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The University Hospital of Somewhere Else

Babel: The Voices of a Medical Trauma

Editor’s Note: This week, on the eve of Pulse‘s second anniversary, we offer a remarkable piece. It is the true story of a hospitalization as told from three points of view: first, the recollections of the patient (who happens to be a physician); second, events as recorded in the medical charts by doctors and nurses; and third, the version put forth by the hospital.

FRIDAY

Patient:
It is fall 2005, and I am nine months pregnant. A healthy 33-year-old pediatrician, I am a longtime patient of Doctor A and Doctor B, who delivered my two young children at this hospital. My husband and I are eagerly anticipating the birth of our third child.
One evening after dinner, the contractions start coming every five minutes. My husband and I pack our bags and drive to the hospital. I am nearly 4 cm dilated. After observation, Doctor C calls Doctor A, makes a diagnosis of false labor and sends us home.

Chart:
9:25 pm: 33 year old gravida 3, para 2, 38 5/7 week seen in office this AM almost 3 cm. Negative PMHx, c/o contractions q 5 min. Cervix

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Sweet Lies

Leave a Comment / Stories / Marilyn Hillman

Marilyn Hillman

I can sense the question before it comes.

“How are you doing?”

I want to answer, How do you think I’m doing, with my husband morphing into a ghost? I’m dying here. But thanks for asking.

Instead I clench my fists and deliver a cheerful response: “I’m good.” Which is, of course, a lie.

My husband is demented.

I cannot say these words out loud. Pushed to the wall, I’ll say that my husband has dementia, like it’s temporary–a virus curable by bed rest and chicken soup. Murray admits only to memory problems, while I split hairs over which verb I can stand to put next to his decline. We skitter around the truth like insects caught in a pool of light and scurrying for cover. The reality is, we’re on a steady downhill course, with Murray in frantic pursuit of words and ideas he can’t remember, while I chase after him, trying to mine precious nuggets of coherence buried in his muddy ramblings,

Murray imagines himself still capable of living a richly layered life, despite what his psychiatrist calls a severely impaired executive function system. What the hell is

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Family Business

Leave a Comment / Stories / Joanne Wilkinson

Joanne Wilkinson

My mother’s mother was more a force of nature than a person. Chablis in hand, stockings bagging a little over her solid, practical navy pumps, she delivered her opinions without the slightest sugar-coating. She used words like “simply” and “absolutely” a lot. “He is quite simply the worst mayor we’ve ever had.” “She had absolutely no business having four children.” My cousins and I all listened and quaked, hoping the wrath would not be turned on us. Even after my mother’s death, when you might imagine she would soften toward me a little, I still felt the need to stand up straighter whenever she looked at me. Behind her back, I called her “The Graminator.”

The Graminator had been retired for almost as long as I could remember and she had three major interests: wine, the stock ticker on CNN, and the politics of the Catholic Church, upon which she delivered opinions at every party.

I thought of her almost like Scrooge, hoarding and counting her certainties while all the people she had alienated went out to eat together in a messy, shabby, second-rate fellowship of true happiness. I felt caught in the middle: I cared

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The Case of the Screaming Man

Leave a Comment / Stories / Paula Lyons

Paula Lyons

As everyone knows, the human body has orifices. Occasionally, these become occluded, or occupied, by things that aren’t supposed to be there. Every doctor knows this, as does almost everyone else. Who hasn’t heard, as a child, the cautionary phrase “Don’t stick beans up your nose”?

Human nature being what it is, almost every clinician must deal with foreign objects–flora, fauna–that have been put into places where they don’t belong. Sometimes, though, “beans” can materialize without a patient’s permission.

Here is one such case–a personal favorite of mine–that I’ve mentally entitled “The Screaming Man.”

I was back in the furthermost part of the clinic, arguing with an insurance company representative about the need for a patient’s CT scan, when one of our receptionists ran up.

“Dr. Lyons! There’s a man screaming in the waiting room!”

“Is he bleeding?”

“No, he’s banging his head with his hands and screaming! I think he might be crazy!”

I ran to the front. There in our packed waiting room was in fact a seemingly crazy man, screaming, dancing around and batting at his left ear with both hands. The other patients were cringing

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Keeping Secrets

Leave a Comment / Stories / Reeta Mani

Reeta Mani

Rohit walked into our HIV-testing center in South Mumbai one busy morning. I was struck by how stylish he looked in his jeans and casual linen shirt, very different than the usual patients who visit our sprawling public hospital campus. He paced back and forth in a corner, looking at his watch and whispering into a cell phone.

I guessed that he’d chosen this crowded setting because of the anonymity it afforded; here he stood little risk of running into an acquaintance who might start to wonder.

During Rohit’s pre-test counseling, he confided his fear of being HIV-positive. He told us about having unprotected sex with female commercial sex workers during overseas business trips–and about a routine insurance health checkup that had hinted at something wrong.

He was here to learn the truth.

The next day, when he came for his results, Rohit was astonishingly calm.

“Your blood sample has tested positive for HIV,” I said and, per our routine, handed him the lab report so he could see for himself.

Rohit held the piece of paper and sat, gazing deeply into nowhere. Just when I thought he might have

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Postmortem

Leave a Comment / Stories / Sandy Brown

Sandy Brown

Coming out of my exam room on a Monday morning, I saw two overweight police officers standing in my waiting room. From past experience, I knew that they were there to tell me that one of my patients had died and to collect information for the coroner’s report. Even as I geared up to hear the impending bad news, the doctor in me couldn’t help wondering how they’d passed their department physicals.

“Do I need to call a lawyer?” I joked, trying to guess which of my patients it could be.

“Michael Freund died on Saturday,” said Dalia, my office manager.

It was a shot to my gut. Mike was seventy-three years old, but one of my healthiest patients for his age. He neither smoked nor drank, took no medicines except for the occasional Viagra and played tennis with a passion. He was fit and trim, and I couldn’t imagine what had done him in.

I hadn’t seen Mike in the months since he’d come in for his annual exam, which had raised no red flags. Then I remembered that he had called me the previous Thursday with some vague complaint that I

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Confessions of a 75-Year-Old Drug Addict

2 Comments / Stories / Arlene Silverman

Arlene Silverman

The physician, a slim, young man with a shaved head and intense, dark eyes, reaches out to shake hands. I fumble to extend one hand while the other clutches a questionnaire that I haven’t finished filling out.

“That’s okay,” Dr. Gordon says. “You can finish later.”

He can tell that I’m nervous, but seems to understand. He knows that I’ve had to sign in at a window surrounded by other patients, many younger than my own children. Some of them look dazed; others have dozed off. Still others, alert, look as if they’d just come from their job at the bank.

Me? I walk with a cane. My clothes have been carefully chosen to look presentable. I’ve come through a door labeled “Chemical Dependency Clinic” in small, discreet letters. If you hadn’t been looking for the sign, you’d have missed it. The building has no street-level windows and is in a neighborhood that could kindly be called “transitional,” rundown at its core but reluctantly yielding to gentrification.

I am seventy-five years old, and I have come to Dr. Gordon because I’ve become addicted to drugs.

While he scrolls through my

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May I Have Your Attention, Please?

Leave a Comment / Stories / Adam Phillip Stern

Adam Phillip Stern

Some sentences should never be interrupted.

“We have the results of your HIV test,” the attending physician had begun. But fate interrupted with a seemingly endless loudspeaker announcement:

“May I have your attention, please? Would the following patients please report to the nurse’s station for morning medications….”

Nothing about Benjamin’s story was ordinary. He had been voluntarily admitted to an inpatient psychiatry unit after reporting many symptoms of depression–extreme somnolence, fatigue, thirty-pound weight loss with poor appetite, diffuse pain, decreased energy and joylessness for about three months.

Benjamin was charming, smart and eager to follow medical advice. As a relatively inexperienced medical student, I found interviewing him a refreshing change of pace from my difficult interactions with the poorly groomed individuals who paced the halls repeating nonsensical phrases and questions over and over again. Benjamin always peppered our talks with comments about current events and informed questions about his care. He could often be seen reading the newspaper or interacting with other patients or staff in a way that made me wonder whether he really belonged there.

Benjamin’s life story was as engaging as his demeanor. He had worked

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Pulse Readers’ Hopes and Wishes for the New Year

Leave a Comment / Stories / Pulse Team

Pulse Readers

Editor’s Note: Ten days ago, we invited Pulse readers to share with us their hopes and wishes for the new year. Here are some of their responses.

For my young patients who are living with HIV, I hope for relief from the stigma that shadows their lives, their health and their futures, and for acceptance and respect from family, friends, schools and society. For youth growing up surrounded by violence and poverty and by systems of education, health and human services that often fail them, I wish for empowering systems, safe spaces and nurturing adults who will help them to dream and to realize their potential.

Cathy Samples
(Director, Boston HAPPENS Program
at Children’s Hospital Boston)
Boston, MA

——————–

After watching my daughters experience three miscarriages, my wish (and prayer) for the new year is a healthy grandchild. My oldest daughter is now six weeks pregnant, and her first ultrasound is next week. We’re praying this little one arrives in August, healthy and whole. What greater gift and wish is there than new life?

Elizabeth Szewczyk
Enfield, CT

——————–

I wish that today’s medical students

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Pulse Takes the Day Off–and Reflects Upon a Historic Christmas

Leave a Comment / Stories / Paul Gross

Paul Gross

Dear Pulse Readers,

We’d planned to take the day off, it being Christmas and all–and then a historic Christmas Eve Senate vote gave us second thoughts.

When the Obama administration arrived in Washington this past January it occurred to me that Pulse might have arrived on the scene too late. Once health reform came into being, “the heart of medicine” wouldn’t ache quite so much. Maybe Pulse would become superfluous–like an offer of two aspirin after the headache’s gone away.

I needn’t have worried.

The healthcare reform bill that passed the Senate on Christmas Eve may be, as some say, a first step of historic proportions–a holiday gift for our nation, including some 31 million uninsured it promises to deliver access to. And yet one wonders, as others have pointed out, whether the real gift recipients won’t be the same crowd who’ve made our health system so complicated, expensive and ineffective in the first place.

Is the current legislation a historic promise of health care for all? Or a guarantee of prosperity to those who’ve mucked things up so badly?

Or both?

One thing seems clear: the most meaningful health reform

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

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

Stories

Making Headlines

The University Hospital of Somewhere Else

Babel: The Voices of a Medical Trauma

Sweet Lies

Family Business

The Case of the Screaming Man

Keeping Secrets

Postmortem

Confessions of a 75-Year-Old Drug Addict

May I Have Your Attention, Please?

Pulse Readers’ Hopes and Wishes for the New Year

Pulse Takes the Day Off–and Reflects Upon a Historic Christmas

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

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

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