Month: December 2019

A Flower in Winter

A Flower in Winter

It’s winter of 1993. A cold, snowy day. Windy. A blizzard. The phone rings.

I’m not on call for my patients today–except for one. Daisy has been in my care since the early 1970s, and given the risk that she may suffer a serious downturn, I’ve instructed her nursing home to call me whenever necessary.

This is that call. Daisy, my dear lady, the old artist, is dying.
Throughout her nine decades of life, her passion for poetry and painting, and her ability to engage the people around her, have been her constant companions on what has been a fraught journey. Her heart, however, has grown weary and is finally giving out.
27 dec alan blum sister

The Patient Voice

“My sister was havin’ too much stress on the job; and she got real sick, had to be put in the hospital.
And when she got home, she started tryin’ to stay well, even used that nicotine gum to stop smoking.
But when she went back, they called her in and told her she’s usin’ too much sick time…
and guess who started smokin’ again?”

 

“He doesn’t know anything now about the coins…
I give him his albums, and he go like this, page after page…after two minutes, he look up and stare.
He sit on the couch and he looks into the nothing…
so I took his hand and we both sat on the couch and we look at the nothing…
he remember nothing, his social security number he knew perfect,
now he forgets his name, his mother’s name.”

“Upstairs got robbed. See, she’s got diamonds on her fingers, cause this is her second marriage…
I’ll talk fast, cause I know you’re busy.”

Holiday Concert

Holiday Concert

The door opens, we pause again.
Voices singing in the lobby drown out
her parents and the specialists alike.
I think they added bells this year,
the cheerful carols carefully chosen
to celebrate the season, not a faith.
A guitar picks up a riff, the same
one my daughter played so long ago
in her one embarrassed solo
on the school stage. A song both
fitting and ironic, about keeping up
the fight. Down the hall, their daughter
listens to the voices rise and fall.
The doors open, and the doors close.

Not That Old a Dog …

I don’t know how to share this without sounding like I am bragging. Maybe I am bragging — but not about my ability. I am proud that I learned a skill not usually taught to MDs. A while ago, a long-held interest in massage led me to learn more bodywork; then I worked with a DO, a doctor of osteopathy. I would feel someone’s back and say to my DO colleague, “Mike, I think she’s out here.” Mike would feel and grudgingly reply, “Pretty good hands for an MD.” He would then do osteopathic manipulation therapy (OMT), and the person would feel better — immediately! I thought, “You get to fix people? I want to fix people!”

Being There

Being There

Question: What is the most read book in a psychiatric ward?

Answer:
Based on my observations, it’s the Christian Bible. During my psychiatry rotation in the third year of medical school, I saw so many patients researching, reading and preaching the word of God. Clearly, in those pages they found something they needed: vengeance against those who’d wronged them, a secret prophecy, confirmation of their sanity. Or maybe they saw the central message: “You’re loved. We (God, humans, nature, whatever) care for you and will take care of you. We understand you.”
Seeing these patients cling to the Bible felt moving and deeply sad–painful, really. A younger, more innocent me might have seen some grace and faith. But, honestly, all I saw was emptiness–in the sense that patients in deep despair, who’ve been told, “Your mind is broken,” “Your body is broken” or “You’re going to die soon,” lack something in their lives: real human connection.
The Big Chill

The Big Chill

Tonight was yet another night on call in our emergency department–a chilly winter night on which I did a cruel deed: I discharged a homeless man back out into the cold.
This is a routine event in the life of psychiatry residents like myself. Normally, no one would bat an eye. It shouldn’t have mattered to me, either–except that the previous night I’d had to walk home from the hospital parking garage in decidedly adverse weather.
The streets were covered with slush and ice, which, along with the heavy rain and bitter winds, made my usually effortless fifteen-minute walk a nightmare. As wind gusts kept upturning my umbrella, I struggled to manage it while also trying to keep my feet from slipping on the ice.

Dr. Sarno Saved Me!

Back in the 1980s, I was not a family physician but an engineering manager who had been experiencing occasional back pain for several years. Then one summer I overdid it windsurfing, and for the next two and a half months I was bent over in sheer, excruciating pain that I now recognize was a muscle spasm that would not remit.
 

Just a Little Twist

The ache was in a familiar spot: in my mid thorax, starting over my spine and spreading a little to each side. It showed up a few times a year, always in the same place. It wasn’t terrible. I went to work, shopped for groceries, walked the dog, kept living my life. Maybe I woke up more often at night. Okay, maybe I woke up every hour and maybe sometimes I had trouble getting back to sleep. And maybe I had to cut back on the ibuprofen because it added epigastric pain to my back pain. But it wasn’t bad. I certainly wasn’t going to see a doctor. For one thing, I am a doctor, and I know back pain is self-limiting. For another, I’m a fat doctor, and the last thing I needed was a lecture from a well-meaning colleague about my weight. So I put up with the backache.

Her Father’s Back

I first saw “Mary” as I entered the exam room. She was lying on the table in tears, complaining of a three-year history of excruciating back pain. She had seen two neurosurgeons and an orthopedist (my specialty), had had an MRI and, despite great hesitancy on the part of the neurosurgeon, had had a (failed) back surgery: her pain had been relieved for three days before it recurred exactly as it had been before.  Following a second MRI, she had been referred to me because the neurosurgeon thought I was a “pain specialist,” whereas really I was interested in mind-body medicine as it related to the orthopedic patient — how emotional and psychological stress lead to pain.
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