March 2017


The abuela was a standard admission of my internal medicine rotation. “CVA” said the medical record, which meant this Guatemalan grandmother, or abuela, had suffered a stroke. She was visiting the U.S. to help care for her first grandchild, who was due any day. She had felt fine until, suddenly, her diabetes, high blood pressure, and high cholesterol had imploded. In quick succession, she’d experienced a stroke, a 911 call, and the ER. Uninsured and undocumented, she’d been stabilized and transferred, serendipitously, to our nationally renowned rehab hospital–a stroke (no pun intended) of luck for this far-from-home 54-year-old.

Breaking the Rules

The one rule we were supposed to abide by was to avoid drinking or using water from the faucets. That was our mission’s only rule–one that was instinctive, given the recent earthquake.

It was 2010, and Haiti had just experienced a devastating earthquake that had affected hundreds of thousands of people. I was on a mission to Milot, in northern Haiti. It was my first medical mission. I was a bright-eyed, eager second-year medical student anticipating the start of my third-year clinical rotations.

A Prescription for Change

I cannot pinpoint the exact moment when I knew I wanted to pursue a career in health care. There was simply an accumulation of moments from different parts of my life that somehow guided me in that direction. I do, though, remember making a definite decision to continue heading in that direction.

After my second year as a premed student, I felt the need for something more hands-on than my studies. I longed for confirmation of the reasons I’d chosen to go into medicine. I decided to join a medical brigade that volunteered in places lacking access to care; the group would choose a location and offer a free, three-day clinic run by volunteer doctors, turning no one away.

Waiting Room

In front of me, on one of the narrow, plastic, brown hospital waiting-room benches facing the payments counter, sat a mother with a young girl. Next to them sat a very old woman. I guessed the young girl to be about three years old, out of diapers but not yet into kindergarten. The old woman was somewhere between seventy-five and one hundred.
The old woman was called to pay her bill, and upon returning to gather her possessions, she paused to say good-bye to the girl. I surmised that they had held some sort of conversation while waiting.


I live in Tokyo Japan.

I have a knee injury that necessitates frequent visits to my orthopedic surgeon, and the physical therapy department, which is called “Rehabili,” of the same hospital.

A few weeks ago, as I sat in the waiting area in front of my doctor’s door, waiting for my name to be called, a tall man in a ukata (a cotton kimono-style garment) slowly and regally walked by me. He had his obi tight and low around his hips, and his hair was long, and styled in a shiny chonmage, a topknot, on top of his head. This man was instantly recognizable as a sumo wrestler.


The unscreened windows were wide open, letting in both the breeze and buzzing flies. A chicken roamed about freely, unaware that it was in a surgical area. Off to the side sat a drying rack half-filled with “sterile” gloves, standing at attention like soldiers ready for inspection. In the center of the room lay a woman on the operating table, her feet in stirrups and her dress hiked up to her waist. She had delivered a baby at home a few days before and now was bleeding heavily. In desperation, she had walked by herself, in the heat, on dirt roads, from her hut to the hospital.

Learning to Trust

I admitted Hiral Jacobs, a twenty-something college student who’d collapsed in her dorm, directly to the ICU from surgery.

The OR report said she’d received two units of blood and was still intubated. Given my forty years of ICU nursing, it sounded routine.

“By the way, the patient is Muslim.”

Comfort Amidst the Unfamiliar

In the waiting room, I hear melodious Spanish words and think of my own family.

I think of my abuela (my grandmother) and of my parents–immigrants to a foreign land. They left behind the familiar to come to America. Childhood memories swirl in my mind, of my brothers and me eating empanadas in the evening, of my mother speaking her native tongue. Whenever I crossed the threshold to my school, or back to my house, I remember switching from one language to another.

The Lady Behind the Curtain

Scott Janssen

“Why don’t you talk loud enough for the whole damn hospital to hear you?”

I’ve just greeted my eighty-four-year-old grandmother, and now this irascible voice has erupted from behind the curtain that separates us from whoever is sharing Grandma’s room.

The nursing assistant who showed me in glares across the curtain at the other inhabitant.

“You shut up,” she tells the person firmly, “or I’ll smack you with a bedpan.”

Then she leaves us alone.

Enriched and Humbled

Just over a year ago, a group of my friends and neighbors–after seeing the heartbreak of those forced to flee from Syria–decided to sponsor a Syrian refugee family. We raised money, gathered clothes and furniture and prepared for the family’s arrival. We knew this family had children ranging in age from two years old to twelve years old and had spent several years in a refugee camp. We also knew the youngest girl had some medical problems.
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