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

Falling in Love With My Doctor

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Judith Lieberman

The other doctors I consulted called him brilliant. His past patients praised his compassion. He actually responded to e-mails. And, lastly, he was known as the best-looking doctor at the cancer center. What more could I ask?

On the other hand, what choice did I have? After twelve years, I was facing a recurrence of a relatively rare oral cancer, located inconveniently at the base of my tongue. The treatment options were not great. The radical surgery recommended by one prominent cancer center could have left me unable to swallow, talk or eat normally.

My incredible husband stayed up many nights researching surgery, radiation, chemotherapy and all the combinations. On the bright side, my teenagers cleaned their rooms without being asked! 

The last straw came when, while talking on my cell phone to yet another cancer center and making the turn into a parking lot, I crashed my car. Just one more broken item needing to be fixed.

* * * * *

I prepare for eight weeks of combined chemotherapy and radiation, which my new doctor candidly describes as “setting off a bomb in your mouth.” Sitting in the exam room, I know that my husband » Continue Reading.

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Broken

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Jordan Grumet

I was a third-year medical student in the first week of my obstetrics rotation. The obstetrics program was known to be high-pressure, its residents among the best. Mostly women, they were a hard-core group–smart, efficient, motivated–and they scared the heck out of us medical students.

I remember the day clearly: Not only was I on call, but I was assigned to the chief resident’s team. I felt petrified. 

We’d started morning rounds as usual, running down the list of patients in labor. Five minutes in, my chief got a “911” page from the ER, located in the next building. This seldom happened, so instead of calling back, we ran downstairs and over to the trauma bay.

We walked into pure chaos. The patient was 27, in her last weeks of pregnancy and actively exsanguinating–bleeding to death. She and her husband had been fighting; apparently he’d picked up a kitchen knife and stabbed her in the neck.

As the ER physician and the trauma surgeon worked rapidly on the woman’s neck, my chief readied herself to deliver the baby. She turned to me.

“Quick, get me a sterile gown and a scalpel.” 

Helping her to gown and glove, I

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Dr. B Gets an F

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Gregory Shumer

Flashback to a year ago: I’m a first-year medical student–a fledgling, a novice–trying to integrate countless facts into a coherent understanding of how the human body works. Professors slam me with two months’ worth of information inside of two weeks’ time. They tell us that this is a necessary process, one that all doctors must go through: we must first learn the science of medicine before we can master the art of healing.

My life revolves around tests, labs, deadlines, long hours in the library and very close relationships with the baristas at Starbucks.

In the midst of this chaos, I developed a crippling ankle condition that transformed me into a concerned patient for the first time in my life. The pain started as a dull ache that I experienced only during exercise. Then it gradually worsened, to the point where I could barely walk to school the day after I’d played a basketball game. A golf-ball-sized bulge stuck out from my right ankle, and my two months of medical education suggested no remedies.

It was at this point–worried, looking for answers and desperate to get back to normal–that I decided to see someone.

Dr. B, the orthopedist

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Angels and Phantoms

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Joanna Dognin

“Mama,” a little voice pipes from the back seat. “Why is that boy in a chair?”

The sun is beaming into the car as we sit at a stoplight, waiting to exit a store parking lot. My two-year-old daughter has spotted a young man, barely twenty, who smiles weakly as he rolls by in an electric wheelchair, collecting money for muscular dystrophy.

“He’s in a chair because he needs help moving around,” I say.

“Why?”

“Because his legs need help.”

“Why? Because they don’t work?”

“Well…”

“Why are they broken?” she asks. “Is he broken? Why is he here? Where is his mama? Mama, where is the boy’s mama?”

* * * * *

“Dr. Lobozzo, you got any kids?” Gabriel asked, calling me by my maiden name rather than the married name I’d only recently begun using.

“No,” he continued with a sly smile. “Don’t tell me. I already know. You have two sons.”

I was newly married (without children), living in one of New York City’s boroughs and working in the Manhattan HIV primary care center I’d joined after getting my psychology license. The center integrated mental health and social services into

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James and Bob

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Paul Rousseau

I think his name was James, but I can’t remember for sure. What I do remember is the day’s heat, the metal cart and a rust-colored dog. 

Like many homeless people, James carried his belongings in a grocery cart–a sort of mobile home for the homeless, but without the protection of a roof, the support of four walls or the security of a front door.

I’d just walked out of the local Safeway store into its parking lot. He ambled over from a park across the street. His eyes were narrow, his face tanned and his clothes dirty brown from weeks of sleeping in the streets.

Being a dog lover, I found my eyes drawn to the dog–a mixed breed with matted hair, worn eyes and gray hairs on his snout. He looked underweight; I guessed he weighed no more than thirty or forty pounds. He stood obediently by James’ side, tethered by a rope leash. 

“What’s his name?” I asked.

“He’s Bob–best dog there is. In fact, best friend a man could have,” said James in a deep smoker’s voice. He smiled and rubbed Bob’s back. 

Then he asked, “Can you give me some money so I

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The Cruelest Month

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Ray Bingham

One day in April, I took the assignment none of the other nurses wanted: Baby Michael. A hopeless case. 

Born almost four months premature, weighing barely a pound, he was now all of six days old. His entire body wasn’t much longer than my open hand. As he lay motionless on a warming bed with the ventilator breathing for him, the night nurse gave me report: serious intestinal infection, bowel surgery, septic shock, multiple antibiotics, infusions to support his failing heart, transfusions to replace the serous drainage seeping from the surgical incision on his darkened, swollen belly. 

“Take good care of him,” she finished. “He’s been through so much already.” 

As experienced nurses, we both knew that a premature infant rarely survives so many medical complications.

Tiny and sick as he was, his parents Frank and Tonya loved him. Midmorning, they came to visit. They were a young African-American couple–he, tall and wiry; she, shorter, with thick, wavy dark hair. They both looked so weary. 

With the attending physician, Dr. Moore, I joined them at Michael’s bedside. Trying to be compassionate but honest, we described the progress of Michael’s infection and his grave prognosis.

Still, when Tonya held

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Trauma in the ER

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Michael Gutierrez

It was 5 pm on a cold November day. I was a third-year medical student heading into my first night on surgery call.

Changing into my scrubs, I wondered what it would be like. I knew that we had to carry a “trauma pager” and, when paged, get to the ER as fast as possible. There my job would be to listen as the ER physician called out his exam findings and enter them on a history-and-physical form.

I felt a mix of things. I was excited about the learning possibilities, but I also knew that whoever gets wheeled through the ER doors is someone’s daughter, son, mother or father. I decided not to think too hard–I’d just take what came my way and organize my thoughts later.

The night started off slowly. I checked on a patient our team had operated on earlier and added a couple of people to the next day’s surgery list. If the evening stayed this mellow, I might have time to study in the call room and get some sleep before rounds the next morning. 

Around midnight, my pager went off: “29 y/o female; head on motor vehicle collision; laceration of head;

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The Winner

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Majid Khan

I pull up on the side of the road on this rainy British summer’s day. The rain doesn’t make it easy to get my doctor’s bag out of the trunk, which I do in a hurry so I can make my way to the house where I’ve been asked to visit a 37-year-old man named Kenneth.

This really isn’t ideal. Now my bag is wet, my papers are wet, my trousers are wet and my mood is wet. I didn’t want to do this visit anyway, but I’m still in my last year of training before becoming a full-fledged GP, and I’ve been given the task by one of the senior GPs in the practice.

“Cough/temperature” says the note the receptionist has scribbled. But while reviewing this patient’s records at the surgery I’d also spotted the words “demyelination” and “bed-bound”–words that had triggered my resistance to coming at all.

I knew this visit would upset me. Kenneth has an autoimmune disease like multiple sclerosis that is slowly destroying the sheaths covering his nerves. Kenneth is only nine years older than me.

The brown wooden door opens, and a plump, smiling lady wearing an apron welcomes me in, tells

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Stuck

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I have never told this story to anyone.

It all started one night about ten years ago, three months into my internship. I was on call, having just admitted a man with a possible meningitis.

He now lay curled up in fetal position on the bed in front of me, looking thin and ill. Preparing to administer a lumbar puncture (a diagnostic test that involves removing fluid from the spinal canal), I gently pushed his head further down towards his legs.

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Ms. Taylor

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Remya Tharackal Ravindran

Ms. Taylor was one of three newly hospitalized patients I saw that morning. She was a previously healthy woman in her forties, single and childless, who worked in the fashion industry. As I scanned her admission notes, three things stood out: shortness of breath, elevated calcium level and kidney failure. I read on, thinking of possible causes, then something caught my eye. Her breast exam had revealed multiple breast masses, and her chest x-ray showed fluid-filled lungs.

Everything fell into place: cancer, first in the breast and then spreading to the lungs. I was spared a diagnostic challenge, but I now had to face something more difficult–talking with Ms. Taylor about her diagnosis. Did she even know what it was? It didn’t seem so.

For me, breaking bad news is an elusive art. As I walked to Ms. Taylor’s room, I tried to recollect some of the strategies I’d been taught, like finding out what the patient thinks is going on and asking how much he or she wants to know. Still, I didn’t know how Ms. Taylor would react. I felt nervous. 

Ms. Taylor was sitting upright in bed, wearing an oxygen tube. She was a

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Pearls Before Swine

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Kate Lewis

I’m a third-year medical student, and I’m starting the second day of my new rotation–a month that I’ll spend with a family physician, Dr. Bauer, in his small, efficient home-based office.

Yesterday, my first day, a young woman named Sara came in for “strep throat.” She had dark Latina eyes, broad cheekbones and a delicate tattoo of the Chinese character for “dream” on her left wrist. She was 17 and seeking out a primary-care doctor for the first time in her life; I applauded her for taking responsibility for her own health care. Her tonsils were big and purple, covered in pus, but the rapid strep test was negative. She also reported a vaginal discharge. Dr. Bauer wanted to do a pelvic exam to check for a sexually transmitted disease (STD). He started her on antibiotics, ordered some blood tests and told her to return today to discuss her lab results and have the pelvic exam. 

Now Sara returns with her mother, wanting to know why the exam was scheduled. Impressed by Sara’s thoughtfulness, I tell her that we recommend the test, but assure her that the choice is hers. She looks me in the eye, confidently reports

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Adverse Effects

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Kenny Lin

Flashback to summer of 2008. I’m looking forward to August 5–the day that I’ll no longer be a faceless bureaucrat. The day that the US Preventive Services Task Force (USPSTF) will issue its new recommendations on screening for prostate cancer–recommendations I’ve labored on as a federal employee for the past year and a half.

For much of 2007 I combed the medical literature for every study I could find on the benefits and harms of prostate cancer screening. In November of that year I presented my findings to the USPSTF, a widely respected, independent panel of primary care experts They discussed and debated what the evidence showed and then voted unanimously to draft new recommendations. I didn’t get to vote, but it has been my job in 2008 to shepherd the draft statement and literature review through an intensive vetting process and to finalize both. 

As August 5 approaches, my colleagues in public relations warn me that the last time the USPSTF said anything about prostate cancer screening, the phones started ringing off the hook. I’m not so secretly hoping that the same will happen this time.

And I’m not disappointed! After we release the statement, my normally

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