as he lay in the hospital bed. His wife, Esther, a petite, lively woman also in her eighties, stood by his head, grasping the bed rail. At the foot of the bed stood their son, a middle-aged man with a baseball cap on his head, his hands fisted in his pockets. Flanking the bed were his sisters (both nurses), one with curly hair and a baggy sweatshirt, the other slim and well-groomed. A warm summer breeze wafted through the room, bringing the scent of fresh-cut grass.

Jasper had been admitted two days earlier. In the days before that, Esther said, he had “drifted,” becoming quiet and very sleepy, and eating little. On admission, he’d been severely dehydrated and short of breath.

His two daughters had always hovered in attendance. Now one anxiously quizzed my supervising physician about her father’s sodium level. This led to a discussion of his care.

“I want everything possible done for him,” Esther said. Her children agreed.

In the days that followed,

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Physician, Heal Thyself

Leave a Comment / Stories / Randy Rockney

Randy Rockney

After a long day’s work as a pediatrician at an academic medical center in Providence, RI, nothing says “relief” like a visit to my therapist. I don’t see him often, but he has helped me through many life transitions. I think we both agree with the Buddhist precept that the only constant in life is change.

One evening after work, a couple of years ago, I arrived early in the neighborhood of my therapist’s office. I was hungry, but there wasn’t time for a meal, so I stopped at a pharmacy to peruse the snack aisle. The smallest and cheapest option available, a bag of roasted pumpkin seeds, seemed perfect.

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