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Stories

The House Always Wins

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Rashmi Kaura

Death. A five-letter word. The inevitable conclusion to our accomplishments, dreams, emotions and essence. Feared and ignored by the well, acknowledged and perhaps even welcomed by the ailing.

As physicians we are constantly gambling against this inevitability, playing the odds with our arsenal of diagnostics and therapeutics. Even when the odds against us grow longer, we forge ahead, bidding to prolong life through technology and wonder drugs.

Many times, staring into the tired, tortured eyes of a frail and debilitated patient while preparing to subject him or her to painful tests and treatments with a stroke of my pen, I wonder, Why do I insist on playing this game when the house is likely to win? Isn’t the whole point of gambling knowing when to quit, knowing how to cut your losses?

These questions came to mind when, as a medical resident, I took over the care of Jane Barnstable, a 61-year-old woman with terminal leukemia, admitted to the hospital because of general weakness and low blood pressure, and transferred to the ICU on account of worsening metabolic abnormalities.

When I first met Jane, I was struck by her vibrant, put-together look–her short, well-groomed hair, her smiling countenance touched » Continue Reading.

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Shujinwa Byoki Des

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Lucy Moore

I don’t speak Japanese, but I can say “Shujinwa byoki des” (my husband is sick). 

After spending a month in Bali studying art, sweating profusely and slapping mosquitoes, we were heading home to New Mexico, with a stop in Hiroshima on the way. Our first morning there, my husband, Roberto, woke with a fever of 103 and a full body rash. 

The hotel had a thermometer, but no doctor. As Roberto’s fever neared 104, we hailed a cab for Hiroshima City Hospital. (That was when I pieced together shujinwa byoki des from my pocket dictionary.)

In the large, orderly waiting room, we were the only Caucasians. Roberto was a sight–lobster-red and wild-eyed. Staff and patients politely averted their eyes. 

A nurse led us to the lab for blood work, and after filling several tubes, she withdrew the needle and pressed a gauze pad onto the site. She bent Roberto’s arm to stop the bleeding, but when he opened it up, the gauze pad, red and soggy, fell onto the floor, and a little fountain of blood squirted from his arm. 

I laughed. To me it was comical, but one look at the nurse’s face told me otherwise. Her eyes widened,

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Past Medical History

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Donald Stewart

My career in medicine began when I was three years old.
Holding tightly to my father’s hand at the end of a dark hospital corridor, I couldn’t keep up with the heavy, sibilant stream of conversation flowing between Daddy and Dr. Mashburn, the man who had delivered me, who had sewn up my chin after I’d slipped in the bathtub a month before and who was now explaining the details of Mommy’s condition. Something, I knew, was making her bad. Sometimes her arms and her back hurt so much she couldn’t even pick me up.
My attention slipped away from the confusing drone of grown-up words and fixed on a bright black-and-white picture shining down from a lighted box on the wall. The “x-array” film clearly showed a gleaming white shaft of bone (my mother’s clavicle, a word unknown to me at the time) with a perfectly round, dark spot in the middle. One day I would understand this spot to be a hole in my mother’s skeleton. Such x-ray findings were evidence of eosinophilic granuloma, a disease that causes white blood cells to multiply and clump together at various points in the body. This illness was the

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Tryst With The Microscope

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Reeta Mani

“So what kind of doctor are you?” asks my new neighbor, peering curiously at the MD degree on my visiting card.

“I’m a microbiologist,” I tell her. “I work in the lab and help clinicians to diagnose infectious diseases.”

Her questioning look fades. “So you don’t see patients?”

“No,” I answer. “I don’t have to interact closely with patients, except in a few cases.”

She reflects for a moment, then says, “It’s good in a way. You can help them, but you don’t have to witness their pain and suffering up close.”

I agree. In fact, that was one of the biggest reasons why I decided to specialize in microbiology. (In India, after graduating from medical school you can go straight into a three-year residency in microbiology; in the US, you can do a microbiology fellowship after completing a residency in pathology.)

I gained admission to the microbiology residency by describing my “fascination with microbes” and talking about how “infectious diseases are our country’s leading killer.” Later, though, I sheepishly confided to my sister the most important reason why I’d chosen a laboratory-based specialty: I was faint-hearted. 

I’d worked with numerous patients during my internship, and my colleagues

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The Calling

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Lawrence Dyche

I am a non-physician who teaches physicians. A clinical social worker by training, I help doctors learn to be more compassionate and skilled in their human interactions. I sit in with residents as they see their patients. I help them to become better listeners, I remind them that as they touch the body they also touch the soul, I emphasize the enormity of witnessing. And after two decades of doing this work with innumerable students, I still regard the medical profession with awe–not simply the doctors but the calling, and the extraordinary way I’ve seen some people answer it.

Back in the Eighties, when I was beginning this work, I shadowed a resident for an entire day on the wards of a city hospital. Despite the years that have passed, my memory of that day remains vivid. 

Ann was in her second year of training in internal medicine. She was tall, with boyish hair, Gaelic freckles and a quick, self-effacing smile. Older than most of her peers, she had two school-aged children and was making the leap into medicine from a prior career in molecular biology. 

Though easily among the brightest in her class, she tended to be

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Things That Matter

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Paul Gross

For me, the best part of being a doctor, and the biggest privilege, is getting to talk with people about things that matter.

“You look sad today,” I say to a patient I’m seeing for the first time–a thirty-eight-year-old woman with a headache. In response, her lower lip starts to tremble, and she wipes an eye.

As I reach for the box of tissues and hand it to her, I know that whatever has caused her tears will be more important than her presenting symptom.

A forty-five-year-old man comes in wanting help sustaining erections. When I ask for a few details, it turns out he’s having sex every single day of the week, and he’s finding it a challenge to maintain an erection for twenty to thirty minutes. When he misses a day, he has sex twice the next day “to catch up.” He has relations with his wife and also with a girlfriend who lives out of town, where he often travels on business.

Should I laugh? Let my eyes pop out of my head? Wag a finger?

Because I cherish the talking and like to think that I’m skilled at it, it’s all the more comical

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Food

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Joanne Wilkinson

I have a stress test nearly every year. I do this because my mother dropped dead of a heart attack when she was thirty-six, and now I am thirty-five.

They stick EKG leads on me, and for weeks I have blotchy red circles on my skin where it’s reacted to the adhesive. I run on the treadmill. Sometimes the cardiologist scans my heart and arteries with ultrasound; other times, he injects me with a radioactive marker. Sometimes he looks at me as though I’m wasting his time. Sometimes he frowns and looks concerned when he hears about my family history.

I always pass the test.

Why did my mother have a heart attack? I don’t have satisfying answers for this. Was her cholesterol high? I don’t know. They didn’t check young women’s cholesterol in the 1970s; they just gave them Valium for the tightness in their chests and told them not to worry. Was it because she had uncontrolled hypertension? Because she didn’t exercise? Because she was doomed?

Am I doomed?

Last night I had dinner at an extravagant restaurant in New Orleans.

I’d never been to New Orleans before, and part of me was delighted by

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Lost in the Numbers

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Donald Stewart

A nurse entered the operating room; her eyes–the only part of her face visible above her surgical mask–held a look of mild distress. She stood quietly until the surgeon noticed her.

“What is it?” he said.

“It’s your patient in 208, Doctor. His pressure is 82.”

“Systolic?”

“Yes, Doctor.”

The nurse was referring to Mr. Johnson. The previous week, we’d removed a small tumor from his lung without difficulty–and, until now, without complications. He’d been transferred out of Intensive Care to the main surgical floor, and that very morning we had removed the last drainage tubes from his chest. He was scheduled to go home the next day.

Now his blood pressure was plummeting.

“Doctor Stewart, break scrub and go see what’s going on. Nurse, grab that retractor.”

Grateful for the break in a mind-numbing routine (as a surgical intern, my job in the OR was to stand for hours, holding the incision open as the surgeons worked), I stepped away from the table and out of the room, removing my sterile gown and gloves along the way. Running up the stairs to the second floor (surgical residents, like the military, take the steps two at a time),

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Tea and Daisies

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Amy Cooper Rodriguez

It’s been almost ten years since Esther died, and I still think of her almost every day. I was her physical therapist at a rehabilitation hospital. My patients had many different diagnoses–head injury, stroke, multiple sclerosis, hip or knee replacements. I was in my early twenties. I thought that if I tried hard enough, I could help everyone. And often, I could.

* * * * *

“What are you going to do to me?” Esther asked, looking up from her hospital chair.

I laughed and pulled up a chair. “I’m Amy, your physical therapist. I’m not going to do anything to you. I’m here to help you get back to doing things you miss.” 

Esther smoothed her long skirt over her plump legs, then pushed her glasses up on her nose. “I just want to go home and be able to do things for myself.”

“All right. We’ll work together to get you stronger and back home,” I said confidently. 

Nobody could tell why Esther felt weak. Doctors said maybe it was old age (she was eighty), arthritis or a vitamin deficiency. She had to use her hands to lift her legs in and out

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Girl Talk

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Warren Holleman

“I got pregnant. Quit sports, quit school. Quit all my dreams.”

Brenda looks fit and handsome, despite the scar running down the middle of her face. At six feet tall, she commands respect, even though her sweet, high-pitched voice belies her imposing physique.

We are sitting in a circle: Brenda, six other women and me. Most are in their thirties and forties, and in their fourth or fifth month of sobriety. They look professional in the suits they’ve assembled from the donations closet of our inner-city recovery center.

No one is surprised when Brenda says that, twenty years ago, she trained for the U.S. Olympic volleyball team.

“Did you ever compete again?” someone asks.

“Nope.”

“Why not?”

Brenda shakes her head. The group gives her a moment to think about it, to grieve the loss.

“Later, I took up tennis. I was pretty good! Won lots of tournaments. You know, local stuff.”

Brenda pauses, then continues. “The people I played with, they were doctors, lawyers, people like that. Which was kinda cool. But this was the Eighties, and everybody was using powder cocaine. You know what I mean?”

The older ladies do know what she means. They nod

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Bruised

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Eileen M.K. Bobek

The year after I finished my emergency medicine residency, I had all four of my wisdom teeth pulled. 

Afterwards, I looked as if I had taken several punches to my face. My jaw was swollen, my skin a cornucopia of muddied blues, purples, greens, yellows and reds. If people didn’t know better, I told my husband with a laugh, they might think that I’d been beaten. 

It took weeks for the swelling and discoloration to resolve. I went about my life, aware of both my face and people’s responses to it. Their pitying, uncomfortable, sometimes disgusted expressions told me what they were thinking: I was being abused. But nobody ever asked me how I was, how it had happened or even if it hurt. 

“I can’t believe it!” I’d rail to my husband. “Not one person has asked. Not one!” 

It wasn’t long before my disbelief gave way to resentment. I started testing people. When our eyes met, I’d refuse to look away, silently daring them to ignore my face. Sometimes I’d relent and reveal that I’d had some teeth pulled. An expression of relief, tinged with lingering suspicion, would wash over their faces. But their nervous

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Adam

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Genevieve Yates

I tried to focus on the chart in front of me, but it may as well have been written in Russian. I’d been awake for thirty-two hours, and my brain, thick with fatigue, refused to cooperate. I knew I shouldn’t be working, but I was too proud, too stubborn, too something to admit that I wasn’t coping. 

On the first day of my neurosurgical rotation, the resident I was replacing had told me, “Ten-to-fourteen-hour days, twelve days on, two days off. Say goodbye to your life for the next three months!”

I was prepared for the long hours, endless paperwork and ward-round humiliations. I expected that it might be necessary to take a leave of absence from my personal life. What I didn’t expect was that my personal and working lives would collide headlong.

As I sat there, not writing up ward-round notes, my boyfriend, Adam, lay across the hall in the neurosurgical ICU. Twenty-four hours earlier, he’d had a tumor removed from the back of his brain.

We’d met in the med school library when I was a final-year medical student: Waiting in line for the photocopier, we’d struck up a conversation. Adam had just been diagnosed with testicular

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