Month: November 2011

Cracking the Code

Zohar Lederman

I am a medical student in Pavia, Italy, doing my fifth year out of six. It is summertime, and, as I’ve done every summer for years, I’ve returned to my small hometown in the south of Israel. There, among other things, I volunteer as an emergency medical technician (EMT) with Magen David Adom, the Israeli Red Cross. 

It’s 7:30 on a Friday morning. I’m at the Red Cross office, talking with the paramedic and a doctor, when a young volunteer runs in. 

“There’s a car pulling up outside–they’re bringing an unconscious patient!” he says.

The paramedic goes to get the advanced life support equipment, and the doctor and I quickly go out to the car. 

The patient, a pale, eighty-year-old women, sits in the front seat. Her family says that she complained of chest pain, so they drove her here. She lost consciousness on the way. 

We whisk her out of the car and begin chest compressions right there on the pavement. The equipment arrives almost instantly, and we have plenty of staff and volunteers around to help perform CPR. Even though …

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Pained

Remya Tharackal Ravindran

The light from my pen torch strikes the steel-blue eyes of the patient lying before me. Her pupils stand wide open and still.

My pager’s shrilling pierces the quiet. Fumbling with the buttons, I read the message: “Call 7546 STAT.”

It’s my first rotation on the floor as a new internal medicine resident. I dial the number, various possible disasters bubbling through my head.

“The patient in 723, Mr. Martini, is complaining of severe abdominal pain,” says a nurse’s voice. “The day-shift resident ordered one milligram of morphine, but he refused it. I want you to come and evaluate him right away.”

“Can you give me two minutes?” I ask. “I’m in the middle of doing a death pronouncement. Is he otherwise stable?”

“His vitals are fine. But don’t take long. He’s driving me crazy.”

Moments later, hurrying to Mr. Martini’s room, I grab his chart from the rack. Mr. Martini, fifty-six, was admitted earlier today for abdominal pain. Presumed diagnosis, inflammation of the pancreas. He’s suffered from alcohol-induced pancreatic inflammation before. He’s also had surgeries on his back and knees. …

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Escape to HuHot

Jennifer Frank

Hunched, shriveled, pinched
Enclosed in the metal prison of the wheelchair
You long to be free, unencumbered
By the oxygen tube connecting you to life

Each visit with me brings worse news
Creatinine up, red cells down
Carbon dioxide rising, oxygen falling
You have a medication deficiency

Once you were adventurous
Living life on the edge
For your generation,
You defied expectation

Now you are ending like
Everyone Else.
Hospital-home-hospital-rehab
Home-hospital-nursing home
Death is next

Your passions now are distilled into
Shopping at Walmart 
Lunch at HuHot Mongolian Grill
I have never been

While I recite the monotony 
End-of-life care
Advise hospice
Encourage compliance
Lecture about smoking
Offering nothing you want or desire

I imagine
Casting off the tubes
Tossing the meds
Lifting you from the prison-chair
Offering you my arm
As we escape to HuHot

About the poet:

Jennifer Frank recently transitioned from academic practice to full-time clinical practice with ThedaCare Physicians in Neenah, Wisconsin. “I write, in part, to help process the often difficult emotions that accompany being a family physician. It is a way to honor my patients and …

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Crafting My Own Safety Net

Nicola Holmes

As I guide my car through the evening traffic, I feel tears on my cheeks.

I am a doctor who plans ahead: I write out plans for my patients. This has led to my nickname, “Plan Doctor.”

Each of my consultations is carefully crafted in separate steps. The conclusion is laid out in my own neat copperplate handwriting on a plain white page. (My father taught me to write copperplate. For hours every evening I would copy stencils of words he’d written out. At the time I felt persecuted; now each day, as my writing flows, I marvel at his wisdom.) 

Each plan leaves the room with the patient, melded with his or her hopes. It is real–you can hold it in your hand. Some patients tell me they put their plans on the fridge; once an elderly lady brought in a crumpled one dating from nine years earlier. 

I always share plans A and B with my patients and hold plans C and D in reserve. The plans are clear, unambiguous. I put in time scales: “review in 5 days if still has …

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First, Do No Harm

Alison Block

It’s one of my earliest memories: I’m wrestling with my brother, and I’m losing, because I’m five and he’s seven, and he’s bigger and stronger than I am. So I bite him, hard.

Instantly I know I’ve crossed some sort of line, and I employ my most primitive defense mechanism, shouting out, “He bit me! Jon bit me!” I feel shame, because I am old enough to know it is wrong to hurt people–and to lie.

Some years later, I am accepted to medical school. I go to the first ceremony of my medical career–the one where I get my short white coat–and I take a modernized version of the Hippocratic Oath. I will try to do the best I can for my patients, and I will recognize the awesome responsibility that it is to care for other human beings. I notice one thing is lacking, though–the often-quoted phrase “First, do no harm.” The sentiment is there, but the words are not. I don’t make too much of it.

I spend two years sitting in class learning about various -ologies, and then I take an eight-hour test, the national board exam, to prove that I’ve learned something. I …

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