Month: December 2018

The Best Storyteller Award


Daniel Becker ~

At the clinic retreat everyone gets a prize,
and the Best Storyteller reminds us of those times
a man goes on a journey. Not just any man: Dr. William Osler,

the doctors’ doctor, the professors’ professor, the textbook author,
and this Canadian in Philadelphia crosses the Delaware to Camden
where Walt Whitman, the great American poet, the poet’s poet,

endures fame and poor health.
Every case is supposed to be interesting, but Whitman,
according to Osler, suffered only from what his age could explain

plus or minus the usual slings and arrows,
the wear and tear of gravity,
the side effects and worries,

BLUM mombabe

The Mother and Babe

Alan Blum

About the artist: 

Alan Blum is a professor and Gerald Leon Wallace MD Endowed Chair in family medicine at the University of Alabama School of Medicine in Tuscaloosa. A self-taught artist, he has published three books of his sketches and stories of patients, and his artworks have appeared in more than a dozen medical journals and textbooks. Many of his sketches have appeared in Pulse. He is a frequent guest speaker at medical schools in courses in the humanities.

About the artwork:

“From my first year of medical school until the last day of my family-medicine residency, I kept a visual diary, filling numerous notebooks with clinical vignettes, stories patients shared with me, scraps of overheard dialogue and pasted-in sketches of my patients in ballpoint pen on index cards or prescription pads with pharmaceutical advertisements. This is one of the sketches from more than seventy binders I have filled throughout my career.”

Visuals editor:

Sara Kohrt

Closure 100 Days After

 
I was walking around the neighborhood with my mom as we discussed our plan to visit Grandma in Vietnam. My grandma was suffering from Alzheimer’s, uncontrolled diabetes, and necrotizing skin lesions on her back. We decided to plan our visit in three months’ time–knowing it would be a long, restless wait.

About Last Night


H. Lee Kagan ~

It was a night like many others. I was taking call from home for my medical partner and myself. My wife and I had settled in, planning to stream the new season of Goliath on Netflix. But the internet was down, so we were watching a talent competition on regular TV instead.

At 8:30, my phone rang.

“Hello, this is Dr. Kagan.”

A long pause, then a tentative “Hello….”

I muted the TV. “Can I help you?”

More silence, then I heard a woman’s voice uttering inarticulate sounds.

“Who is this?” I asked. “Are you looking for the doctor?”

At the Flick of a Switch

“I want to do something now. What can I do?”

My mother’s body and mind were restless, moving in their own patterns just like the gray, low-hanging clouds that morning in August. “Why don’t you tell me what you want me to do?”

She didn’t wait for my response but shouted, “Don’t you dare tell me what to do, I’m not a child!” while pounding her cane on the floor with such might that I could feel the vibrations in my stomach. Then she sank into her chair and fell silent, her eyes glazing over.

How to Fire Your Doctor

Look your doctor straight in the eye. It’s okay to smile. Or not–it’s your choice.
Don’t mince words. When your doctor says, “I’d like you to try this prescription…” (or physical therapy or whatever) “…and come back in three months,” that’s your cue. By all means take the prescription, or the referral sheet, and then say, “I won’t be coming back. I’m going to look for a new doctor…”

I’m Still Here


Inez Martinez as told to Erin McCoy ~

Editor’s Note: Having just finished her first year of medical school, Erin McCoy became a summer intern for Pulse and embarked on a project to collect patient stories through interviews. One day, a family-medicine resident at a Bronx family health center told her about an interesting lady in Exam Room 8. “I go there,” Erin says, “introduce myself and explain my mission. She agrees to speak to me, on one condition.”

As long as you don’t ask me how many drinks I have in a month.

I promise her that I won’t, and press “record” on my iPhone.

I’m a survivor of 9/11. But I don’t want to talk about that.

Adieu

One week into a three week “staycation,” I enjoyed drinking coffee on the loveseat with my husband, holding his hand and pondering life. We sat in comfortable silence, but an inner turbulence unsettled me. He tapped his foot to some inaudible percussion. 
“I’ve got two weeks of vacation left, and I already dread going back to work,” I blurted without thinking, without self-editing. 
His foot stilled. “Then don’t,” he said.
Fingerstick min

40,674 Finger Pricks

Jennifer Caputo-Seidler

About the artist:

Jennifer Caputo-Seidler is a hospital physician at the University of South Florida. She is also a corgi mom, baker, bookworm and type I diabetes advocate. She can be reached on Twitter @jennifermcaputo. 
About the artwork:

This photo depicts a moment in the life of an individual with type I diabetes. At the time, the subject had been living with diabetes for 6,779 days, which included 40,674 finger pricks and 47,453 insulin injections.

Visuals Editor: 

Sara Kohrt

Let Him Go? Hell, No!

Several decades ago, my elderly patient, Mr. Waverly, coded in the ICU. Dr. Schiller, myself, and three other nurses tried feverishly to resuscitate him. Unfortunately, without success.
 
Fond memories flashed by of the patient I nicknamed, “My easiest patient with the sickest heart.” He struggled with uncomfortable abnormal heart rhythms and fainting spells, yet he never complained. While he confided in me about his fear of dying, he also made me laugh with funny cow stories from his dairy farm.
 
Minutes ago, Mr. Waverly and I had been chatting about his newest grandchild. Now, he was gone, and I was holding his hand. Looking down at his lifeless body and feeling the coolness of his skin, I mentally let go of my favorite patient.
 
Choking back tears, Dr. Schiller pronounced the time of death.  We bowed our heads around the bedside, observing a rare moment of silence in the ICU. The pungent odor of death filled the air as his sphincter relaxed. Clinical death.
 
Before I could turn off the monitor screens, another cardiologist, Dr. Revell, rushed in, “I just got the page, what’s going . . . ?

The Hardest Decision

I prepared to let go and wished for more time. There was nothing left but to let my youngest son be at peace. Tomorrow we would unplug the machines.

His transplanted liver was failing, and he was too sick to get another. He coded three days earlier. Now, beneath the sedatives, paralytics and seizure medications, he was convulsing continuously.

There was no hope for meaningful recovery. As a physician, I knew it was the right choice. As a mother, I was heartbroken. How could I reconcile the rightness of the decision with something that felt so wrong?

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