Month: July 2017
Dianne Avey ~
One night on my nursing shift in the cardiac intensive-care unit, I received a new patient from the operating room: an eighty-eight-year-old woman who had suffered a major heart attack and had just undergone emergency coronary-artery bypass surgery.
Her bed was wheeled into the room along with the usual accoutrements: six different IV drips, a ventilator, an aortic balloon pump and various other lines and monitoring devices. Her name, I saw on the chart, was Mrs. Green.
The young surgeon took me aside.
“I don’t care what it takes, just keep her alive for twenty-four hours,” he told me, clearly more worried about his surgical-outcome stats than he was about Mrs. Green’s welfare. The hospital and insurers kept data on these procedures; it didn’t look well for a surgeon to have too many patients die during or right after surgery.
“No problem,” I replied confidently and went right to work, adjusting drips to maintain her blood pressure, cardiac output and heart rhythm.
Despite my efforts, Mrs. Green’s health status remained very unstable. Her heart was extremely weak, and she showed signs of brain damage.
Every evening at dusk
As the sun finally shutters its eye,
The mosquitos rise and sing
Their tiny tuneless song
Because mosquitos cannot know
They have only a few weeks to live and find us
They cannot grasp how we recoil
From their delicate voice and touch
Our skin surprisingly vulnerable
Our blood remarkably easy to invade
Maybe they enjoy the breeze and purple sky
As much as the rest of us
Unable to fathom just how slyly
They disperse the miniscule vectors of disease
David Edelbaum ~
When I finished my medical training, almost sixty years ago, I was like many new graduates: I thought I knew it all.
I opened a private office in Los Angeles and paid courtesy calls on the local physicians to let them know my qualifications and my availability for consultation, as both an internist and a nephrologist. (The treatment of kidney disease was then in its infancy, and I was the area’s first such specialist.)
With a wife, two children under age four, a home mortgage and an office to support, I needed to make a living. I took call at the local emergency rooms, worked nights at the VA Hospital and told my answering service to mention my availability to other physicians who might need assistance.
One of the very first doctors I visited was Dr. Lud, a large, friendly, highly competent and respected family physician. His patients adored him, and if he asked you to consult on one of his cases, that was the Good Housekeeping Seal of Approval: It assured your standing within the medical community–and, of course, a steady income.
It was election night. November 8, 2016. As a southern, affluent, white male from a conservative household I leveled with her: “This election isn’t life or death.”
About the artist:
Tasneem Kaleem is a radiation-oncology resident. “I was always artistically inclined from a young age, engaging in painting, dance and violin. I spent a summer in Rome studying artistic anatomy, which piqued my interest in medicine.” Kaleem’s artwork has been featured in many exhibitions, and recently her pastel work was selected to be a front cover for an international medical journal.
About the artwork:
“Waiting rooms bring together people for a purpose–to obtain medical attention. Whether it is you or a family member, it is a stressful yet universal experience. Some may be waiting for loved ones to return from surgery; others maybe awaiting a meeting with the doctor to review a recent diagnosis. The waiting room is where we come within close proximity of one another for a common purpose. Despite this closeness and shared experience, most waiting rooms are quiet because of the psychological distance between those present. I have observed this not only as a physician but …
Kristin Beard ~
“Get the patient on the monitor.”
“How long has he been down? Someone get on the chest!”
“Keep ventilating. He’s in v-fib. Defibrillate at 200.”
“Charging, everybody clear?…Shock delivered.”
“Resume compressions. Push one of epinephrine…Hold compressions. What rhythm is he in?”
“He’s asystole, resume compressions.”
We repeat the process a hundred times over. The medic said they started coding the patient an hour ago. The family is in the consult room with the chaplain.