Month: May 2012

A Greater Truth

Nancy Elder

Should someone have to lie to get care? For millions of uninsured Americans, finding a way to receive health care is a challenge. In my practice, I’ve been seeing more and more of the following:

“Where have you been living lately?” I ask my third patient of the morning, a heavy-set, forty-nine-year-old man with dark, weathered skin and rough hands.

“I’ve been staying with my friend,” comes the casual reply

“How long have you been staying there?” I continue.

“You know, for a while.” His tone is a bit guarded.

“How long is ‘a while’?” I am wary now.

“You know, a bit of time.” I can see that I’m making him uncomfortable.

“A month, six months?” I persist. “A year, two years?” 

He capitulates. “Maybe a year or two.”

I sigh inwardly. Instead of starting my conversation with “What seems to be the matter today,” I am vetting his housing status. For eight years now, my clinical practice has been exclusively with the homeless of Cincinnati, and despite our program’s generous definition of “homeless,” this man does not qualify for our …

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The Hallway

Colleen Fogarty

Sitting here, waiting to teach a medical student.

My eyes lock
onto the windowed display cabinet of anatomic pathology specimens.

Aging bottles of shriveled dun-colored parts, pale reminders of bodies once vital.

My thoughts drift
my rib pain, localized, continuous, nagging.
my breast cancer, localized, excised, treated…just over a year ago.

What pains my rib?

Mets?
Muscles?

These tumor specimens cut too close.

I got my daughter to kindergarten; what about sixth grade?

About the poet:

Colleen Fogarty, an associate professor in the University of Rochester Department of Family Medicine, has dabbled in poetry and prose most of her life. Medical school temporarily killed her creative muse. In the years since residency, she has published creative work in Health AffairsThe Journal of Family PracticeFamily Medicine and Medical Humanities. She practices and teaches writing fifty-five-word stories with colleagues and residents and edits the “55-Word Stories” column for Families, Systems, and Health.

About the poem:

“This poem is about an experience during a teaching session that brought me, …

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Mother And Son

Adnan Hussain

I judge. Even though I’m not supposed to, even though I try my best to stop myself, I still judge. Fundamentally, I guess, I’m a creature of habit, caught up in an endless current of seemingly instinctive behaviors. As a first-year medical resident, I sometimes feel acutely aware of this in my dealings with patients.

I stand at the bedside of Sharon Weathers, an unassuming woman in her mid-thirties for whom I’ve been caring over the past few days. She was admitted with excruciating abdominal pain that has proven resistant to our attempts at pain management. Each morning, I visit her to ask, “How did you sleep? On a scale of one to ten, how would you rate your pain?” And each morning, I feel a pang of suspicion–near-certainty, actually–that her pain is mostly a calculated attempt to get us to give her ever-higher doses of morphine. 

This morning, Sharon looks as if she just woke up, her tangled blonde hair falling haphazardly across her face. As she struggles to sit up, I’m struck by how incongruous the cheerful polka-dot hospital gown looks on her tough-looking physique. 

Sharon looks strong; she has the aura of a battle-hardened gladiator. …

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Stepping Into Power, Shedding Your White Coat: Donald Berwick’s Graduation Address

Donald Berwick

Editor’s Note: Donald Berwick, recent Administrator of the Centers for Medicare and Medicaid Services in the Obama Administration, and a founder of the Institute for Healthcare Improvement, gave this speech at his daughter’s graduation from Yale Medical School on May 24, 2010.

Dean Alpern, Faculty, Families, Friends and Honored Graduates…

I don’t have words enough to express my gratitude for the chance to speak with you on your special day. It would be a pleasure and honor at any graduation ceremony. But, I have to tell you, to be up here in this role in the presence of my own daughter on the day that she becomes a doctor is a joy I wouldn’t dare have dreamed up. I hope that each of you will someday have the chance to feel as much gratitude and pride and love as I feel right now, joining you, and, especially, joining Jessica. Thank you very much. I am so proud of you, Jessica.

Now, I have to tell you the truth about Jessica. Jessica was supposed to be a boy. At least that’s what the ultrasonographer said when we took a look at “him” in utero. “Never been wrong,” said the ultrasound …

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