Month: May 2010

Pearls Before Swine

Kate Lewis

I’m a third-year medical student, and I’m starting the second day of my new rotation–a month that I’ll spend with a family physician, Dr. Bauer, in his small, efficient home-based office.

Yesterday, my first day, a young woman named Sara came in for “strep throat.” She had dark Latina eyes, broad cheekbones and a delicate tattoo of the Chinese character for “dream” on her left wrist. She was 17 and seeking out a primary-care doctor for the first time in her life; I applauded her for taking responsibility for her own health care. Her tonsils were big and purple, covered in pus, but the rapid strep test was negative. She also reported a vaginal discharge. Dr. Bauer wanted to do a pelvic exam to check for a sexually transmitted disease (STD). He started her on antibiotics, ordered some blood tests and told her to return today to discuss her lab results and have the pelvic exam. 

Now Sara returns with her mother, wanting to know why the exam was scheduled. Impressed by Sara’s thoughtfulness, I tell her that we recommend the test, but assure her that the choice is hers. She looks me in the eye, confidently reports …

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Adverse Effects

Kenny Lin

Flashback to summer of 2008. I’m looking forward to August 5–the day that I’ll no longer be a faceless bureaucrat. The day that the US Preventive Services Task Force (USPSTF) will issue its new recommendations on screening for prostate cancer–recommendations I’ve labored on as a federal employee for the past year and a half.

For much of 2007 I combed the medical literature for every study I could find on the benefits and harms of prostate cancer screening. In November of that year I presented my findings to the USPSTF, a widely respected, independent panel of primary care experts They discussed and debated what the evidence showed and then voted unanimously to draft new recommendations. I didn’t get to vote, but it has been my job in 2008 to shepherd the draft statement and literature review through an intensive vetting process and to finalize both. 

As August 5 approaches, my colleagues in public relations warn me that the last time the USPSTF said anything about prostate cancer screening, the phones started ringing off the hook. I’m not so secretly hoping that the same will happen this time.

And I’m not disappointed! After we release the statement, my normally …

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The Disabled Boat

Steve Gunther-Murphy

Drifting on the sea of disease
in a cardboard boat,

never knowing when the slash
of a spinal eel
will lunge from its coral-bone cave
and cut through
the threads
of a once dancing ankle
or the push of a thigh
singing race or run.

Waiting without wanting–
as the slap of a wave
against the paper-thin stern
then bow
brings on the storm
that pummels every movement
until you slip into a coma of the wind;

your sails ripped from the mainstay
and the tar between the rails
yelling like the death of a two-year-old child.

You wake weeks 
later
and notice
that your keel is gone;

your body shakes like a rock cod against
the pith of the boat’s floor
with the hook deep in your gill;
making you talk in slow motion
and without air.

Who wants to live this life
of a shadow fish,
pulled from the depths of who you were
and gutted of simple motions
or the ability to sing glee from your gullet?

This is not the space I am.

This is not the blue …

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