Month: October 2019

X Factor

I was a brand-new intern on the intensive-care unit, and Cassandra was the very first patient I saw there. A petite, slender woman, she was rolled in on a stretcher, accompanied by her tall, athletic husband, Jack.
Cassandra was in her twenties, like me–but mortally ill. That grabbed my attention from the start. But the biggest lesson she taught me came about because we got her prognosis all wrong.
She had lupus, an autoimmune disease that unleashes the raw power of the immune system against the patient’s organs and joints. Fortunately, my attending rheumatologist, Dr. Schmidt, was an expert in lupus and its intricacies. Although small in stature, he cast a large shadow in the field; physicians from near and far referred their most challenging cases for his consultation. He radiated confidence, and, like my teammates, I admired his clinical acumen.

Lost in a Frigging Spaghetti Maze

Several times a month, I’d find a patient wandering the lobby of my medical building, looking very lost. One afternoon, hurrying from work to beat the rush hour traffic, I came upon an elderly gentleman staring at the office directory on the wall.
I approached him and spoke softly, “Help you find something?”
He grinned, “Thanks, honey, but this place’s a frigging spaghetti maze. Got here early cause it’s my first time. Looking for Dr. Smith, know him?
“No, sorry, don’t think he’s in this building.”

Learning to Live 8.5 Hours From My Autistic Daughter

The last time we talked
she said she wanted
every bone in her body
to break.
And so I picture her on a ledge
flirting with the idea of flying,
knowing she admires the flitting of butterflies
from one pollen hive to another
I watch her wings
open and close open and close
like they are breathing
like her wings are lungs
When IVF Works

When IVF Works!

“This healthy young woman and her husband were unable to conceive and tried assisted reproduction. Over a two-year period, she endured seven cycles of egg retrieval and one failed embryo implant before she succeeded in becoming pregnant. In this photo, she is twenty weeks pregnant and never happier. The baby was born in November 2018.”

Confronting a Colleague’s Loss of a Child

It’s too painful to confront a colleague’s loss of a child.
Three or more decades ago, we physicians had more difficulty dealing with death and dying than in more recent times. But it is still very difficult.
We are particularly at a loss when it comes to the death of a physician’s child. And it is even more challenging when it is a colleague, a member of the hospital staff’s child who has died.

Why We Had a Steel Band at Mom’s Memorial Service

Charm City Steel, the five-piece band, pick up their sticks and in rhythm tap out a fetching tune on their huge steel drums. This is the preamble to a special program to celebrate and remember my mom, who died of advanced dementia at age eighty-seven in my home. The music lifts me as people wander in.    

It is Mom’s memorial service, and she asked for this. It was ten years ago out of the blue, between steel drum dance tunes while vacationing together in Maine. She pointed at me from across the village green and said, “I want a steel band at my funeral!” No matter that she never brought up death or dying before or since. At that moment the heavens opened, and she delivered her wish to me. And I said to her, to myself and my daughter Amelia: “Done.” 

Prayers of Passage

The day began in Mom’s room with a 10:00 am conference at Upper Valley Medical Center, west of Columbus, Ohio. In attendance were my ninety-three-year-old mother Joanne (now in her third week of hospitalization), her palliative-care nurse Richard, her Episcopal priest Mother Nancy and myself.

Mom was on high-flow oxygen therapy delivered through a nasal cannula. Despite this, her blood-oxygen levels were well below normal. Clearly, her lung function was declining. Her heart wasn’t pumping well, and her blood pressure was barely seventy over fifty.
Things can change quickly with our elders. Thirty days earlier, Mom was going to dinner with friends and taking excursions in her assisted-living facility’s van to pick up things she needed, including small bottles of wine to share with “the girls” at dinner.

The Power of Doing Nothing

In the support group that I facilitate for family and friends of individuals struggling with addictive behaviors, people spill their stories of sadness, of anger, of frustration…

Mary barely introduces herself before describing her struggles. Married for thirteen years, the mother of two little boys, she complains about her husband’s alcoholism. Her in-laws’ get-togethers revolve around heavy drinking, dancing, and singing, often extending into the next morning. Last weekend, after her husband got fired, she took her boys and slept at her mother’s place.

With a Little Help from My Friends

Six years ago, I retired early because of serious health problems. I’d worked for decades as a doctor.

Early on, it was difficult for me to ask for and accept help. I was always the one who stepped in, not the one who needed assistance. Well-meaning friends would say, “Let me know if I can do anything.” I was floundering.

Keeping the Flame Alive

This month, at medical schools across the country, first-year students will officially don the physician’s traditional white coat for the first time.

The white-coat ceremony is a powerful symbolic moment. It signifies that the students are moving beyond their identity as ordinary citizens and into their new identity as healers. The ceremony celebrates their idealism and their commitment to a life of caring for others. And, although they may not realize this, it constitutes a pledge to assume responsibility for their patients’ health and well-being–and the stresses that go with that commitment. As the students accept this responsibility, their lives will be forever changed.
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