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

Jeannie

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Andrea Gordon

“The person with the contractions gets to pick the channel,” I reassure Jeannie, as she tries to talk me into watching The X-Files. It’s not my favorite, but I’m just the moral support–oh, and the doctor.

When she first came to see me, eight months back, Jeannie already had a four-year-old boy and didn’t think that there was much my little white nulliparous self could teach her about pregnancy. I’d offer her my book-learned advice about pregnancy or suggested sources of support, and she would listen patiently, then do what she wanted. She did show up for all her appointments, and she humored me at times: although she refused to stop smoking pot for her nausea, she cut down a little “to make you feel better.”

Jeannie shared everything without embarrassment. Well-trained resident that I was, I asked her about bleeding or discomfort during sex. She said that it sometimes hurt when she was on top, “But he don’t like havin’ to be up there doin’ all the work.”

Now, two weeks before her due date, she’s come into the office contracting. Sure that this is it, she’s already arranged care for her son. We make the ten-minute pilgrimage to » Continue Reading.

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Losing Tyrek

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John Harrington

Tyrek’s mother and I must have spoken for two hours in the Pediatric Intensive Care Unit, covering every topic but the one that was glaring at us: death. A fourteen-month-old child is not supposed to die–and even though I knew the situation was dire, I couldn’t bring myself to face it. So I excused myself, sat down with her son’s chart and stared blankly at it. 

I first met Tyrek and his parents when he was just three months old. Tyrek had Down syndrome, clubbed feet and a large sternal scar on his chest from surgery to repair a complicated heart defect. Despite his bad luck, Tyrek’s most impressive characteristic was his cheery disposition. His mother was a tall African-American woman with straightened hair and warm eyes that always appeared weary. Tyrek’s father stood well over six feet, a sharp contrast to the “little man” he held in his arms.

I became Tyrek’s pediatrician through a referral from a cardiologist who knew that I care for children with special health needs and that I happen to have a son with severe autism. Tyrek’s parents and I bonded quickly, our conversations more animated and collaborative than the typical doctor-patient

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Once

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David Goldblatt

Movement disorders can be horrifying. Afflicted persons are solidified or contorted. They may flail so violently that a fork endangers their lives. As a beginning neurologist, I assumed that all such patients curse their fate. Once I got to know Brian, though, I realized that I could be wrong. 

Brian and one of his brothers had inherited Wilson’s disease, a rare, genetic movement disorder that had spared their eight siblings.

People who have Wilson’s disease can’t handle dietary copper properly. It accumulates in–and poisons–the kidneys, liver and brain. Avoiding foods rich in copper does not halt the progression of the disease, but it helps. If patients are also treated early and consistently with a drug such as penicillamine, which binds copper and aids in its excretion, they can expect to live a normal lifespan. If not treated, they die young.

Oscar, Brian’s younger brother, was less affected than Brian in his movements and speech. He looked out for Brian in an unusual way: he punched, pushed and made fun of him. (Psychiatric disorders are common in the disease.) Oscar died in his twenties in a car accident. His spleen, swollen because of Wilson’s-related liver disease, ruptured, and he

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First Patient

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It was a quiet knock on my door that morning. So quiet, in fact, that I wondered if I was dreaming. Maybe if I went back to sleep it would go away.

Nope. There it was again: soft but persistent. This time I knew that it really was a knock, and it really was on the front door of my one-room cabin. What I didn’t know was that I’d be hearing that knock for the rest of my life.

I got up, tired and rumpled, and pulled open the door. A young woman I’d never seen before stood there, barefoot and wearing the simple white linen dress of the campesina (as a woman who works the land is called in rural Paraguay). She was probably no more than sixteen, but in her eyes was the look of a mother, and something else: distress. In her arms she held an infant.

“Xe memby o-hasy (my baby’s sick),” she said in her native Guarani.

I didn’t understand a word, but I knew it wasn’t good. I looked at her baby–face gray, eyes open, too sick to cry. What was I supposed to do?

Back then, I wasn’t a doctor. Heck, I hadn’t even taken

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Our Town (Chinese Spoken)

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By the time Mrs. Zhang came to see me, her headache, left-sided weakness and facial numbness were two weeks old. Like many Chinese immigrants in this country, she’d hesitated to seek medical care because of language and cultural barriers and her apprehensiveness about Western medicine. In fact, she hadn’t seen a physician in the ten years since she and her husband had come to America. Only after a friend told her about me, the sole Chinese primary-care physician in a small Pennsylvania town, did she and her husband come to see me.

Mr. and Mrs. Zhang struck me as a typical older Chinese couple. With smiles on their faces, they bowed repeatedly to everyone in my office.

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Finding Innisfree

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Roger looked up at me over the oxygen mask, his eyes drawn wide by the sores stretching his face. He lifted a hand for me to take.

“I’m glad you’re here,” Jen had said before I’d entered his room. “They’ve taken him off a lot of the medication. He’s very lucid, but he’s depressed and scared.”

The previous fall, Roger and Jen had begun couples therapy with me. They were both thirty-two and had been together for ten years. Three years before they came to me, Roger had been diagnosed with leukemia. A bone-marrow transplant had left him cancer-free, but his prognosis was guarded. He and Jen argued frequently, his desire for independence clashing with her insistence on managing his care.

When they first visited my office, Roger shuffled in, bent and thin, on a walker. He wore a baseball cap, pulled low to shield his light-sensitive eyes. When he removed it, I saw that his face was covered with scabs, his bald head mottled in odd colors.

Jen spoke first, asking how much I knew of Roger’s medical situation. I shared what I’d been told, being careful not to paint too negative a picture. Then Roger spoke. His calm,

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A Brush With the Beast

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It all begins one Sunday morning when Mrs. Morris, a 75-year-old retiree with a heart condition, trips on her way out of church. She falls flat on the sidewalk, can’t get up, and ends up in our Bronx emergency room. A CT scan shows a pelvic fracture, and she’s admitted to our inpatient team.

When I join the family medicine residents to see Mrs. Morris the following day, she can’t get out of bed. She’s got short, unruly white hair and a gee-whiz expression that charms us. “What a pain!” she says. Given how close she lives to the brink–terrible circulation has cost her one heart attack and several toe amputations–I’m impressed with her good cheer.

Things looks promising. Follow-up studies confirm that the fracture won’t require surgery, and in the afternoon a physical therapist pilots her through a few wobbly steps.

The next morning we come to Mrs. Morris’s room and find her peering at a novel. “I think it would be great fun to be a secret agent, don’t you?” she says to me.

We make arrangements to transfer her to a rehabilitation facility, where therapy will get her walking again.

All goes smoothly until a hospital

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The Pencil Man of Western Boulevard

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Paula Lyons

His history was Dickensian. As a little boy, born with an IQ of about 80 and a wandersome nature, he’d toppled onto the train tracks and gotten run over. How he didn’t die is a mystery–this was more than fifty years ago, and he lost both legs up to his hips–but live he did.

I met him in the hospital, where he’d had surgery on the pressure sores that came from long hours perched in a wheelchair. When I asked him to roll over so I could see, he hoisted his whole body (200 pounds without legs!) out of the bed via the orthopedic trapeze. His arms were massively strong, his disposition was sweet, and he spoke and behaved like a well-mannered six-year-old. “My name is Andy,” he told me. “I like you.”

At the nursing station, the charge nurse teased, “So now you’ve met the Pencil Man of Western Boulevard.” That was how the folks of Baltimore knew him–I was caring for a minor celebrity! Every day except Sunday, Andy sat in his wheelchair on the sunny corner of Western and Eastham, next to a leafy park, selling pencils and chatting with passersby. It was not a

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Mothers and Meaning

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“Dr. Scott, this is Dr. Font.” The call came from my mother’s cardiologist as I was about to see my first patient of the morning. “Your mother is worse. You’d better come as soon as you can. I don’t think she’ll survive the day.” Those blunt words shattered my denial: I had convinced myself that it was possible to fix the cumulative, lifelong damage wreaked on my mother’s heart by her atrial septal defect, a congenital condition.

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My War Story

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Marc Tumerman

My practice is in a small rural Wisconsin town just down the road from a large military base. I see soldiers pretty regularly these days; they stay here for several weeks of pre-deployment training before shipping off to Iraq. They come from all over the country–men and women of various ages, some single, some married and with families. Their health-care needs aren’t too different from those of my civilian patients: maternity care, chronic illness management and the usual scrapes and bruises. I like having them on my schedule; their Boston accents and Georgia drawls make a pleasant change from my neighbors’ familiar, made-for-radio Midwestern monotone.

I don’t dwell much on what these soldiers do for a living. I do my best to take care of their needs and move on to the next patient. Once in a while, though, I run into one who sticks in my head at night as I lie in bed trying to make sense of the day.

Captain America is one of these patients. Sitting on my exam table, this 29-year-old man looks like a cross between G.I. Joe and the Terminator, his well-sculpted V-frame a walking advertisement for the U.S military.

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