Month: December 2009

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

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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Babies

She tells me she wants to have a baby,

my daughter who was my baby
so many years ago.

Everything comes back to me–
the waiting, the wanting, the whisking
off to baby-earth, that angelic place,
passing through life
with its normal sounds, smells, and sights,
into the realm of women’s starlight, bright
as Polaris, a celestial universe of power,
revolving so far away
that only women with growing
babies under their swollen, milk-gorged breasts
could inhabit this land.

Just for a moment, I want to have a baby again.
My aging body with its downhill breasts
and lost uterus aches to soar to that planet.
I want to feel life inside wiggle its
bowed, floppy legs, delicate arms,
those rubbery appendages not yet knit together.
I want to feel it somersault at
the top ledge of my ribs, understand
that surprising quiet of knowing
something inside me will come…
without him.

Just for a moment I want
every muscle in my baby-battered
body to unite for the same cause,
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An Intern’s Guilt

Anna Kaltsas

“She’s been here for two months already. She’s very complicated; you’re going to be spending a lot of time with her and her family,” my fellow intern said as she began signing out her patients to me. 

It was my first rotation in the medical intensive care unit, and I was terrified. I was in my first few months as a “real” practicing physician–a title that I still felt uncomfortable with. If a nurse called out “Doctor!” I wouldn’t respond, thinking that she couldn’t possibly be referring to me.

My fear mushroomed as my co-intern rattled off the patient’s problem list–bone-marrow transplant, shock liver, congestive heart failure, anemia, coagulopathy, sepsis, acute renal failure, ICU neuropathy, encephalopathy, ventilator-dependent…I knew what these meant, I just felt overwhelmed to see them all in a single patient.

Her name was Laura. Her story was impossibly tragic. A newly married, successful young professional, she’d visited her general practitioner two months back, complaining of weight loss and a headache, only to have blood tests reveal devastating news: leukemia.

Her first inpatient chemotherapy treatments had been followed by a bone-marrow transplant, then by complications from chemotherapy. A barrage of serious infections had …

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Mom

Diane Guernsey

By this time next week, my mother may be dead.

In a sense, she’s been dying for a long time. This leg of her journey is the last in a decades-long trek with Parkinson’s disease.

She lies there, her head small and delicate on the pillow. Her hair is a wispy white thatch; her throat muscles are rigid, as if she’s just lifted a huge barbell. But her breaths come slowly, with long pauses in between, as if she’s nearly too tired to go on. Her brown eyes stare up sightlessly, lids half-open.

This nursing facility is part of a stepped-care retirement center where my parents moved more than ten years ago, anticipating the day when my mom would need more help than Dad could give her. They lived in an apartment there for years, while Parkinson’s slowly chilled my mom’s brisk, jaunty gestures and muffled her lively, Texas-inflected conversation into an inaudible murmur. (We all knew that this was inevitable, even though she received the most up-to-date drug regimen.) When a stroke unexpectedly felled my dad seven years ago, my mom, then 80, chose to move into the facility’s nursing wing.

About a …

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