Month: November 2022

Gift of Gratitude

We all remember our patients who die, though the first patient death really stands out from the rest. This was certainly true for me.

I was just starting the second year of my internal-medicine residency. This wasn’t the first time I’d seen someone die, but it was the first time I’d seen someone who’d been alive and well, and talking to me that morning, be dead by the afternoon–a shocking dichotomy that haunts me to this day.

The Expect

Statistically, to avoid missing a case of appendicitis, one must send to the ER some patients with symptoms of appendicitis whose appendices turn out to be normal. This lesson from medical school is imprinted indelibly on my mind.

In my residency program, if a resident sent a patient to the ER, the resident was required to go the ER to evaluate them, to further their learning. However, this created a conflict of interest—if you had to meet a patient in the ER, you missed out on sleep. Hence I thought hard about the disposition of each patient.

Shock and Awe

My ambulance partner and I responded to a 9-1-1 call for a person with difficulty breathing at a department store, but we couldn’t find anybody needing medical attention. A worker pointed to the metal ladder at the back, saying there was a guy working on the roof, and they hadn’t seen him in a while.

Finding the Words

A hush fell over the room as reality sank in. “He likely will not survive this,” the surgeon said.

The patient’s brow wrinkled in confusion. Why was everyone so quiet? His eyes met mine, pleading for a clue and awaiting my translation.


You’re in the hospital again, propped in bed with pillows keeping you from listing to one side or the other, and I’m sitting on a pink pleather chair I’ve pulled up next to the bed.

We watch Dr. Phil until 4:00. I always find this show melodramatic, but you seem riveted. You want to know about these people, their lives, their lies, what they’ll do with the information unveiled to them.

When Dr. Phil signs off, I switch on the Classic Country music station, and we talk.


I find him sitting
in the midst of his fellow residents
in the dining room
that doubles as an activity space.

His eyes are fixed
on the TV screen

The Power of Belief

At 3:00 a.m. one morning, my wife collapsed in our small bathroom with a crash. She was, it turned out, having her first epileptic grand-mal seizure at age 48. Out of the blue! I was able to get her back to bed and then watched her have another nine seizures before calling the ambulance company. Shortly afterward, a fire truck, a paramedic truck, and an ambulance arrived, along with seven first-responders.

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