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

Steep Sledding

Jonathan Han

“Don’t worry,” my doctor said.

I barely heard what he was saying; lying there in the hospital bed, I was caught up in contemplating the diagnostic procedure I was scheduled to have the next morning.

“With these anesthetics,” he continued, “you won’t feel or remember a thing after it’s over.”

“Okay,” I answered weakly, signing the consent form with unaccustomed legibility. But could I really forget the emotional trauma of these past twelve hours?

I’m a physician, and blessedly accustomed to standing on the other side of the health-and-illness divide. But after four days of crampy abdominal pain, my self-diagnosed “gastroenteritis” had horribly morphed into a “rule out carcinoma” directive. Now I faced another twelve hours of waiting–reviewing the possibilities, expecting the worst–until my procedure could be performed. Could I stop silently reviewing my CAT scan findings (that suspicious abdominal mass) and numb my feelings of anguish and anticipatory grief?

“Do you want a sleeping pill for tonight?” asked my doctor.

“I don’t know,” I stammered.

“It may help you sleep,” he pressed.

“Okay,” I said, grasping at the chance to escape this nightmare. Inwardly, though, I craved » Continue Reading.

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Late Again

Paul Gross

One thing I love deeply about being a family doctor is that I get to take care of people–body and soul. A patient comes into my exam room with a litany of physical symptoms (“My shoulder…my knee…my stomach…so tired…this nausea…”) and then, in response to a questioning look, suddenly bursts into tears.

It’s all mine to deal with. The shoulder. The stomach. The tears. I get to gather the pieces and see if we can’t put this broken person back together again.

What a privilege.

And yet the joy of primary care is also its curse. With each patient, I have to keep track of everything–the trivial and life-threatening, the physical and mental, the acute, the chronic and the preventive. And try as I might, I simply don’t have enough time.

On paper, my office schedule looks simple: I see one patient every fifteen minutes beginning at 8:30 a.m. If I stick to my timetable, I can wrap up my twelfth patient by 11:30, finish up any leftover paperwork and enjoy an hour’s lunch before starting again at 1:00.

Ha.

The reality is that I’m never done by 11:30. In fact, my colleagues

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The Emaciated Infant

Paula Lyons

The police had been called to the house by a neighbor who said she heard children crying and hadn’t seen the mother in two days. It was the middle of a night in July, and the children’s wails would have traveled through the project windows left open to catch cooling breezes.

Paramedics provided transport to the hospital, but the normally cynical and well-defended police were so outraged that they also came to the ER, where I was the resident on call.

The police came to find and punish those who had neglected this waif, but I also sensed that, despite their tough exteriors, they came also to vent their impotent rage and to seek reassurance that this tiny, dirty, appealing thing would live. Our hospital had no pediatric ER staff, and although I was only a second-year Family Medicine resident, I was the senior “pediatrician” in-house. And so I needed information. How was the baby found? What diseases had she been exposed to? Why was she so starved? I chose the greenest member of the team, knowing that he would be the most talkative. And, as a rookie myself, I sensed a kindred spirit.

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Chris

Lisa deMauro

My big sister Chris, 55, had recently returned to her first career, nursing, when she wrenched her back one day while helping to lift a patient. After weeks of physical therapy proved unhelpful, her internist ordered some tests, which indicated that her back injury might signal something more sinister. She’d had a lumpectomy for a “stage 0” breast cancer five years earlier, and her doctor advised her to make an appointment with the newly appointed head of a brand-new cancer center nearby.

Chris and I were nine years apart–a difference that precluded any sisterly rivalry–and we’d always been very close. She’d occupied a central role in my life: first, as a playful second mother to me, then as my ideal of teenage glamour, and finally as a friend with whom I shared confidences about the joys and sorrows of grown-up life. When it became clear that she might be getting bad news, I needed to be with her, just as my parents did.

The three of us converged on the Pennsylvania town where Chris was living. We met her in the hospital lobby, hugged each other for long moments, then headed off together to meet with the

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Looking for Respect

Ashrei Bayewitz

This may sound strange, but I secretly looked forward to my colonoscopy.

I was excited to see the people in the colonoscopy suite–the receptionists, the nurses and my doctor. I knew that they would like me, because I would be brave and respectful. That’s what’s always happened since I was diagnosed with Crohn’s Disease ten years ago. During my multiple colonoscopies and countless doctor visits and other outpatient procedures, I invariably build up a rapport with someone, be it a doctor, nurse or staff member. I’ve always been a good patient, and now that I’m a second-year medical student as well, I can understand their work a little better. I expect them to sense my goodwill and to treat me in turn with respect and caring.

This appointment got off to a good start: The woman who registered me seemed nice and appreciated my interest in the pictures decorating her cubicle wall. And I wasn’t just being polite–I really did like those black-and-white photos of old TV and film stars. She even had The Honeymooners up there! I also got along well with the first nurse–we shared a laugh about the trouble I’d had finding a quarter

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Tug-of-War

Jo Marie Reilly

As I teach first- and second-year medical students to take patient histories and to perform physical examinations, I always feel humbled and privileged–energized by their compassion, enthusiasm and facile, curious minds.

Occasionally, I feel particularly challenged–especially when I’m teaching a student who, though bright, is struggling to acquire some of medicine’s basic skills. As we journey up the learning curve together, my responsibilities can conflict: as a teacher, I want to nurture an aspiring student physician, yet as a physician, I must ensure that patients receive appropriate care.

Now, sitting quietly in the corner of the room and watching a young medical student interview a county hospital psychiatric patient, I begin to feel this tension.

“What brought you into the hospital?” the student queries nervously.

Small and reserved, she’s quite a contrast to her patient–a burly, imposing middle-aged man, his body splattered with tattoos of birds of prey and firearms. He folds his arms tightly across his chest, and a large cross sparkles on his neck chain.

“It’s when I tried to commit suicide on the bridge,” he responds agitatedly.

There is a long, awkward pause. “So…what medication did you

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Invisible Thread

Donald O. Kollisch

From: Michael

To: Donald O. Kollisch
Subject: Serious medical update

Don,

I can’t say for sure why I’m writing to you, but you were such an important part of my life during the onset of my illness that I feel a strong desire to communicate with you.

The mysterious autoimmune disorder that was lurking in my body has finally had the decency to declare itself. Unfortunately, it is systemic sclerosis, also called systemic scleroderma, which means I’m facing a gradual but ultimately fatal process of skin, joint and organ degeneration.

It has hit my lungs, seriously affecting my breathing capacity, and has hit my digestive system also. Recently I was in the hospital for ten days because of serious digestive problems and an inability to eat. I’m now on intravenous nutrition, with a line in my arm. I can eat a small amount of food for pleasure, but there’s a real question as to whether I can ever take in enough nutrition by mouth to get off the intravenous line.

My rheumatologist at DHMC is wonderful–a good, honest and very compassionate young doctor. She has been completely

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Millie

Edgar Figueroa

Looking at Millie in her living-room-turned-hospital-quarters, I can’t help reflecting on the four years we’ve shared as patient and doctor. 

We’ve come a long way since our first visit. I was an inexperienced resident; she was a wiry woman who looked to be in her late sixties but was actually fifty-three. 

She’d sat back and stared at me, sizing me up.

“You know I have kids that are older than you?” were her first words. 

I wasn’t sure if she was complimenting me on my youthful looks or expressing uneasiness at having me as her doctor. I smiled, blushed, quickly refilled her prescription and asked her to follow up.

Over time, I grew quite fond of Millie; seeing her name on the schedule always sparked feelings of pleasant anticipation. She, for her part, somehow grew to trust me, and the health-center staff learned not to argue when she insisted on seeing only “my doctor.” At each visit she would share more of her story: how hard she’d struggled for much of her life, raising three children as a single mother with little support and less money; how much she liked her cigarettes and the occasional drink.

Now Millie

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The Save

Dan J. Schmidt

I started medical school thinking I wanted to be a family doctor–someone who could work in a small town and deal with whatever walked through the door. But in our third year, when we received our first taste of clinical medicine, I found my surgery and ER rotations exciting. I was at our state’s major trauma center, and I loved it. Fixing things gives me a thrill–and the power to save a life is even more alluring.

Each “save” felt like a miraculous triumph. Take the nineteen-year-old visiting Australian, stabbed in a random street altercation, his blood pressure dropping as fluid accumulated around his heart. Right there in the ER, he had his chest split open and his right ventricle patched by the very cool chief surgery resident. 

But after several weeks of 5 a.m. surgery rounds and every-third-night call, I started to feel a nagging sense of unmet need, both my own and the patients’. To me, it seemed that the specialized care we were giving was excellent but fractured: No one was responsible for the whole person. 

It was 8 a.m. during my third week of the rotation. The third-year resident had led us medical

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Giving Care

Ronna L. Edelstein

When I was six, my family and I spent a week in Atlantic City. I loved the Boardwalk with its saltwater-taffy aroma and colorful sights, but I feared the pier that jutted far out into the Atlantic. One moonless night, my big brother bet me a bag of taffy that I couldn’t walk to the pier’s end by myself. Never one to back down, I accepted his bet. But the farther out I walked, the more frightened I got. It felt like one more step would send me off the pier’s edge and into the bottomless black water. My parents rescued me by dashing to the end of the pier and carrying me back to safety. 

I spent the next half-century living under two illusions: one, that nothing in my life would ever be as scary as that dark pier; and two, that my parents would always be there to save me. In school, when my Lilliputian classmates mocked my five-foot-eight-inch stature, Ma and Dad talked to me about inner beauty and strength. After the rice strewn along my wedding aisle disintegrated into sharp slivers of divorce, Ma and Dad gave me the financial and emotional support

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Touched

Karen Myers

“I can feel the life force leaving me,” Mike says as he massages my legs with his rough, careful hands. He doesn’t use oil or lotion like the other massage therapists. Just his sticky, Marlboro-scented fingers. I lie in my underwear beneath a green sheet. My bony shoulder blades and crooked spine press into the table, having long since lost their cushion of muscle. 

“We’re getting older,” Mike says, even though we’ve barely reached forty. “Maybe that’s why we’re so afraid. We don’t have the energy to fight like we used to.”

Mike’s eyes bulge like a bullfrog’s. When I first knew him, I found them a bit frightening. His voice is raspy and deep. He has a fading tattoo on his left biceps and a ponytail that curls down his back. I met him at the massage school, where he was training to be a therapist and I was getting treatment for muscular dystrophy. I always thought he was quirky, and he talks too much, but his massages are cheap.

Since my diagnosis at age fourteen, when we first noticed a slight limp and a protruding shoulder blade, I’d spent most of my years ignoring my body.

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To My Left

Anne Herbert

I walk down the airplane aisle, scanning the rows. My eyes finally fall on 15F. My seat.

My nightmare.

This window seat means only one thing to me: someone to my left. A man, to be exact–middle-aged, reading the New York Times and snacking on a bag of peanuts. He doesn’t notice as I shove my purse under the seat and sit down. My only thoughts are of blending in–with the other passengers, with the chair, with the plane itself. Anything.

My objective on this five-hour flight is simple and clear. It’s the same one that I cling to almost every second of every day: to keep my left side hidden from the world.

Everyone has a good side–a more photogenic side, a certain way that they turn when taking pictures. I don’t have a good side, but rather a “less bad” side–a side whose mere completeness is what appeals to me. 

My left side charts the history of my birth defect. My severe underbite is an orthodontic byproduct of my cleft lip and palate. The scar under my nose records the surgery that closed my cleft lip. The scar on my hip commemorates a bone-marrow transfer from hip to

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